SSWAHS and its brush-off of concerns raised in the Southern Highlands

"Keep it short, make it simple, and say nothing" possibly epitomises the thinking of the senior executive members of any Area Health Service or Departmental bureaucrat. However, SSWAHS has learned to refine it to an art form. If it wasn't so serious an issue one might be tempted to stand and applaud the sort of misinformation and disinformation rolled out by the SSWAHS executive.

At any time an Executive which, having learned the hard lessons from Campbelltown Hospital, and seemingly so principled in the application of "clinical governance" would be expected to have transparency and haste to resolve any conflict they might have or generate. Not so with SSWAHS.

One patient from the Highlands who made a serious allegation of professional misconduct of a staff member was eventually contacted by a senior bureaucrat of the SSWAHS mental health service. That is, they tried to phone the patient, maybe once or twice. They then left a letter for the patient to be given it by the staff at the treating unit. The patient was so offended by the patronising approach of this bureaucrat that they failed to respond to the letter. SSWAHS carried out no investigation of the alleged misconduct while that person remained in their employment. When the staff member resigned SSWAHS then sent the patient a letter stating that since the staff member was no longer their employee they could not do anything about investigating the complaint. There was no reference of the complaint by SSWAHS to the registration board or the HCCC for their information or investigation. Some months later an advocate made a formal complaint to the HCCC about the allegation. The matter was sent to SSWAHS for investigation and comment.

The usual practice was for the SSWAHS to be required to respond to the HCCC within 60 days. At the end of the 60 days SSWAHS asked for an extension. At the end of the following 60 days SSWAHS asked for another extension. Within 14 days they were able to inform the HCCC that they could now finalise the complaint investigation.

Why, you might ask, did it take so long for them to investigate something that they had already investigated previously. Well quite simply, that 130 days was just how long it was for the patient, who had made the original complaint and allegation, to die from an inoperable lung cancer. The patient's terminal condition was well known to SSWAHS because they had been providing treatment and palliative care in Bowral Hospital and community nursing services. Unfortunately, HCCC agreed with SSWAHS that it was now too late for the matter to be resolved.

Call me a cynic.... and maybe there's a glass of hemlock waiting for me in some part of SSWAHS, but really.....! Come on SSWAHS, you certainly know a thing or two about transparency, timeliness and clinical governance.

Bowral Hospital and Community Health Services

Bowral Hospital and the people of the Southern Highlands need more local control and management over their hospital and community health services.

The remote, micro-managed, executive control of our local health services by the Liverpool based Sydney South West Area Health Service (SSWAHS) has failed our local people.

SSWAHS has done this by starving our local health services of funding enhancements, specialist services, and infrastructure building programs.

Why and how? SSWAHS has done this by diverting any additional capital and service enhancement funding to their metropolitan based hospitals – Liverpool, Campbelltown, Concord and Royal Prince Alfred Hospitals.

In the meantime they have left the Southern Highlands community to raise their own funds for health services development and essential capital works.

Ø The Renal Appeal by Rotary and the local community has ensured that local people requiring dialysis can receive the necessary treatment at Bowral Hospital. The only problem is the reluctance of SSWAHS to provide the staff to assist in treating local dialysis patients at Bowral Hospital.

Ø The Children’s Ward Appeal by the BDCU and the funding provided by the local community finally embarrassed the SSWAHS Executive to allow the renovation of the Bowral Hospital’s Children’s Ward.

Ø The local community’s response to the two Cancer Walks has provided the resources at the Cancer Support Services based at the SHPH Day Treatment Specialist Centre in Bowral.

Ø The local CanAssist Cancer Support group has raised much of the funding applied to resources and services to palliative care patients at home.

In the meantime, necessary community and hospital health services continue to struggle with the local demand: drug health services, social work services, mental health services, women’s health, sexual assault, palliative care, community nursing, child and family health nursing, child and family psychological services, dental services, aged care services do not have enough resources (mainly staffing) to provide the same level of care to our local community that is provided to, and expected by, the metropolitan communities. Those in the local community who have to wait for these services would confirm this poor state of the local services.

