Chris Dobney, Editor
Chris Crawford, chief executive of the Northern NSW Local Health District, is a captain in charge of a creaky, leaky vessel. It may not be the Titanic but there is no sense that he knows how to turn his ship around.
If he does know what he is doing, he is either unable or unwilling to communicate it to the crew – let alone his passengers.
Mr Crawford is a long-term health bureaucrat and has headed up the service since its inception at the beginning of last year, effectively continuing what is now a 12-year reign at the top of the region’s health bureaucracy.
The creation of the district came as the result of the federal government’s shake-up of health services throughout the country. The focus was to be on the better delivery of services, with the big stick of threatened federal intervention if outcomes did not improve.
But the prime minister who promised the big stick is gone and there is little good news on the horizon for long-suffering locals. Services – especially emergency services – in our area have gone from bad to worse.
In September last year, nurses at Lismore Base Hospital were forced to take industrial action over long-term low staffing levels that were causing stress and burnout. Only after such action was announced did management seem to step up its attempt to fill a number of long-vacant positions.
In October, Lismore Base Hospital failed benchmark rates for the transmission of staph blood infections, as recorded on myhospitals website.
That same month, a section of the roof of Campbell Hospital at Coraki sustained some damage in a storm. It has not reopened since, despite Save the Campbell Hospital Committee saying that funding is available to pay for necessary repairs.
In April this year Bonalbo Hospital’s night facility shut down after a doctor couldn’t be found to replace the retiring doctor there.
In May it was announced Mullumbimby would lose its night doctor, despite there being local doctors willing to work at the hospital, in favour of a video link to Tweed Hospital’s emergency doctor. (In fact, Bonalbo would seem to be the ideal place to trial such a solution, rather than Mullumbimby, where a willing list of doctors already exists. It would be a win-win instead of a lose-lose.)
Tweed’s emergency department, while it has had some minor improvements, is already reputed to be at breaking point, with patients waiting in chairs and stretchers when beds are not available. (I was admitted overnight into Tweed emergency with a perforated appendix in December 2010 and spent the night on a stretcher as no bed could be found for me then.)
Last week it was announced that a play therapy room at Lismore Hospital had closed as the therapist who oversaw it had left and was not being replaced.
Death by a thousand cuts.
Amongst all this you might think the recent announcement of $80 million to upgrade emergency facilities at Lismore Base Hospital might be a positive sign on the horizon.
But coroner Jeff Linden’s comments on Friday scotched any notion of that. He was commenting on the tragic death of Glenn Peter Rubbo from a stroke in the hospital car park while waiting to gain access to the overcrowded emergency waiting room.
Mr Linden said staff ‘worked in deplorable conditions and often faced insurmountable workloads’.
On the day in question, the 16-bed emergency ward had 55 patients, with 80 having been treated in the course of the day.
Mr Linden said Lismore Base cannot wait for the building program and must implement changes and upgrades immediately, preferably including a new blood analysis system, which is not even slated as part of the upgrade.
What emerges from all this is a sense of a reactive health bureaucracy in a perpetual state of crisis management, with no vision and a desperate determination to cut corners. This opportunistic approach is pushing ever more onto the major hospitals, which are already overcrowded, understaffed and ill equipped.
If we could be persuaded that doctors and nurses would at least be relocated there might be some consolation in losing localised services.
At the eleventh hour, and only after doctors came out in support of nurses at Mullumbimby, Mr Crawford has agreed to keep on the night doctors for a few more months during the trial. But is it a genuine concession on his part or more to do with the fact that the implementation of the Connecting Critical Care video-link is running behind schedule?
Nor has there been any further mention of Byron Central Hospital, which received a paltry allocation of planning funding in the last round and nothing at all in the current one.
There is an alarming sense of lack of vision at the head of our health district. Certainly if there is one, Mr Crawford has failed to annunciate it. As far as we are aware he hasn’t even issued an apology to the family of Mr Rubbo.
Northern NSW residents have a right to expect the same quality of healthcare as their city neighbours. In a region that is growing, and with tourism and major events constantly impacting on the need for emergency services, this is not the place to be cutting.
The role of the top health bureaucrat in the district should surely be to acquaint politicians to these needs, not inflict a series of opportunistic and un-thought-out cuts on local populations.
If Mr Crawford cannot see his way to doing this, perhaps it is time for him to pass on the baton to someone who can.