MLHD v hospital staff: letters on hospital plan published in full

Below is an open letter to NSW Health Minister Brad Hazzard from Griffith Base Hospital medical staff council, and the full response to the letter from the Murrumbidgee Local Health District.

Letter from medical staff council 

Dear Mr Hazzard,

In an emergency meeting of the Medical Staff Council on 21/2/18, the recently published Griffith Health Service Plan summary was discussed. There are several points which caused grave concerns to members.

1. Mention has been made about "Where the information comes from" in which it is stated, "consultation and planning with staff including doctors, nurses and other health professionals." We have had departmental meetings with the planning personnel and with Owen Thomas, Acting GM, but it was unanimously felt that nothing we had expressed as requirements and future needs for Griffith Base Hospital is included. We have not been given any feedback with those "planning sessions", matter which I raised in the "business breakfast meeting" with Jill Ludford and members of the community

2.The table on page 2 regarding "existing, projected need to 2031 and Proposed" mention:

- an increase of only 9 inpatient beds (from 40-49)

- decrease in Med/surg day only beds from 12-9

- decrease in obstetric bed from 14 down to 12 (projected need 5)

- projected need for paediatric beds down to 6 from 10

- aged care and rehab up to 20 from 0 (no mention of a rehab physician full time to look after the patients)

- projected need of operating rooms down to 1 from 2 (this is after our department insistence on the need for recruiting more full time surgeons, for increasing throughput and establishing departments of orthopaedics, urology, ENT and eye in Griffith

- greatest increase in spaces is in the outpatient spaces/rehabilitation services.

On page 1 in Future Opportunities, mention is made of "Establishment of a dedicated after hours transport service with specifically trained staff to reliably and safely transfer consumers requiring admission to Wagga Wagga. Further down mention is made of an "Acute Surgical Unit Outpatient Clinic." Wagga Wagga Rural Referral Hospital has an "Acute Surgical Unit (ASU)", not Griffith. It appears that MLHD management is gearing towards transferring more acute surgical patients to Wagga Wagga and have a follow up clinic in Griffith.

There is more stress on expansion of rehabilitation and geriatric services than there is on acute medical and surgical services. Orthopaedic services is only second last in the priorities.

In spite of the efforts being made by members of the Griffith Base Hospital team to increase their ability to care for complex and serious problems of this community, it appears that all the information and feed back given to MLHD management is falling on deaf ears.

The erroneous information we were given in July 2017 by Dr. Andrew Lawrence (Imaging Associates) brought up with Jill Ludford and members of MLHD and GBH administration. We protested that we were being sold a 5 year old CT scanner being decommissioned from Box Hill hospital under false information that it could be installed on the existing CT scanner platform and that it would be up and running by mid October 2017. Based on that information, some of the members agreed to accepting that unit, even though others had concerns about the purchase of old equipment in a day and age of rapidly changing technology. The CT scanner in question is nowhere in sight and we have been given information from MLHD that major building works would need to be done to install the unit. We have requested information about the costing of the CT scanner and the project of installation which we have not been given.

The sterilising service is also being closed down and handed over to the private hospital in spite of our protests that the Base hospital is more in need of having its own upgraded full time CSSD because of the major surgery and emergency work being done here. It is of grave concern that your own statement, on the fact that "there is no difference to NSW Health cost wise over the next decade whether the Base hospital gets its own upgraded CSSD or if the service is outsourced" seems to support our stand on this issue. The sum of $560,000 annually was quoted as the cost of outsourcing this service. One one hand we are being told by management that overtimes would not be paid and cost cutting exercises need to be in place and on the other hand the Base hospital budget has to handle this exorbitant cost for sterilising services. The Medical Staff Council has written to GBH administration about our concerns that patient safety and clinical reasons are significant requirements for staff to work extended hours and for which they need to be paid overtimes as per the state awards.

It is the concern of the Medical Staff Council of Griffith Base Hospital that these matters be addressed urgently. A copy of this letter is being sent to The Area News as information to the community.

Dr. Jayachandran Narayanan


Medical Staff Council

Griffith Base Hospital NSW 2680

Response from MLHD

Dear Mr Jones,

It has been heartening to receive feedback on the Clinical Services Plan and it shows the spirit and commitment from our clinicians, which is well and truly backed by our wider community members. We have received excellent feedback from the community to date and have decided to extend the deadline for input by a further week. Comments will be welcome up until close of business on Monday 12 March.

It is important that we clear up some of the incorrect information on bed numbers, treatment spaces and services, in Dr Jaya Narayanan’s letter on 1 March. The new Plan clearly proposes more specialist services be provided locally in Griffith and does not reduce services.

The District has received valuable feedback from our clinicians in recent months and this has been reflected in the proposed beds and spaces outlined in the Plan. At times Dr Narayanan’s letter quotes the results of the data analysis - rather than the final proposed numbers we determined with clinicians.

To clarify, the Plan proposes:

 An increase in inpatient beds from 100 to 126 and allows for flexibility in the bed use across clinical specialties.

 An increase in paediatric and maternity clinics and short stay services. There is an increase in paediatric treatment spaces from 14 to 16.

 An increase in operating theatre capacity from the current 1.5 to three – two of these would be equipped as theatres (one for orthopaedics) and one as a procedure room for scopes. In addition, St Vincent’s Private Community Hospital has two theatres and a procedure room leading to a total of four theatres and two procedure rooms on the campus.

 An increase in renal services to 12 dialysis spaces, including two training bays and an increase in chemotherapy treatment spaces from four spaces to 10 spaces.

In considering future service needs, we looked at where people currently go for services. The new Plan includes reversing the current patient flows from Wagga Wagga and other locations across the state to increase services offered locally in Griffith. The District has also used the Council’s population data for the proposed beds and treatment spaces.

In line with modern medicine, there is an emphasis on expanding medical care provided in an outpatient setting, including diagnosis, observation, consultation, treatment, intervention, and rehabilitation services. This care includes advanced medical technology and procedures.

Surgical services at Griffith Base Hospital will continue to expand in the future in general and sub-speciality surgery. Dr Narayanan’s comments about a ‘dedicated after hours transport service’ relates to helping acute mental health and drug and alcohol consumers access appropriate clinical services in a timely manner. There is no plan “to transfer more acute surgical patients to Wagga Wagga” as Dr Narayanan suggests in his letter.

A detailed workforce capability plan is being developed separately to grow a sustainable workforce.

A CT scanner with greatly enhanced capability is being installed for Griffith Hospital. This high-technology machine requires some changes to the building and the minor works are now under way. The hospital clinicians were consulted and endorsed going ahead with the new machine.

The combined sterilising service with St Vincent’s Private Community Hospital provides both Griffith Base Hospital and the private hospital, with a modern state-of-the-art instrument tracking technology. This single unit avoids unnecessary duplication of services, allows instrument sharing and ensures both hospitals have an excellent level of service.

We look forward to working together in building the new hospital and clinical services for the people in the Griffith and surrounding communities.

Yours Sincerely

Jill Ludford

MLHD Chief Executive