Public health service in crisis

November 11, 2016

The 2015 Annual Report from Barwon Health revealed a budget deficit of $13 million. Barwon Health is Victoria’s largest regional health service and Geelong’s largest employer, with more than 7000 employees across all its operations.

Barwon Health’s board aims for small surpluses, but the report revealed the 2015–16 operating deficit contributed to a total net deficit of $22 million after depreciation and other capital items were accounted for.

This follows an operating surplus of $1.3 million last year, and net surpluses in the two years prior to that. The last net deficit was recorded in 2011–12. Barwon Health has not pinpointed specific reasons for the sudden downturn.

Victoria’s Minister for Health Jill Hennessy has already moved to fix the financial mess, revealing she has appointed her own delegate to the Barwon Health board. Former Austin Health, Alfred Health and Red Cross Blood Service chief Jennifer Williams started in that role in July as Belinda Moyes stepped in to the role of CEO. Williams holds the same powers as the other nine members on the Barwon Health board and reports directly to the Minister for Health.

It has been revealed to Green Left Weekly that on October 22 an internal memo was emailed to all staff at Barwon Health from Moyes, announcing 30 bed closures in the University Hospital Geelong to address the budget deficit. The memo also announced a new 22-bed short stay ward to “reduce the pressure on the Emergency Department (ED) and improve flow to inpatient beds throughout the hospital”.

These bed closures and openings have been explained as “a necessary realignment”, in which “underutilised beds” are to be realigned to meet new projected operating costs to address the budget deficit. It was also revealed that a high use of casual and agency staff had contributed to the deficit and this would be addressed by ensuring staff vacancies were filled as soon as possible.

The bed closures will affect nursing, cleaning and allied health staff, particularly staff on Birdsey Wing 7, a general medical ward of 24 beds, which is set to completely close and align with Baxter 7 where 10 beds will open.

Other bed closures include eight beds in a short stay surgical ward, four beds in a vascular and plastic surgery ward and four beds in a cardiology ward.

Barwon Health has promised that all staff will be redeployed to fill current vacancies at other Barwon Health sites as well as staffing the proposed short stay ward.

The Australian Nursing and Midwifery Federation (ANMF) and the Health Workers Union (HWU), whose members are the most affected by these bed closures, are in the process of talking to staff and Barwon Health management to assess the impact of these changes. The proposed changes are set to take effect in December.

A Barwon Health employee and nurse told Green Left Weekly: “What the Geelong community needs to be asking is where has all the money gone?” The Minister for Health said Barwon Health was given a $20 million funding boost in 2015–16 and an additional $33 million this year.

This funding may have been enough for the growing regional health service, but last year Barwon Health decided to rebrand Geelong Hospital as University Hospital Geelong, a move costing thousands if not millions in signage, letterheads, uniforms and infrastructure changes.

Given the $13 million deficit, how can closing 30 beds, while opening 22 beds address the bottom line? The proposed new short stay ward next to the ED will ease congestion there and help prevent patients from staying in the ED more than 24 hours, which results in Barwon Health receiving a fine.

However, moving patients from ED — where highly specialised and qualified staff deal with all kinds of critical events — to a short stay ward may impact on the quality of care patients receive.

Barwon Health currently employs a large bank of casual nursing and other staff, who will struggle to get enough work in the foreseeable future, motivating many to leave and deplete the pool of casual staff that generally cover sick, annual and long service leave.

This is the state of the public health service and the question needs to be asked: is it capable of meeting community need? Funding cuts at a federal and state level have made healthcare increasingly out of reach of the poor and even “well paid” workers.

Meanwhile, the private healthcare system benefits from billions of dollars in direct and indirect government subsidies. While Geelong’s only public hospital “shuffles deck chairs on the Titanic” to recover from the deficit, Geelong’s third private hospital opened its doors in July in the southern suburbs. Epworth Geelong received $22.5 million in federal and state grants to get up and running.

On November 2, the ANMF held a members’ meeting on site at University Hospital Geelong, attended by about 200 nursing staff, who were angry and upset at the moves to close beds. Most ANMF members present at the meeting were concerned about the impact the bed closures would have on the Geelong community rather than their own uncertainties over their jobs.

The meeting passed resolutions, with ANMF members voting unanimously to refuse to cooperate with Barwon Health’s plans until more information about the budget deficit and the impact of the bed closures on the bottom line is explained. Members also voted to approach the state government to impress upon them the devastating effect these bed closures will have on the Geelong community.

ANMF delegates will meet with Barwon Health managers to put these resolutions to them and to renegotiate the timeframe of the proposed changes.

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