Twenty new emergency beds at the Royal Children’s Hospital will be left empty when a long-awaited, multimillion-dollar redevelopment is completed in November because the health service lacks the staff to use them, a damning leaked internal email reveals.
In a scathing memo sent to staff earlier this month, the hospital’s director of emergency medicine, Dr Stuart Lewena, accused the state government of turning down a desperate funding request for more frontline doctors and nurses be able to open the beds, despite record numbers of sick children flooding to the health service.
“On the 10th of November, the builders will be gone, and the 20 additional beds will be ours,” Lewena wrote in internal email sent to staff on September 11. “Unfortunately, we will not be able to open any of them due to lack of staff.”
The senior doctor warned that patient care for Victorian children was already being impacted by severe staffing shortage and chronic under-resourcing.
He alleged the government had rejected a “responsible and modest” request for operational funding to allow the 20 beds to be opened and staffed.
“Despite our best efforts, the standard of care we would like to deliver and believe our patients deserve [is] being compromised,” he wrote.
The 20-bed expansion was intended to be a turning point after years of overcrowding at hospital and was meant to increase the department’s capacity by about 50 per cent.
“It is not enough just to build new facilities. They must be able to operate,” he wrote to staff.
Lewena said the emergency department had been plagued by “flawed planning” since moving into its current building in 2011, which was originally built for 60,000 children a year.
By 2018, it was treating more than 80,000 children every year, forcing staff to expand into nearby spaces and work in areas never designed for emergency medicine, he said.
“Since moving into this building in 2011, our ED has been grossly undersized for the size of the work to be performed,” Lewena said.
Lewena said the emergency department at Victoria’s major specialist paediatric and flagship hospital had exceeded its capacity within the first year of relocating to its new building at Flemington Road in Parkville.
He warned the hospital’s emergency department was now treating about 90,000 children a year, roughly 50 per cent more than the 60,000 annual presentations the existing department was designed to accommodate.
The senior doctor also lashed the government over suggestions that the pressure mounting on the hospital could be alleviated by diverting children with less serious conditions away from its emergency department.
He said a claim that children who “should have seen their GP” are clogging the department is “not the problem”.
“We cannot allow thinking that blames patients for the failings within the system,” he wrote.
Lewena said the “so-called” lower-acuity category 4 and 5 patients represented about a third of presentations and include children who require emergency treatment.
He said that in an audit earlier this year, this cohort included children with conditions such as appendicitis, pneumonia, septic arthritis, new diagnosis of leukaemia and other serious conditions that cannot be treated by GPs or virtually.
Only about 10 per cent of category 4 and 5 patients are deemed suitable for GP care following assessment, he said.
The email also claimed that independent benchmarking showed the Royal Children’s Hospital had the lowest nursing and medical staffing levels among children’s hospital emergency departments across Australia.
Lewena cited a recent Australasian College for Emergency Medicine annual site census, which he said found an Australian emergency department that treated a comparable number of patients had, on average, 40 per cent more nurses, 50 per cent more doctors and 60 per cent greater access to emergency assessment beds than the Royal Children’s.
“Calling us undersized and understaffed is not an opinion, but is backed up by facts,” he wrote.
Lewena said the hospital’s leadership supported the department’s staffing requirements for the 20 new beds.
The hospital has previously reported wait times in its emergency department had blown out to 12 hours on occassions where there had been extraordinarily high patient demand.
A spokeswoman for the Royal Children’s Hospital said the health service was on track to complete the redevelopment of the emergency department later this year.
“We are continuing to work with the Department of Health to provide improved access to emergency care for children and young people as part of all urgent care services in Victoria,” she said.
The state government did not answer a detailed list of questions from The Age about the rejection of its funding submission, current emergency department staffing deficits, or when the new beds would open to patients.
However, a government spokeswoman said the works at the Royal Children’s Hospital emergency department were due to be completed this year.
“We’re working closely with the hospital to transition services into the expanded emergency department once works are complete,” she said.
The government said it had invested more than $32.3 billion in Victoria’s health system this year and that it continued to work with the hospital on the operational and workforce arrangements for the expanded emergency department.
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Melissa Cunningham is a health reporter for The Age. She has previously covered crime and justice.Connect via X or email.From our partners
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