THE state's health crisis worsened yesterday as Royal Prince Alfred Hospital executives told doctors they will close its women's health ward and are considering closing its children's ward.
The moves could see patients recovering from gynaecological surgery in mixed-sex rooms and children who need emergency admissions moved to already overwhelmed children's hospitals at Randwick or Westmead.
Furious doctors were briefed this week about the cost-cutting closures, designed to shave $8 million from the hospital's annual budget, after the former treasurer Michael Costa in September revealed a $300 million blow-out in health spending.
Paul Sutherland, a senior gynaecologist and obstetrician at the hospital, said he was "astonished" at the 20-bed women's ward closure, which clinicians have been told will occur on November 1. The ward accommodates women after treatment for cervical, ovarian and breast cancer, as well as general gynaecology patients. It also routinely treats women who have experienced miscarriages - for whom the need for sensitive care was highlighted by the case of Jana Horska, who miscarried last year in a public toilet at Royal North Shore Hospital, triggering a parliamentary inquiry.
Dr Sutherland said Royal Prince Alfred Hospital was a centre of excellence for advanced gynaecological surgery and was frequently used to repair operations that had been poorly performed elsewhere. Such patients required specialist doctors and nurses "used to dealing with the same potential complications. If you have [patients] spread through the hospital you're not going to have that expertise," he said. It would also become harder to train junior doctors.
Another senior gynaecologist, who did not want to be named for fear of being sacked, said it was "totally unsuitable" that women who had hysterectomies should be put in four-bed wards with male patients, and clinicians were concerned that if they were forced to admit fewer patients, they would perform fewer operations and have their operating theatre times cut further. "It is beyond belief that women will be treated this way," the doctor said.
A Sydney South West Area Health Service spokesman confirmed "some changes to one of its surgical wards" - which doctors understand are expected to save the hospital $6.5 million a year. He said fewer gynaecology patients needed an overnight stay and the hospital was "dedicated to caring for all patients in a respectful and dignified way". A four-bed bay would be set aside for female patients, he said.
Pediatricians have been told the 10-bed children's ward is also slated for closure, forcing children to travel as far as Canterbury Hospital for routine admissions for straightforward conditions, or to the dedicated children's hospitals at Randwick or Westmead.
The ward, which deals mainly with asthma, chest infections and broken bones, admits about 2000 children a year, some of them transfers from children's hospitals after they have reached capacity. Staff said they were increasingly admitting babies discharged early from the hospital's crowded maternity unit, who needed to return because of feeding problems.
The hospital had a catchment of at least 100,000 children, one clinician said - including a high proportion of disadvantaged and Aboriginal children who could not easily travel elsewhere. "Current [state] budgetary pressures are being filtered down to the areas and they're having to make these cuts. It disenfranchises all these people," the doctor said.
The health service spokesman said proposals for the children's ward had not been finalised and that "RPA will continue to provide pediatric services". But he would not say if this would be through a dedicated children's ward.
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