Crikey

Queensland health services are getting messier and messier by the week. The much vaunted Beattie Government election promise of a $1b plus Queensland Children’s Hospital “delivering exceptional health services” is proving a nightmare for the Bligh government.

The government is now caught in a “fiction and compromise” web in trying to justify the promise on a site near the Mater Hospital, in South Brisbane.

Frustrated doctors, nurses and ancillary services personnel are so incensed over misrepresentation, threats and half truths from QCH project head Alan Isles and the Health Minister Stephen Robertson that they are considering passing motions of no confidence in them.

The issue has cost an AMA executive his job; divided the medical fraternity, including world authorities in their fields; compromised health services and research; caused threats of sackings to doctors and hospital staff who opposed the site publicly; blown costs; seen a cardiac surgeon being offered $750,000 (three-times that of others) to take a job because no one else would step forward ; and is continually causing the Health Minister to make decisions on the run and then being caught out.

The site itself will require almost half the budget for the hospital to be devoted to clearing it for construction. Statements have been made by government officials that it will vary between $200 million to $600 million.

However, on the other side of the city is land, facilities and services in the grounds of the State’s leading paediatric hospital, the Royal Children’s at Herston.

No one believes Health Minister Stephen Robertson’s claim that Herston is not possible simply because of an historic building on the site and engineering difficulties.

He has not produced any response to proposals which could see the building utilised for exceptional parent/patient accommodation and the large areas of land at Herston utilised to fulfil Beattie’s vision and all within the $1billion and without compromising current world-class ‘research to bed side’ treatment services.

He also will not reveal:

• what services the now $500million(?) hospital will contain ($1b minus the land clearance costs)
• why the government had not foreseen having to buy the original “gift” of the land for the site from the Mater Hospital because a hospital on it would have had to conform to the moral principles of the Catholic Church
• why the government will have to lease number of floors in the existing Mater Hospital to ensure space for some subspecialty services
• how economical it is to move chronic diseases treatment programs
• how justifiable and cost effective it is to move specialised pathology services at the Royal Brisbane to the Mater. How much the state will pay the Mater for these services, when at least one-fifth of the work done at Royal Brisbane and Women’s Hospital involves paediatric pathology services
• how it can justify losing or ceasing Clinical research at the RCH which is extensive and considerably larger than the Mater Children’s Hospital in almost every area of paediatric medicine: burns, respiratory, gastroenterology, foetal medicine, aboriginal health, metabolic diseases, endocrinology, neurology, oncology, bone marrow and liver transplant
• why the Mater research centre is being moved to the Prince Alexandra site and whether it’s because of the lack of critical mass at the Mater site
• how it is justifiable, or economic, to redeploy the ‘continuum of care models’ at the RCH (children to adult clinics) for a number of areas of chronic disease and others which are currently being developed
• why school children from nearby schools will have to walk though the hospital to get to their buses.

These questions were raised in a showdown recently between the government (Health Department officials and the Minister) and the medical fraternity of both the Mater and Royal Children’s.

The depth of frustration of the doctors, nurses and others were highlighted in a major report undertaken by Ernst& Young for the government on an assessment and recommendation for managing the change to integrate the services and resources of the two hospitals.

The damning report said that the lack of clear and consistent information was leading to uncertainty of purpose; there was confusion around role and disempowerment in decision making; projects were not being aligned or co-ordinated; the governance structure and processes were not clear; and there was a lack of detail in the current structure of the QCH program. These were only some of more than 100 overall observations made in the report.

Health care providers highlight that high quality care is about human resource management, not election promises which appear to be incorporated in a secret 30-year contact between the Mater and the State government to deliver children’s services until the 2020s.

The providers say that if Queensland Children’s is to deliver high quality care and have the ability to critically research and appraise processes for future medical developments, there is a need to have the hospital on a site which does not cost or disrupt current services and at far less cost than the model being proposed for the Mater site.