Labor loses out, fight for surgical program at children’s hospital continues

by GRACE JOHNSON

Labor councillors have lost their motion to rescind support for the retention of paediatric cardiac services at Sydney Children’s Hospital at an extraordinary council meeting held at Randwick City Council last night, meaning the fight to reinstate critical services for sick children will continue.

The Labor councillors on the Randwick City Council, three out of the fifteen total, put forward a notice of rescission motion, following Mayor Philipa Veitch’s mayoral minute on October 24. Council had resolved to write to the NSW Premier and the NSW Minister for Health and Medical Research, requesting that the State Government restore and maintain an appropriately funded program for paediatric cardiac surgeries, including cardiac bypass, at the Sydney Children’s Hospital.

Council also resolved that the Mayor and General Manager meet with the Health Minister in relation to this matter, and use social media channels to promote the petition to save the paediatric cardiac services. 

Labor councillors were against this, and put forward a notice of rescission motion, which lost at last night’s extraordinary council meeting.

Mayor of Randwick Philipa Veitch told City Hub, “I’m very happy that the notice of rescission motion lost last night.”

“Now we can begin the real work of reinstating critical services at the Sydney Children’s Hospital.”

Councillors Dylan Parker, Alexandra Luxford and Kathy Neilson, who had put forward the motion to rescind support, seems to have been confused about the situation.

It seems that they were under the impression that NSW Health Minister Ryan Park had offered a briefing to the Mayor and General Manager about stopping medium to high complexity cardiac services at Sydney Children’s Hospital. Their motion to rescind thus requested “That Council defer consideration until the offered briefing to the Mayor and General Manager from the Minister for Health has been accepted and has occurred.”

No such briefing was offered.

Misguided decisions

In July, the health minister wrote to Sydney Children’s Hospital informing them that only low complexity surgeries would be able to go ahead – all medium to high complexity surgeries will be redirected to Westmead Children’s Hospital, over 30km away.

This decision was made without consulting neither the hospital, nor the council, nor other relevant committees.

Staff at the Sydney Children’s Hospital, devastated, wrote an open letter to the health minister. 

Medium complexity surgeries were stopped at the children’s hospital in Randwick in 2018 due to concerns about mortality rates.  The Royal Australasian College of Surgeons then conducted a review commissioned by NSW Health, which found that “analysis of survival rates at the two hospitals indicated no significant difference in 30-day mortality.”

The NSW Paediatric Cardiac Services Model of Care Panel made recommendations that low and medium complexity surgeries take place at both locations, concluding that the low number of high complexity cases would not support operation at two sites.

During the election process for the Legislative Assembly, Health Minister Ryan Park, Member for Coogee Marjorie O’Neill and Member for Kingsford Matt Thistlethwaite had all supported the reinstatement of cardiac surgeries, but have since backflipped on the decision, despite expert recommendations. At the time of publication, City Hub has reached out to the two Members but to no avail.

Run-on effects

What are the consequences of not having a cardiac surgery program at Sydney Children’s Hospital?

The short answer: there are many.

Dr Puneet Singh, who has worked as an Intensive Care Doctor for the past fifteen years, and Chair of Senior Medical Staff Council at Sydney Children’s Hospital, spoke to City Hub about the disastrous run-on effects the halted cardiac program will have, putting thousands of children’s lives at risk.

Dr Singh told City Hub that the cardiac surgery program is essential for safe provision of extracorporeal membrane oxygenation (ECMO) at the hospital.

“ECMO is not just for children with heart problems. It’s for children with trauma, cancer, pneumonia, sepsis, airway disease, for babies born with illnesses at Royal Women’s Hospital and babies transferred to Sydney Children’s Hospital from all over New South Wales.”

The cardiac bypass service used during children’s cardiac surgery is also used for windpipe reconstruction surgery and major blood vessel surgery.

“We can currently handle emergency situations with the ECMO service. And because we have experience of previously doing cardiac surgery for more than three decades and doing regular emergency drills and simulations,” said Dr Singh.

“But we need regular surgery to maintain the skills of all staff, not just the surgeon. This includes ICU doctors, ICU nurses, operating theatre nurses, anaesthetists and perfusionists.  It’s a whole team,” he emphasised.

His analogy was trying to fly an airplane in difficult weather conditions when you have not been regularly flying in good conditions.

Dr Singh said that there have not yet been tragic consequences of having to transfer a child between hospitals.

“But are we waiting for a death to happen? These are still critically ill children being transferred, which is preventable by providing cardiac bypass surgery services at Randwick.”

SCH supports children from all over NSW

The Sydney Children’s Hospital supports children not only in the area but from all over New South Wales.

In the 2022-2023 period, Sydney Children’s Hospital received 1068 admissions to their Intensive Care Unit.

50 per cent of all admissions were within the 50km radius.

20 per cent came from a 51-100km radius, and 10 per cent from a 101-200km radius.

The remaining 20 per cent came from all parts of New South Wales, but also from different states, including Western Australia and South Australia.

Some children have already had to be transferred over 30km to Children’s Hospital Westmead (CHW) while in a critical condition. The trip can take an hour or more, depending on traffic.

Longstanding competition between Randwick and Westmead

The children’s hospitals at Randwick and Westmead were merged into the Sydney Children’s Network in 2010. The two hospitals have reportedly been competing for status and funding since 1962. 

There have been some benefits to the merger, including the ability to share patient files. The network is also the largest paediatric health entity in Australia, so there is a political edge, too.

It’s when the competition between the hospitals starts to compromise patient care that it becomes a problem, and this is well on the way to happening.