The SSWAHS Executive is suggesting that specialist services can be accessed by our community travelling to Campbelltown or Liverpool. They obviously don’t know of the difficulty of travel to the metropolitan areas from the Southern Highlands! Some of them don’t even know where to find Bowral or have difficulty in travelling any further south than Campbelltown.

Ø To ask sick Highlanders to travel 74+ Km to the hospital at Campbelltown and to wait 4+ hours in the Emergency Department or Outpatients to be seen and treated is appalling, yet typical of the thinking of the bureaucrats who make up the SSWAHS Executive and Clinical Divisions.

Ø Mental health patients requiring involuntary admission to SSWAHS mental health facilities may start at Bowral Hospital but then have to be transported to an already overworked Campbelltown Hospital Emergency Department, and perhaps in many cases be re-transported to Liverpool, or Concord, or RPA hospitals for their treatment. Mental health patients in the community are not being well supported by the current service providers because of the higher priority need to deal with acutely unwell mentally ill people.

Ø Drug health patients requiring specialist detoxification will be required to travel to Fairfield Hospital for their treatment. The two drug health staff members at Bowral are required to provide all assessment and treatment services to the Hospital and the community health centre.

Ø Social work services at the hospital and community health centre have constantly complained that there is a lack of staffing sufficient to meet the needs of both inpatients and those who attend the community health centre. Their role in comforting bereaved families, in supporting victims of road trauma, in supporting mothers of still-born infants, in providing social support to the indigenous community, to the displaced and disadvantaged cannot be met by the current allocation of social workers at Bowral.

Ø Parents waiting for psychological assessments by the Child and Family team at the Bowral Community Health Centre are often waiting for weeks and may even have to self-prioritise their needs against the needs of other families.

Ø Urgent dental treatment at Bowral Community Health Centre is sometimes several weeks wait for local people. The reason is that qualified dentists are in short supply at Bowral, and the administration of their clinical stream is based in Sydney.

Ø The Aged Care Assessment Team (ACAT) struggling with the increased referrals in aged care treatment.

What the SSWAHS Executive does do well is to alienate local private practitioners and to ignore the contribution that local general practitioners, allied health professionals, psychologists, social workers, addictions experts, psychiatrists, counsellors and non-government organisations who can, and do, provide excellent clinical services for the people who attend their practices.

The SSWAHS Executive and Clinical Directors could do more to utilise the local private practitioners in care coordination, ongoing treatment, monitoring health and well-being of the local patients that their limited SSWAHS services are unable to cope with.

Instead, the local SSWAHS services are restricted by their Executive and often fail to be proactively supporting their patients to seek out private practitioners for ongoing care, treatment and support.

Ø Medicare Australia has made it much easier for patients seeking ongoing treatment for chronic disease conditions, for mental illnesses, for pregnancy support and for access to ongoing health services for Indigenous people. This is usually available through their general practitioner, or psychiatrist.

Ø If you are a patient of one of the Hospital or Community Health Centre health services ask them for a list of local private practitioners in your area so that you can inform your general practitioner of your choice.

Finally, what if SSWAHS stays in control of our hospital and community health services? Will it be more of the same? Will they continue to strip away the clinical services that our growing population should be expecting to have local access to?

And if this is the outcome what can we as a local community in the Southern Highlands expect to see?

A Bowral Hospital without specialist services will become an Emergency Department outpost for Campbelltown Hospital. Local maternity, surgical services, inpatient treatment for cardiac and stroke patients will be moved north. Our aged population, which is constantly increasing with retirement villages and the expanding aged care residential facilities, will be travelling north if they require hospital based treatment.

Or perhaps Bowral Hospital will become another Balmain Hospital in the SSWAHS Grand Plan. A Geriatric Hospital denuded of all health services not relevant to aged care.

If this is NOT what YOU want – then become an advocate, an activist, or an agitator. Make your voice heard NOW by SSWAHS!

If you are happy with the current micro-management, control and plans of the SSWAHS Executive and Clinical Directors – then do nothing! But don’t complain in the future if you don’t get the health service at Bowral that you or your family need!