Thursday 22nd November 2007
Federal government ignores community’s plea for help
The financial collapse of a community-owned hospital in western NSW has shattered a small town’s dream and put the jobs of 21 nurses in jeopardy.
Health authorities in Canberra refused to rescue Yeoval Community Hospital, despite the federal government advocating local ‘community’ control via independent boards as the salvation of the public hospital system.
Yeoval Hospital started losing money last year, partly because it was unable to attract a doctor to move to the bush – a problem plaguing rural health services.
Yeoval’s local board went to the Department of Health and Ageing in July for money to keep the hospital going. The department refused, offering only to provide a consultant to help find a buyer.
The snub to Yeoval contrasts with the federal government’s decision to spend at least $50 million to take over the struggling State government-owned Mersey Hospital in Tasmania, and place it under the control of a local board.
Mersey Hospital is in a marginal Liberal electorate, which the government is desperate to hold at this month’s election. Yeoval is represented by independents in the federal and state parliaments, so there is little to be gained politically by mounting a rescue operation.
NSW Nurses’ Association Assistant General Secretary, Judith Kiejda, said Yeoval’s experience showed that putting hospitals under the control of local boards was no solution to problems afflicting public hospitals caused mainly by lack of funds and staff shortages.
‘Yeoval also shows that a local board’s good intentions and hard work may not be able to make the best decisions if it lacks clinical and financial knowledge and experience,’ Judith said.
Yeoval Hospital’s assets and debt have been taken over by the United Protestant Association, for conversion to a low-care aged care facility.
The UPA says most nurses will be re-hired but only for part-time jobs and 24-hour/7-day registered nurse coverage will be slashed to just one RN for 12 hours a week.
The NSWNA is negotiating to secure as many hours as possible for nurses who have to work but cannot travel to another town for employment, and redundancy pay for those left without jobs.
‘The nurses are apprehensive; some are very anxious and withdrawn. No one knows if they will have a job, everything is up in the air,’ said Lynne Wirth, president of the NSWNA branch at Yeoval.
She said when nurses were told the extent of the hospital’s problems they agreed to help with measures such as working less than their contracted hours.
‘I’m currently on holiday and the hospital couldn’t afford to give me holiday pay in a lump sum due to the financial crisis,’ she said.
Yeoval, population 400, sits on flat dry sheep country midway between Orange and Dubbo. A cost-cutting state government closed its eight-bed public hospital in 1988, erasing a vital facility. But the community was not ready to let the hospital disappear without a fight.
Public meetings voted to form the Yeoval Community Hospital Cooperative Limited. ‘People felt very strongly about trying to keep the hospital viable – everyone bought shares,’ Lynne said. Shareholders elected a board of nine volunteer directors.
The town raised $100,000 through local charities and the federal government provided almost $300,000 under an aged and community care program. The NSW Cooperative Development League guaranteed bank loans and in July 1989, the renovated facility reopened with a seven-bed hospital including an Accident Assessment Unit and a seven-bed nursing home.
Three years after it re-opened, a nine-bed hostel was added at a cost of $450,000. In 1999 a $500,000 eight-bed special care unit for dementia residents was unveiled. The town and surrounding districts enjoyed services such as physiotherapy, optometry, X-ray, audiometry, dietary, podiatry and an early childhood and community nursing service. A team of five trained volunteers operated an ambulance.
Politicians were quick to jump on the bandwagon of success.
Senator Bronwyn Bishop, then minister for aged care in the Howard government, hailed ‘the vision and commitment of the Yeoval community’ and promised: ’The federal government supports community organisations that are prepared to take such a proactive approach to addressing their local needs.’
The next year Senator Bishop presented the hospital with an award for excellence in staff training and development.
In 2003 the NSW Minister for Rural Affairs, Labor’s Tony Kelly, stood in parliament to congratulate Yeoval Hospital on ‘a remarkable success story…The Yeoval community has generated $1.5 million in hospital funding over the past decade. As the largest employer in town, the hospital has provided an obvious flow-on effect to other local businesses.’
The hospital traded in the black until November last year, according to Rex Morris, former co-op chairman who took over management of the hospital after the health services manager left.
Mr Morris, a fourth-generation farmer born at Yeoval Hospital, said it had not had a permanent doctor since September last year, leaving acute and sub-acute private beds empty, with consequent loss of income.
‘When we asked Canberra for financial assistance to keep the hospital going they told us that we were a square peg for a round hole, that our cooperatively owned model did not fit any of the current funding models,’ he told The Lamp.
Lynne Wirth, a 30-year veteran of Yeoval Hospital, said that despite their good intentions and hard work, board members lacked both financial and medical expertise.
‘The board put doctors up on a pedestal and thought they could do no wrong, and were reluctant to listen to nurses.
‘We asked for nurses’ representation on the board for several years but there was a lot of resistance and reluctance to keep staff informed. I was elected the first staff representative on the board only this year – after they got into financial problems – and the hospital folded before I could attend a board meeting.’
Lynne said the board spent $320,000 building a house for a doctor who quit the hospital before he could move into the home. There was conflict between the doctor who replaced him and the health services manager.
‘Last July the board called a staff meeting to announce severe financial problems and asked staff if we had any suggestions to make the hospital viable. They wanted input from us all of a sudden!’
Lynne said the hospital’s conversion to a low-care facility was a huge blow to Yeoval. ‘We will have no high-care residents, no emergency capability and no acute beds. The volunteer ambulance crew will go, as will the special care unit for dementia because remaining dementia patients will reside with low-care residents in the nursing home area.
‘The new owners say they will cut nursing hours by 50%-60%. Some staff will be forced to look for work in bigger centres like Parkes or Dubbo, but there is no public transport to these towns.
‘We realise that in this situation we have no power as individuals, but most of us are in the union and the union is doing a good job keeping us informed of developments and arguing for our entitlements.