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Axiomatic Or An Exercise In The Bleedin’ Obvious

By Michal Holland

“In the Spring a young man's fancy lightly turns to thoughts of love.” Alfred Lord Tennyson

In the Eurobodalla, One New Eurobodalla hospital campaign’s fancy turns to thoughts of unrequited promises.

It is now three years since a review by the NSW Health Agency for Clinical Innovation recommending improvement in Critical Care services in the Eurobodalla.

Two years since a petition of over three thousand signatories to the NSW Legislative Assembly to instruct the Minister for Health to provide immediate improvement to the Accident & Emergency, Critical Care and Perioperative services of the Eurobodalla Shire by funding and upgrading the existing infrastructure and workforce.

Why is this important? As health policy should be determined by clinical need, is there evidence supporting the aim of this petition?

Axiomatic, self-evident, obvious are adjectives which could be readily applied to the health needs of the Eurobodalla.


The following data is easily accessible from the Australian Institute for Health and Welfare - My Hospitals website : www.aihw.gov.au

The total number of Accident & Emergency presentations in the Eurobodalla in 2018/19 was 25,503.

This compares to 15,395 in the South East Regional Hospital, Bega and 16,983 in Goulburn Base Hospital.

Let’s now perform some anatomical dissection.


Semi-urgent cases accounted for;

· 12,847 presentations in the Eurobodalla

· 7,555 in SERH

· 7748 in Goulburn

Urgent cases made up;

· 9424 attendances compared to

· 5975 in Bega

· 7019 in Goulburn

Emergency presentations amounted to;

· 3169 cases as opposed to

· 1,812 in SERH

· 2139 in Goulburn

At the most extreme end of clinical emergency, 163 patients required resuscitation in the Eurobodalla, compared to 53 in SERH and 77 in Goulburn.

The total numbers are bleedingly obvious enough without the additional evidence that the number of most seriously ill patients requiring resuscitation are two to three times greater in the Eurobodalla.

After three years, our Accident and Emergency departments still lack the equivalent clinical support of a unified service with Accident & Emergency specialists, credentialled A&E VMOs and nurses as is provided in the neighbouring less clinically active units such as SERH, Bega and Goulburn Base Hospital.

The Moruya Accident & Emergency department which deals with the highest acuity of clinical emergency services has deteriorated physically and functionally to a point of lack of fitness for purpose.

The resultant highly stressful environment and lack of response to requests by senior clinical practitioners, well supported by the evidence above, has led to a breakdown of clinical leadership.

There is no specialist supported Close Observation Unit to provide current high dependency patient needs and to allow transition to Intensive Care services in a new regional Eurobodalla hospital with level 4 clinical services across the range of clinical streams before 2031.

Hence, our local health service continues to send approximately 100 patients per month outside the Eurobodalla by road or aeromedical transport for services which cannot be provided locally.

The service remains only 56% self-sufficient for clinical services.

So, one thing leads to another.

No improvement in Accident & Emergency services, no development of specialist Close Observation critical care services, no Intensive Care service on the opening of a new regional Eurobodalla hospital, no level 4 services in all clinical streams until 2031.

The development of Accident & Emergency services and Critical Care services in the Eurobodalla has to happen now and must match the clinical needs of this clinical evidence.

Our community does not deserve further equivocation on this issue from the NSW Government.

Sophistry

the use of clever but false arguments, especially with the intention of deceiving.

Equivocation

the use of ambiguous language to conceal the truth or to avoid committing oneself; prevarication.

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