Doctors who care for some of WA's most sick children say plans to move the state's main women's and babies' hospital 20 kilometres from its current location risk increased "mortality and morbidity" of critically unwell infants.
Key points:
- The new facility is due to be built next to Fiona Stanley Hospital in Murdoch
- Child and Adolescent Health Service staff are worried about the move
- One doctor fears it is the worst decision ever made by WA's Health Department
The government had initially planned to move the facility from its current site at King Edward Memorial Hospital (KEMH) in Subiaco to the QEII Medical Centre precinct, integrating it with Sir Charles Gairdner (SCG) and Perth Children's Hospitals (PCH).
In April, Health Minister Amber-Jade Sanderson and then-premier Mark McGowan shocked doctors by announcing those plans would be abandoned and the hospital would be built as part of the Fiona Stanley complex in Murdoch, in Perth's south.
Ms Sanderson later defended not consulting doctors about the move, saying "no amount of consultation" would change the government's mind, given warnings of "too many risks, extended timelines and unacceptable patient disruption".
Now, a draft report prepared by staff within the Child and Adolescent Health Service (CAHS), which runs KEMH and PCH, explains why they want to see the government stick with its original plan for what's known as "tri-location" – building adult, paediatric and women's and babies' hospitals on the same site.
"Any other option would pose unacceptable risks to women and babies, particularly neonates," the report reads.
"The research is clear, neonatal transfer is associated with increased mortality and lasting developmental impairment.
"Only tri-location provides neonates access to time-critical emergency care and mitigates the risk of transport."
'Population growth not large enough'
The government has promised to build improved neonatal facilities at FSH to limit the number of transfers that have to be made between the new hospital and PCH.
But the report rejects that solution.
"The WA population growth is not large enough for two specialist paediatric hospitals, or to duplicate neonatal and paediatric subspecialties at Murdoch," it said.
"Therefore, the [new women's and babies' hospital] must either be tri-located on or near QEII, or the PCH will need to be relocated to the Murdoch site.
"The CAHS position is informed by extensive consultation with senior clinicians, consumer representatives, evidence and best practice reviews and jurisdictional comparisons."
According to the report, PCH's surgical division believed neonatal surgery could not be replicated at the Murdoch precinct in any way and must remain at its current location, saying there is not a "critical mass" of suitably trained doctors for any other solution.
Senior doctor fears increased deaths
A senior doctor who has worked at PCH, who did not want to be identified, told ABC Radio Perth the decision to relocate to the FSH precinct was one of the worst ever.
"It's actually difficult to know where to start," he said.
"This is quite possibly the worst decision that has been made in the history of Department of Health.
"We are worried that this will lead to increase in preventable death and disability for both women and babies."
The doctor said it was about bringing the best services to women and babies.
"The best way of doing that is to have us all together," he said.
"This isn't just a matter of opinion, this is regarded as international best practice. There's any amount of evidence that supports this, and as soon as we start to fragment, the quality of care drops and bad outcomes happen.
"It was really quite heartbreaking when it was announced that instead of coming together, we'd be fragmented, and instead of doing a better job we're going to have to compromise."
Sticking with original plan the 'majority' view
Australian Medical Association WA president Michael Page, said a "majority" of doctors at PCH and CAHS had signed a letter contained within the draft report.
"So, 145 senior doctors working at Perth Children's Hospital and within the Child and Adolescent Health Service … have signed the letter to government, which articulates their grave concerns around the current plan," he said.
"This is not some minority view; this is the view of the majority of clinicians working in this area.
"These hospitals need to be located near each other for the safety of the sickest newborn babies in the state."
Dr Page said it was "essential" the government worked with the clinicians to get the project off the ground.
Original site risked 20-year delays: premier
Premier Roger Cook said the draft report was being used as part of a clinical consultation process that was ongoing.
He said not all clinicians had come to the same conclusions about the move.
"I expect a range of views to be expressed by clinicians," he said.
"We want to make sure that we can develop a women's and babies' hospital sooner rather than later.
"To develop it on top of Sir Charles Gairdner Hospital, Infrastructure WA said could see delays of up to 20 years."
He said KEMH was a great hospital with great clinicians, but it was around 100 years old.
"We need to get on and develop a new women's and babies' hospital. The fastest way we can do that is develop it at Fiona Stanley Hospital," Mr Cook said.
"That will also mean that regional patients will get care much quicker, because we know that the women's and babies' hospital developed at Fiona Stanley Hospital will have much faster linkages to our Royal Flying Doctor Service."
Report 'not endorsed' by CAHS
CAHS chief executive Valerie Jovanovic issued a statement in response to the report.
"This document is not endorsed by the Child and Adolescent Health Service (CAHS) executive or board," she said.
"CAHS understands the decision to relocate the project to the Fiona Stanley Hospital precinct, given the myriad of risks outlined in the business case.
"We continue to work with the state government and the project team, who are consulting with clinicians, including at CAHS, to understand and address their concerns around neonates who require urgent surgery following birth."
Addressing the issue in Parliament, Health Minister Amber-Jade Sanderson said she appreciated and accepted the concerns being raised, promising to take them seriously.
"I don't agree with the language and I don't think that is an acceptable way to conduct a public debate," she said.
Ms Sanderson quoted from a letter she said had been sent to her from senior neonatal leadership at Fiona Stanley Hospital, which she said pointed to the array of services already available at the facility.
"There have been numerous and frequent inflammatory and hurtful comments published in the media from past senior King Edward colleagues," she said the letter read.
"We are deeply concerned about the potential for unsubstantiated reputational damage to Fiona Stanley Hospital group."
Ms Sanderson said the doctors were concerned about an "unnecessary and frankly irresponsible level" of public anxiety that could be created as a result.