Independent inquiry needed into Women’s and Children’s Hospital: SA-BEST

30 November 2022

An independent inquiry must be held into serious claims sick children fighting for life in the Women’s and Children’s Hospital are being left without a doctor on site, SA-BEST called for today. 

SA-BEST MLC and Health spokesperson, Connie Bonaros, said the disturbing claims by the respected College of Intensive Care Medicine of Australia and New Zealand (CICM) were deeply disturbing and needed to be investigated as a matter of urgency. 

Connie said the inquiry must also investigate the reasons the CICM has withdrawn the hospital’s accreditation for its Paediatric Intensive Care Unit as a training centre following its earlier warning that the unit was at risk of losing its credentials to train young doctors in providing intensive care to children. 

“Heads at the Women’s and Children’s Hospital must roll. It is said a fish rots from the head down so the blame starts at the top,” Connie said. 

“Senior management – and presumably the Board – have known about these accreditation failings for a significant period of time but here we are,” she said. 

“The disturbing revelation sick children in the hospital’s Paediatric Intensive Care Unit (PICU) are being left without a doctor on site, I would argue, borders on medical negligence. 

“The Minister must order an immediate independent inquiry to get to the bottom of this crisis – including how the lives of desperately sick children have seemingly been put at risk due to the hospital Executive’s significant mismanagement. 

“Serious questions must be asked at the Hospital’s AGM tomorrow morning about how a hospital with a once world-renowned reputation stands accused of leaving sick kids in a ward without appropriate qualified or experienced doctors on site. 

“The blame lies entirely at the feet of the hospital management and not at the hard-working, dedicated medical clinicians who dedicate their lives to our sick children.” 

The revelation has been revealed in a damning report undertaken by the CICM after it carried out an inspection of the hospital last month. 

In its report, the CICM also found/states: 

  • the junior medical staffing model is one registrar per shift. This single person is also required to attend outside ICU activities such as medical emergencies, difficult IV access in both the wards and the emergency department (noting they are often an adult ICU trainee with limited paediatric experience), as well as the review of obstetric patients at times. This means no doctor is immediately available in the ICU during these times, which breaches the College Minimum Standards for Intensive Care Units. 
  • nursing staff are exhausted. The unit is running consistently over funded activity. Most days the nursing staff are pulled from vital non-clinical duties (Equipment / Education/ Nurse Unit manager) or from days off or other leave to facilitate clinical care. This seems to be as an “open” model with requests from hospital executive to run extra beds when the medical and nursing staff believe the unit is already at capacity. This approach does not comply with College requirements where all admissions to the ICU are approved and accepted by the Intensive Care Specialist on duty. Unfortunately, the long-term consequence of this approach is staff burn out and fatigue. 
  • the Medical specialist on call is onerous duty and not sustainable. They are often required to attend after hours due to the specialized nature of the patient cohort. 
  • Staff at all levels are so busy with clinical work that other non-clinical work such as teaching, research and Quality Assurance activities are regularly deferred or cancelled. 

“I am absolutely appalled and will be calling the hospital’s Executive team before a Select Committee I chair at the earliest possible convenience in an attempt to get to the bottom of this crisis – and who is to blame for it,” Connie said. 

“The CICM’s damning report paints a picture more akin to a hospital in a third-world country,” she said. 

“The government must now come out and publicly declare whether it has full confidence in the Board and management of the W&CH – if not, they must be removed as a matter of urgency.”

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