Swift action halts hospital carve-up

Public outcry has forced health bureaucrats to shelve a decision to close beds and cut staff at Bathurst Base Hospital – for now, at least.

Stop press: Western NSW LHD management has broken its commitment to conduct an independent review before proceeding with any cuts to Bathurst Hospital services. Angry nurses said they felt betrayed by a shock announcement that five beds in the medical ward will close from December 9. Management is also refusing to give new graduate nurses any commitment to ongoing employment next year. A meeting of 67 NSWNMA members called on management to reverse the bed closures. The branch has called for a public forum on the hospital crisis to be held on December 2.
More than 80 union members from every department met at the hospital to discuss the cuts.

The Western NSW Local Health District has backed down from a decision to abolish about 15 full-time equivalent (FTE) frontline nursing positions plus allied health and clerical positions at the hospital.

Following a week of community outrage LHD management announced an external review of hospital operations to identify cost-cutting measures.

All changes to bed numbers and staffing were put on hold pending the outcome of an investigation to be finished before Christmas.

Nurses were stunned by the original decision to implement bed closures and staff cuts affecting the rehabilitation unit, emergency department, intensive care unit and operating theatres.

Announcement of the reductions came without any warning or consultation. It followed the closure of five surgical beds earlier this year and a dispute over serious understaffing of the ED.

Hospital general manager David Wright, accompanied by a human resources functionary, delivered news of the latest cuts to affected staff and heads of departments on October 29, saying cuts were imminent and necessary because of a budget blowout.

Nurses in redundant positions would be moved to other parts of the hospital involuntarily if there were not enough volunteers.

The next day more than 80 union members from every department met at the hospital with organisers from the NSW Nurses and Midwives’ Association.

Assistant Secretary of the union’s Bathurst branch, registered nurse Kathi Hamilton, said nurses were in shock when the news came through.

“People are very disheartened and frustrated and very worried about the services that will be lost to the community,” Kathi said at the time. “We just had a battle in May and June over the closure of surgical beds, and now this happens.

“If there is a need to save money we deserve to have an input into the process to decide where savings can be made.”

NSWNMA Assistant General Secretary Judith Kiejda said these were the biggest cuts at Bathurst anyone could remember.

“I cannot believe government and management think this is the way to go,” Judith said. “Bathurst is a large and growing regional city so service demand will increase. The hospital is a major rural referral centre that was redeveloped in 2007. It makes absolutely no sense to cut services and staff.”

Judith said the impact on the community would be severe with patients forced to travel long distances to other hospitals and many going without care.

“The LHD says this must happen because of a budget imperative. They have no idea what this does to a regional area.

“The union will fully support whatever decision the Bathurst nurses take to defend their hospital and their community.”

Bathurst Medical Staff Council chairman Dr Ray Parkin said the cuts would have a massive impact not only on existing service levels but also on the hospital’s ability to attract specialist staff.

The Bathurst-based Western Advocate newspaper urged the community to get behind hospital staff and called for a protest rally outside the hospital.

“If the doctors and nurses at Bathurst Base Hospital are ready to fight for its future, then the rest of the community has no choice but to stand beside them,” the paper said. “The state government needs to understand that … it cannot rely on the solid support of the people of Bathurst based solely on the extraordinary result of the last state election.

“If the state government thought the people of Bathurst were an easy touch, then they are about to learn they were very wrong.”

Just three days after General Manager David Wright walked around the hospital telling individual nurses their positions were about to be eliminated, public reaction was already forcing the authorities to backtrack.

On November 1 the chief executive of the LHD, Scott McLachlan, issued a media release complaining that press reporting of the issue “lacked balance”.

He claimed, incredibly: “There is absolutely no plan to downgrade or downsize Bathurst Hospital. No decisions have been made about changes to staffing or service levels at Bathurst Hospital. Any changes will be made in collaboration with the hospital’s doctors, nurses and staff as well as the community.”

Mr McLachlan then maintained that Bathurst was too expensive to operate without changes because it admitted patients who could be cared for at home and who stayed longer than patients at other hospitals.

Health Minister Jillian Skinner entered the debate, describing any talk of Bathurst Hospital being downgraded as “nonsense and scaremongering”.

The general manager and director of nursing addressed a second meeting of the union’s Bathurst branch on November 7.

In front of 85 members they confirmed that all changes were on hold pending an external review of the Bathurst health service. They added that intensive care unit bed and staff numbers would be quarantined from changes.

The branch adopted a unanimous resolution seeking input and sign off of the inquiry’s terms of reference and an assurance that management would talk to the branch about the inquiry’s recommendations before making any changes.

Biggest cuts in hospital’s history management’s plan for bathurst hospital included:

Rehabilitation unit

  • Cut bed numbers from 16 to 11.
  • Shift 4.30 FTE nursing positions (RN and EN) to other parts of the hospital.
  • Reduce nurse staffing by one per shift, seven days a week.
  • Management to consider running an outreach service from the rehab unit to assist people at home.

Intensive care unit

  • Move 5.50 FTE registered nurses to other parts of the hospital.
  • Cut nurse staffing from three per shift to two per shift, seven days a week.
  • Enhance the role of the NUM to take over ICU, high dependency unit and emergency department.
  • NUM2 positions in both ICU and ED would be lost with the creation of the NUM3 position over the ED/Critical Care areas.

Emergency department

  •  Reduce the clinical nurse educator position from 0.84 FTE to 0.42 FTE.
  • Remove the NUM position.

Theatres

  • Reduce elective surgery including in orthopaedics, urology, obstetrics and gynaecology, general surgery and ophthalmology.
  • 1.65 FTE nursing vacancies will not be filled.

Critical care rotation

  • All 3.0 FTE critical care rotation nurses put on temporary contracts.
  • Their contracts not renewed and the 3.0 FTE positions not filled.
  • The three nurses would become casual employees.

Casuals and temps

  • All temporary nursing contracts not renewed so nurses become casual employees. Casual nurses to lose hours.