Queensland paediatrics deserves better

Two and a half years before it’s scheduled closure under the Beattie-Bligh plan, Queensland’s major paediatric teaching hospital, the Royal Children’s Hospital (RCH) is being systematically ravaged against professional and public opinion. This is in spite of Premier Newman’s pre-election commitment to maintain the hospital.

The RCH Medical Staff Association has been reduced to an impotent rump with most of the membership having tired of attending meetings in which they are denied meaningful input. The highly successful RCH Foundation was shut down in November 2011, with all ten Board members and three senior executives resigning in protest at the cavalier demolition of the RCH Foundation and the diversion of its $15-20 million dollar assets. RCH paediatricians have been excluded from the supposedly independent Chiildren's Hospital Board.

The RCH paediatric emergency department (PED) has been depleted to supply staff to a ‘substitute’ opened at Prince Charles in August 2012. The ‘substitute’ however is a dumbed down version of the comprehensive PED at RCH, which is backed up by a fully serviced on-site paediatric hospital. 

The unit at Prince Charles is operating unnecessarily - and in close proximity to the RCH - for the next two and half years it will represent an accumulated waste of $35-40 million in running costs.

The removal of on-site paediatric hospital support will devastate the neonatal unit of Royal Women’s Hospital (RWH), the State’s designated centre for high-risk obstetrics. This separation contravenes national best practice. Newborns requiring surgery will be put to increased risk of transport to the Mater Hospital. Mothers separated from their newborns are at increased risk of post-natal depression and feeding problems. The RWH will thus dwindle from a centre of excellence to a cottage hospital, which will not attract quality post-graduates.

The removal of the RCH, and the crippling of the RWH, will spell the end of the well-functioning complex of three major mutually supporting teaching hospitals, which is unique in Australia, and has served the State so well for more than a century. The pioneers who established the Medical School in 1936, as part of the State’s major hub of medical education, would be appalled.

What gain is there for Queensland paediatrics from all of this? There isn’t any; indeed Queensland paediatrics will be going backwards and important opportunities squandered. The new hospital (QCH) will be cut off from the quality support services in pathology, genetics, imaging and research essential for a modern teaching hospital, which have been built up in the Herston campus, and will not be moved to the Mater site. Bed numbers will be insufficient for current and future needs. Gastroenterology and dentistry will be less satisfactory than is currently available at RCH. There will be no hydrotherapy pool or gait laboratory available at QCH. At least 38 of the 93 units accommodating country parents in ideal conditions within easy walk of the RCH will remain at Herston.

The issue of cost remains an embarrassment. Up from an original estimate of $700 million to be financed by sale of the profitable Golden Casket, the now near $2 billion dollar cost is a significant hit to the State’s parlous finances, and a significant factor in the forced sale of assets and job losses in Q-Health and the broader public service.

How could a near $2 billion dollar expenditure of public money proceed without the support of any document of validation, and in contempt of every inquiry into paediatric services that has showed Herston as the preferred site for a major paediatric teaching hospital? Five pillars of falsehood underpin the QCH plan.

First, was the misapprehension by Premier Beattie in the parliament on 30 March 2006 that there were moves to close Mater Children's. Second, the promise of improved results for paediatric cardiac surgery by removing this section from Prince Charles to MCH (to become the cornerstone of a new children’s hospital), when in fact the Prince Charles unit was performing to world standards, as demonstrated in published audits. Third, the rejection of Herston as suitable for redevelopment, based on a perfunctory assessment by a Q-Health functionary who appeared on site in August 2006 without consulting any of the on-site engineers. Fourth, a misguided obsession with a one-hospital policy, which eliminates back-up in the event of disasters and ignores the functional two-hospital system operating in Sydney and Melbourne. Fifth, the claim that the QCH plan will deliver a ‘world-class’ hospital when in fact it will not do so.

Why has the strong resistance to the QCH plan been ineffective? Within days of the August 2006 Beattie announcement, the stunned RCH staff were admonished by management that any public criticism would be taken as breach of contract. As a sign of serious intent, at least two senior medical staff were dismissed for expressing reservations about the plan.

In essence, a well-functioning and important asset is being sacrificed under a plan conceived in secret without any document of justification, for an unnecessary, inadequate and poorly sited construction in a former Premier’s electorate, and at a cost which is bleeding the State dry. Inquiries and Royal Commissions have been held for matters less serious than this. Queensland paediatrics deserves better.