Public health

Hospitals at odds over one- vs two-site model for paediatric cardiac services

Thursday, 21 Feb 2019

Paediatric cardiology services in Sydney are in turmoil in a long running dispute over whether cardiothoracic services should be concentrated at one site or continue in a shared two-site model.

The head of cardiac services at Sydney Children’s Hospitals Network, Dr Gary Sholler, has resigned amid claims by clinicians at Sydney Children’s Hospital, Randwick that cardiac surgery services at their hospital are being neglected in favour of those at the Childrens Hospital, Westmead.

A letter circulated by the hospital’s Senior Medical Staff Council said that since administration of the two hospitals was merged into one network in 2012, resources had been allocated preferentially to the Westmead rather than Randwick hospital.

It said patient safety was being put at risk because the merger had left Sydney Children’s Hospital, Randwick without fully functioning cardiac surgery services, and children were being transferred unnecessarily.

Last year specialists wrote to the network to complain about the running down of services at Randwick, saying that having on-site cardiothoracic surgery unit was essential and that proposals to have surgeons visit in emergencies were “unsafe and ludicrous”.

Some clinicians at Westmead have suggested that concentrating cardiac surgery services at one site would result in better quality and safety outcomes for all patients.

The Sydney Children’s Hospitals Network said it was still committed to a two-site model and was recruiting more staff for the Randwick site.

NSW Health Minister Brad Hazzard has stepped in, appointing an independent medical administrator, Dr Kathy Alexander, CEO of the Royal Children’s and Royal Women’s hospitals in Victoria, to investigate clinical governance issues relating to cardiac surgery at the two hospitals.

“As Health Minister I want the [the cardiothoracic teams] to sit down and do what they should do and sort out the clinical issues carefully and appropriately,” he told the Sydney Morning Herald.

“It should not be up to the health minister, who is not a clinician, to somehow settle a spat that has gone on for many years.”

The issue has become a political football, with the Opposition Labor party saying it would fully fund cardiac services at both hospitals, and criticising the current NSW Liberal government for spending billions on building new sports stadiums rather than health services.

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