About 20 obstetricians have threatened to resign from Blacktown hospital in western Sydney, as a government review is underway into the safety of the hospital’s birthing and maternity service following the deaths of four babies in less than two years.
The extensive review is being conducted by the New South Wales Health chief obstetrician and the Clinical Excellence Commission. It commenced in late August after Blacktown hospital confirmed that of about 6,000 babies delivered in the 18 months prior, four unexpected neonatal deaths had occurred. The final report is expected “soon”, Blacktown hospital general manager Ned Katrib told Guardian Australia.
“Providing safe and appropriate care for mothers and babies is our absolute priority at Blacktown hospital,” Katrib said. “The birthing and maternity service at Blacktown hospital continues to operate. We are listening to and working with our medical workforce to address their concerns.”
Those concerns, outlined in a complaint to NSW health minister, Brad Hazzard, include that the hospital is understaffed and that there is a lack of access to operating theatres for caesarean births, which is especially a concern when complications during childbirth occur.
“That is now immediately something that the management are looking at, trying to give better access to an operating theatre straight away rather than having to wait for a few hours,” Hazzard told the ABC Radio Sydney, adding that he had on Wednesday morning spoken to the father of the fourth newborn to die in the hospital. That baby died in June.
The obstetricians have threatened to resign next year.
“We will continue to assess the quality and safety of care provided, including staff resourcing,” Katrib said.
Hazzard, Western Sydney Local Health District chief executive Graham Loy, and director of medical services at Blacktown hospital, Dr Brett Gardiner, will address the concerns in a press conference at 1.30pm on Thursday.
A senior obstetrician working across hospitals in the district told Guardian Australia that Blacktown is one of the fastest growing populations in Australia and as a result, the obstetrics unit has grown busier over the years.
“The complexity of the cases has increased,” he said. “There’s a high Indigenous and non-English speaking community, and changes have occurred around maternal transfer procedures so Blacktown is taking a higher load of more complex obstetric cases. So you have a perfect storm of all these things happening and there have not been the staffing enhancements needed to keep pace with that.”
He said negotiations between the obstetricians who had threatened to quit and senior health department and hospital staff were ongoing and that he was hopeful of a positive outcome.
“A fresh look needs to be had at staffing support for senior and junior and midwifery and obstetrics, so the skill mix of the staff needs to be examined. There is a lot of work taking place at the negotiating table at the moment to try to find a solution and help the department navigate its way out of the current situation, and all parties are entering the process with the same goals in mind.
“Blacktown serves a high needs population and it’s important it has a strong and viable public obstetrics and gynaecology department. That’s what everyone agrees women deserve.”
National Association of Specialist Obstetricians and Gynaecologists president, associate professor Gino Pecoraro, said the issue of adequate resourcing for maternity services was a problem throughout Australia, and a result of undervaluing women’s health services.
“Inadequate, frozen and non-indexed Medicare rebates have affected access to specialist women’s health services in the community,” he said. “In addition, rising private health insurance premiums have seen many patients opt out of cover and pregnancy is excluded in all but the most expensive of policies. Up to 50% of spontaneous pregnancies in Australia are unplanned, and this all adds up to less and less expectant mothers going outside the free public system.
“This puts enormous pressure on a public system that was not designed nor properly funded to manage this volume of patients.”
A professor of midwifery at Western Sydney University, Hannah Dahlen, urged for people to wait for the results of the NSW Health review.
“I think we have to be very cautious about deaths over a period of time, as babies do unexpectedly die sometimes, not necessarily because of anything someone could or should have done,” Dahlen said. “You must investigate it, and do that proportionately to other hospitals with similar demographics and proportions of risk.
“Not all babies live, and that’s a sad reality which we must investigate properly and objectively.”
Executive director of the Australian Salaried Medical Officers’ Federation of NSW, Andrew Holland, said the federation had been caught off-guard by the resignation threat.
“There’s been no consultation with us,” he told radio station 2GB. “I don’t think it would have been the desired course of action we would have recommended.”
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