Problems at Nepean Hospital

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The Nepean Hospital at the foot of the Blue Mountains is the key tertiary care hospital providing services to constituents from my electorate. It provides critical health and emergency care services to more than 350,000 people.

The Baird Government has starved it of critical funds, which has placed staff and patients under severe stress. 

I condemn the Baird Government and the Minister for Health for reneging on the $360 million election promise to adequately fund Nepean Hospital.

This Government lies; it does not care about those who live in Western Sydney. It has an ideological fixation with cutting services, and forcing the working class and the poorest in our society to pay for basic, essential services.

The mental health unit at Nepean Hospital is in crisis. On NSW Health's own reckoning, mental health services for my constituents are completely underfunded—operating with less than half the funding necessary to meet community need.

Last week in my contribution to debate on the Health Practitioner Regulation National Law (NSW) Amendment (Review) Bill 2016 I foreshadowed the bed block and staffing shortages at Nepean Hospital that were extensively covered by the ABC the next day. Those shortages make it impossible for staff to provide appropriate care for patients with mental illness.

The emergency department at Nepean Hospital is overworked as staff struggle to deal with the number of patients requiring care. A busy emergency department is not the best environment for someone who is experiencing an acute mental health crisis, but each shift six to 12 mental health patients present at Nepean Hospital emergency department.

The Psychiatric Emergency Care Centre [PECC] at Nepean Hospital is intended to take patients from 48 to 72 hours. But for the past couple of years it has been operating as an over-flow area, where patients requiring hospitalisation may remain for more than six days, which is against the PECC guidelines, due to an ongoing bed shortage.

In 2014 the shiny new mental health unit opened with high dependency and acute facilities. But staffing problems continue to besiege the unit with an over-reliance on casual staff and overtime.

The older people's unit has closed intermittently due to a lack of staff to cover those high dependency and acute units. 

The assessment unit was built with an ambulance bay so that distressed patients or high-risk patients could be brought into the unit safely by ambulance or police without causing distress to other patients in the mental health unit. To the disgrace of the Baird Government and the Minister for Health, this assessment unit has never been opened.

In addition to bed block, there is human resources [HR] block. Recruitment practices are extremely slow, with some positions taking up to eight months to be finalised. Thus casuals and permanent staff feel pressured to fill shifts by working overtime or double shifts—I am told this happens every day. 

This practice costs the State money.

Indeed, it impacts not only the health of workers but also the quality and level of care provided to patients by overworked, tired staff. In addition to the shortage of nursing and health services staff at the hospital, there is also a shortage of doctors—some patients wait up to a week to see a doctor.

Many doctors have told me that they are either leaving or planning to leave because of the poor working conditions and patient overload, which impacts lengths of stay and discharge planning for patients. Aside from staffing problems, there are also problems with the facility itself.

Disappointingly, the new facilities are already showing signs of wear and neglect. 

Doors have been kicked in, toilets are often blocked and window coverings in the seclusion room have been pulled off. What is the point in building a new health facility if the Government is unwilling to adequately fund the maintenance and cleaning of it? And that is what is required to run a hospital.

Nepean Hospital must have its maintenance budgets restored and expanded, and its staffing resources boosted.

Patients must have quality care provided by full-time, permanent medical staff that are well rested and not overworked to the point of exhaustion and collapse.

If Premier Mike Baird and his Minister have no interest in running hospitals on a day-to-day basis then they should get out of the business of governing New South Wales.

The delivery of essential health services is the core business of State Government.

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