Northern Beaches Hospital has all but confirmed staff cuts across its adult mental health and maternity services, which medical personnel have confidentially told Manly Observer will have a “huge flow on effect and impact patient care, particularly mental health patients.”
A spokesperson for the Frenchs Forest based hospital, a joint private-public hospital run by Melbourne-based medical company Healthscope, confirmed on the weekend that the hospital had “begun consultation with its team on some minor staffing and rostering across its adult mental health services, and maternity services.
“The proposed changes will in no way compromise the quality of patient care and will have a minimal impact on existing roles. NBH’s child and adolescent mental health services will not be affected by these proposed changes,” they said in a statement.
We understand the hospital is looking to remove half of the unit manager roles (from four to two) across three mental health wards and reduce hours across a number of shifts in mental health and maternity. A maternity role for private patients also looks to be ending which provides pre and post natal support.
Manly Observer has also been told of cuts in the security team and abstaining from rehiring in the administration when staff leave, but have not been able to confirm the claims. We have sent a number of follow-up questions to the hospital spokesperson, who said there was no more to add at this stage, and is now on leave.
The changes were expected to be announced today, 24 April, but announcements have been delayed.
While the upset over forecast cuts has been described privately by some within the hospital as ‘blown way out of proportion’, there are concerns these known changes mark the beginning of further cost-saving measures as Healthscope tries to balance rising costs unmatched by private health insurers.
The cuts also follow news that its owners, Healthscope, and Brookfield Corporation, the Canadian multinational investment firm that purchased Healthscope in June 2019, are restructuring massive debt totalling $1.6 billion.
The Australian Private Hospital Association says just 30 per cent of hospitals made a profit or broke even during the 2022 financial year.
How serious the injury?
A whistle-blower, who agreed to speak with Manly Observer on the condition of anonymity, told us, “The hospital is breaking even but Healthscope is looking for ways to increase their profit so are suggesting redundancies that will have a huge flow on effect and impact patient care, particularly mental health patients.
“Nurses and staff in the mental health units often deal with the most complex patients and regularly experience assaults and abuse,” they said. “While this does not appear in the news due to the patient confidentiality and the expectation that this is “normal” for this area of work, the idea that mental health continues to be so devalued by Healthscope and that they plan to further cut staffing despite significant workplace violence is unacceptable.”
“That they plan to further cut staffing despite significant workplace violence is unacceptable.”
A leaked letter to the Director of Nursing at Healthscope from the NSW Nurses and Midwives’ Association viewed by editor Kim Smee, states the branch is “shocked by the proposed staffing profile for mental health which proposes another significant cut to the mental health nursing hours and nursing unit management (including team leadership on day shifts). The Proposed changes expect mental health nurses to work with unsafe rates compared to their colleagues in public hospitals.”
“The Branch is deeply concerned about the worsening burn-out of mental health nurses and their ability to care wholistically for mentally unwell patients, as well as the deep impact the changes in maternity will have across midwives and the community.”
The letter claims they found that Northern Beaches Hospital is significantly under-resourced compared to other public hospitals in the Northern Sydney area.
Local pollies respond
The staff cuts have provoked condemnation from local MPs Dr Sophie Scamps (Mackellar) and Michael Regan (Wakehurst), both of whom have sought urgent discussions with NSW Health Minister Ryan Park.
Dr Scamps said, “I understand Healthscope is planning to reduce the nursing staff across three mental health wards, resulting in the loss of two nurse unit managers and the equivalent of one 12-hour day shift. This will mean that two nurse unit managers will now be responsible for four mental health wards with 61 beds. I also understand there are plans to reduce the nursing staff in maternity.”
The changes to staffing levels come two months after the state government abandoned plans to invest $7.5 million in mental health services at the hospital, telling the Sydney Morning Herald last week that the previous government had “promised the funding without guaranteeing the hospital could deliver the promised youth mental health beds…”
“I am deeply worried about whether Northern Beaches Hospital, which is run as private-public partnership, is delivering the standard of care that my constituents should legitimately expect,” Dr Scamps continued.
“My office is frequently fielding communications from patients about concerns with their treatment. While they report that the staff are trying their best, they say it is evident that they are literally run off their feet. Patients report waiting for hours to be helped to the bathroom, cannulas left in at discharge, no patient transport available and other signs of a staff stretched to their limits,” she said.
Dr Scamps continued, “Doctors have also contacted us about staffing levels, particularly among more junior doctors, who are crucial to the hospital’s operations.
