Demolition of B block is scheduled as part of the next stage of the Royal Hobart Hospital (RHH) redevelopment; however the RHH Medical Staff Association says recent events at the hospital have made it clear that the decommissioning of the B block cannot proceed until there are adequate replacement beds to counter the loss associated with this demolition.

Drastic bed shortages at the RHH have been compounded by the rising Emergency Department (ED) presentations, approximately 5 per cent per year. The simple fact is the RHH has not had enough beds to cope with emergency admissions.

Chairman of the RHH Medical Staff Association, Dr Frank Nicklason, said whilst the red flags have been up for some time, the train crash will ultimately occur once B block closure is attempted.

“What is required now from the Minister and the Tasmanian Health Service (THS) executive is acknowledgement that the decommissioning of B block can only occur if adequate replacement beds are found,” Dr Nicklason said.

“It is foolish in the extreme to consider removing the B block beds when the new temporary building in the forecourt of the Liverpool Street entrance to the RHH will only be able to accommodate 22 medical patients of the 35, on average, medical patients currently accommodated on the B Block wards. The practical reality is that RHH will be facing a shortage of up to 30 beds when the B Block is demolished.

“The RHH staff have been struggling to provide high quality care in the face of a severe and persistent shortfall in bed availability.

“Patients with complex care needs are being held in the ED for excessive periods, placing them at greater risk of experiencing serious complications and/or dying during their hospital admission.
“A number of elective surgeries have also had to be cancelled.”

The ongoing ED exit block at the RHH resulted in more than a dozen patients routinely being unable to be placed in ward beds. Those patients remain in the ED or are housed in an area being readied for demolition.

Dr Nicklason said the management response is proving ineffective and onsite leadership as well as sufficient authority at the RHH is required.

“The THS executive is current stymied by a highly bureaucratic and centralised mentality with inadequate authority and organisation at the RHH campus to support the level of patient care services that the hospital is required to provide,” he said.

“The RHH has been shown to be one of the most efficient hospitals in Australia. Our staff have been magnificent but they are under severe strain.

“What is urgently required is acceptance that the current THS governance structure has divorced senior managers from the real world of running safe and effective hospitals around the state. A flatter governance structure which facilitates patient care is urgently required. The current structure appears best designed to serve the role of financial restraint rather than sustainable patient care.

“The effort of the THS Executive processes would be better placed serving our community by fostering and supporting the close cooperation of doctors, nurses and allied health in our hospitals, rather than being preoccupied by political spin and building an out of touch, centralised bureaucracy.”

Dr Nicklason said the RHH Medical Staff Association is openly willing to work with the Health Minister to find solutions to the lack of beds at the RHH.
RHH Medical Staff Association