Australia: Understaffing and equipment shortages at new Sydney public-private hospital

Sydney’s new privatised Northern Beaches Hospital saw its third high-level resignation in little over two weeks when Alistair Boyce stepped down as head of anaesthetics on December 5.

Towards the end of November, anaesthetists had called an emergency meeting and voted in favour of cancelling elective surgeries if the problems they faced were not addressed. They did not have the equipment or resources to perform surgeries safely.

Just two days after the hospital’s official opening on November 19, the director of medical services, Louise Messara, resigned after senior doctors at the facility called an emergency meeting to pass a vote of no confidence against her. Earlier that day, the hospital’s CEO, Deborah Latta, also stepped down.

There had been ongoing complaints by staff and patients that the hospital, which began admitting patients on October 30, lacked sufficient doctors and nurses and was not equipped to provide safe, quality care. Many of the staff members had not received proper training on the hospital’s equipment.

There was also a limited availability of vital drugs. Nurses and doctors had to go to the pharmacy or other wards themselves to collect medication and supplies that were not on-hand or had not been delivered.

One patient, Astrid McCrank, waited over an hour for an emergency cesarean section, after doctors and nurses had difficulty procuring and setting up the necessary equipment.

Staff told the Sydney Morning Herald that McCrank’s situation had been life-threatening. She was unconscious and had to be put on a ventilator. The most senior doctor able to attend to her was a junior medical officer.

Basic surgical and medical equipment, such as syringes and stethoscopes, have also been in limited supply. Further reports indicated that no body bags had been delivered to the hospital.

The New South Wales (NSW) state Liberal government marketed the $840 million hospital, which was announced in May 2013 and took three years to build, as having state-of-the-art facilities and a comfortable, clean environment for patients, where “every room has a stunning view of the Northern Beaches.”

The government handed the hospital’s management to Healthscope, Australia’s second-largest private hospital operator, which employs some 18,000 workers across the country. Healthscope asserts that of the new hospital’s 488 beds, 60 percent will be for public patients, with 40 percent for private patients.

Before Healthscope opened the facility, the medical staff had already repeatedly raised concerns that some staff had not been properly trained and that the facilities and services were inadequate.

The hospital’s website declared, however, after the opening day: “There were teething issues; many of which were fixed on the day by our fantastic support teams.”

At the hospital’s opening ceremony nearly a month later, Premier Gladys Berejiklian and Health Minister Brad Hazzard likewise sought to downplay the crisis. They described the unsafe conditions for staff and patients as “teething problems” and “hiccups.”

Hazzard resorted to blaming the staff, accusing them of having “talked up the negative rather than the positive.” He insisted they should “get on with the job they are paid quite well for.”

The opening of the hospital was accompanied by the closure of the nearby public Manly Hospital, and the transfer of all acute services at the state-run Mona Vale Hospital to the new facility. Temporary and casual employees were not eligible to be transferred, nor were employees who did not work in the services provided by Healthscope.

In January, around 40 staff from Manly Hospital walked out for 30 minutes to protest the hospital’s closure. Nurses, doctors and specialists reiterated fears that they would not be guaranteed the hours they then worked, or that their positions would not be transferable, putting them out of a job.

In April, nurses and midwives from both Manly and Mona Vale hospitals voted overwhelmingly for strike action at a meeting called by the New South Wales Nurses and Midwives Association (NSWNMA). The vote was to strike for four hours, ostensibly in opposition to Healthscope’s lack of transparency about how staff would be transferred to the new hospital and the lengthy transition process, which was a year behind schedule.

The union then called off the planned strike action. An hour-long rally was held instead, at which officials assured workers that the union had secured further talks with Healthscope, which would grant them greater access to information.

NSWNMA assistant general secretary Judith Kiejda asserted: “I’m sincerely hoping that holding the employer’s feet to the fire will be able to ensure that Healthscope is the good employer we know they can be.”

The trade unions have continuously promoted the return of state and federal Labor governments as the solution to the problems arising from privatisation. They have insisted that workers can improve their wages and conditions, including staff-to-patient ratios, by making appeals to state and federal MPs.

In recent years, the NSWNMA has published articles such as “New guaranteed ratios system will be delivered under NSW Labor” and asserted that when Labor took office federally in 2007 it protected nurses’ wages and conditions and increased nursing training places.

In reality, both Labor and Liberal-National governments have presided over the privatisation of healthcare, and other services, for decades. A recent Australian Hospitals at a Glance report show that between 2010 and 2017, the number of publicly-owned hospitals fell from 793 to 695, while the number of privately-owned hospitals rose from 573 to 630.

At the same time, persistent funding cuts have resulted in the driving down of care and working conditions for staff across the entire health care sector.

The first public-private partnership hospital venture in Australia, the Port Macquarie Base Hospital, north of Sydney, opened in 1994. The NSW state government bought it back in 2005, after mounting opposition from staff and the broader community to the hospital’s poor working conditions and inadequate services. At one point, it had the longest waiting lists in the state, and patients had to travel to other hospitals for treatment.

By 2001, the hospital had gone through six CEOs, and the managing company, Mayne Health, had systematically cut its clinically-trained nursing staff and employed assistants-in-nursing to save on costs.

As with the Port Macquarie hospital, there was no mention by the state Labor government of a public-private-partnership when the Northern Beaches Hospital was originally mooted in 2006. The then Health Minister John Hatzistergos also publicly denied plans to close Manly or Mona Vale hospitals.

The trade unions later facilitated the public-private partnership, lobbying independent parliamentarians to allow the privately-owned hospital to proceed. To suggest that private, for-profit companies are going to provide quality care to public patients is a fraud, seeking to obscure the ever-greater moves by governments to funnel public wealth into the clutches of the corporate elite.