“It is not acceptable that the 350,000 people who live in the Northern Beaches and surrounds should have a lesser service because of the ownership structure of the hospital, so I am seeking reassurances from both the Federal and state ministers about the operations of the hospital.”
Northern Beaches Hospital counters that it is performing well. “We are proud of the fact that Northern Beaches Hospital now consistently rates highly in ranking tables on key public hospital performance metrics,” a spokesperson said. “We are in regular dialogue with the NSW Government consistent with the nature of our long-term partnership.”
The controversial takeover
Healthscope’s takeover by Brookfield was strongly criticised by Warringah MP Zali Steggall in 2019, and questions have been raised repeatedly by independent journalist Michael West in a series of articles online. Ms Steggall raised concerns with the Federal government over its approval of the sale of 43 Australian hospitals to Brookfiled, which is essentially a company in the Cayman Islands.
“It is not in the national or public interest for Northern Beaches public hospital services to be on-sold to a foreign company, run for profit, and operated out of a tax haven. Over $2 billion of taxpayers’ money has been invested in the new hospital.”
“It is not in the national or public interest for Northern Beaches public hospital services to be on-sold to a foreign company, run for profit, and operated out of a tax haven. Over $2 billion of taxpayers’ money has been invested in the new hospital.”
Earlier this month AFR revealed, “Healthscope’s lenders have appointed McGrathNicol to help restructure about $1.6 billion in debt they refinanced for the hospital operator just one year ago…
“Healthscope’s debt is being reorganised alongside a broader restructuring of its portfolio of 38 hospitals that involves moving its more profitable facilities into separate corporate structures.”
Mental health Michael’s major concern
Wakehurst MP Michael Regan, who is also seeking an urgent meeting with the NSW Health Minister, added, “I am outraged by reports of staffing cuts of mental health nurses at Northern Beaches Hospital. The community has been calling out for better acute mental health care. These cuts are the exact opposite of what’s needed. The decision to reduce staffing levels amidst ongoing systemic issues at the hospital is alarming.
“The reported cuts, including halving the number of full-time nurse unit managers and reducing shifts in crucial areas like adult mental health and maternity, will undoubtedly strain this already overburdened workforce. It is distressing to hear from burnt-out staff who feel unappreciated and concerned about their ability to deliver quality care under these conditions.”
Mr Regan continued, “Reducing staff that are already overburdened will most certainly pose an unacceptable risk to patient health and safety. This is not fair on the amazing, extremely hard working staff or their patients. I fear this is just the tip of the iceberg…
“Too many constituents have shared with me their extremely concerning experiences at the Northern Beaches Hospital, and worryingly the mental health ward in particular…”
History
The hospital has faced a number of operational complaints and management changes since it opened to the public in November 2018. On 1 December 2018, six weeks after its opening, the Health Education and Training Institute (HETI) conducted a site inspection for a report.
In their report, HETI, a provider of high quality training and education to support 110,000+ healthcare workers and managers across the NSW health system, was scathing in its analysis of the hospital’s management.
The report’s author, Dr Martin Mackertich, warned: “The current situation is unsustainable and only working because of the significant commitment of JMOs [junior medical officers] to continue providing a service under adverse conditions.
“Morale amongst JMOs is low, and quick clear progress on issues will need to be demonstrated and maintained to regain their trust in the organisation.”
Although a follow-up report by HETI in January 2019 found improvements, in June 2019, a cancer patient had the wrong side of his bowel removed after a privately contracted laboratory mishandled the patient’s pathology results.
The NSW Government Legislative Council then launched an official inquiry, and later in 2019 a new Chief Executive Officer, Andrew Newton, was brought in to help the hospital further turn around its performance.
The Inquiry report released in February 2020 stated: “Sixteen months since the opening of the Northern Beaches Hospital, and eight months after the inquiry began…. Healthscope and the Northern Sydney Local Health District have worked in a determined way to turn the hospital around from its initial problems. The hospital is now achieving performance standards and results that the committee hopes and expects will continue, and be improved upon into the future…”
The hospital generally performed well in 2022, though some of those metrics have since declined.
Mr Newton recently resigned from his role at the Hospital.
Manly Observer asked a series of detailed questions to the Health Minister Ryan Park, but was only provided the following statement:
“We expect Healthscope to deliver high quality healthcare to the people of the Northern Beaches. We will continue to work closely and constructively with providers to continue delivering high quality patient experience and care.”
Article written by Alec Smart and Kim Smee
