An 11-year fight has been portrayed as a turf war between doctors. And yet, the decision-making rests with others.
In March 2020, Elizabeth Crouch, a stern-looking woman in her mid-50s, became chair of the Sydney Children’s Hospitals Network. The pandemic had only just started as she took on one of the toughest jobs in the state, governing the network responsible for the two biggest children’s hospitals in NSW: the Sydney Children’s Hospital at Randwick, in the city’s east, and the Children’s Hospital at Westmead, in the west.
The Sydney Children’s Hospitals Network has more than 8000 employees. Its size means that if it were a public company, it would rank among the 200 biggest corporations on the Australian sharemarket. The Children’s Hospital at Westmead and Sydney Children’s Hospital in Randwick have been a loggerheads for 11 years over the provision of paediatric cardiothoracic surgical services.
A similar argument was made in a 2008 report by then special counsel, Peter Garling, who led the Special Commission of Inquiry into Acute Care Services in NSW Public Hospitals. Instead, in 2010, after a succession of Labor premiers, the short-lived Keneally government established the Sydney Children’s Hospitals Network to oversee both institutions.The Children’s Hospital Westmead and the Sydney Children’s Hospital at Randwick have very different cultures, and also different approaches to care delivery models. When the network was formed not enough attention was given to how different those approaches were.
The conflict over the delivery of cardiac services has flared again, though it never went away. It was raised in parliamentary hearings recently, in the media, and in a petition. There’s also the prospect of a protest being launched by Randwick doctors and senior medical staff next month. “The current situation of only having two surgeons doing the majority of work, with one covering Randwick, will improve to where we’ll have one in four on-call, plus an additional surgeon at Randwick.”
As far back as 2012, a decision was made that more complex paediatric cardiothoracic surgery would be centralised at Westmead, and that cardiac services could be delivered by one team across two hospitals. John Awad, a paediatric cardiac anaesthetist at Randwick, recently said that “75 per cent of the state’s critically ill children” that need to be sent to a paediatric ICU, arrive at that campus. He said this at a Randwick Council meeting, as he sought support for the hospital staff’s concerns about only being allowed by the state government to provide low-complexity cardiac services.
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