Fate of private services hangs in the balance at Northern Beaches Hospital

The Minns government is primed to announce the fate of private services at the Northern Beaches Hospital on Tuesday, as senior specialists warn a wholesale takeover by the public system would be disastrous for the community.

Staff were in the dark on Monday about the future of the hospital and its almost 200 private patient beds before the planned announcement, which was confirmed by health sector sources unauthorised to speak publicly.

Tuesday’s announcement about the hospital’s future comes after a series of controversies and follows the falling into receivership of operator Healthscope in May. The spotlight on the hospital also intensified after the death of two-year-old Joe Massa last year, which led to “Joe’s law”, which bans future public-private partnerships in hospitals.

Private doctors say they fear the government would not only seize control of the hospital’s public services, but that it would also shutter or significantly reduce private services, leading to a blowout in planned surgery wait time and additional strain on the public system.

The union representing doctors employed directly by the hospital said the government’s takeover and the end to the public-private partnership would be a critical step towards improving conditions and patient care.

On Friday, during the first hearing of a parliamentary inquiry into the hospital, doctors representing the northern beaches medical advisory committee said removing private services would result in services closing, longer surgical waitlists and increased pressure on the public system.

Dr David Jollow, the committee’s chair and director of women’s health at the hospital, said reintegrating public services into the state hospital system “makes absolute sense” but losing the 20,000 private surgeries performed each year would put immense strain on public waitlists.

“We don’t want to throw the baby out with the bathwater,” he said. “Our concern is if we can’t provide that service, a lot of that work will end up on a public waiting list.”

Associate Professor Vijay Solanki, the hospital’s director of cardiac services, said private billing had allowed the hospital to develop an around-the-clock heart attack service for public and private patients. The angiogram service might also be unviable without the volume of elective angiograms funded by private health cover, he said.

Many staff members were considering leaving and one nurse from the cath lab team had resigned “citing a lack of certainty about the future of the hospital”, Solanki told the inquiry.

Data from industry group Private Health Australia shows 79 per cent of the northern beaches population, more than 211,000 people, have private health insurance, significantly higher than the 55 per cent of people nationwide.

Healthscope chief executive Tino La Spina defended the hospital’s positive performance on key metrics, and staff who had continued to serve the community “under intense public scrutiny”.

“Our people have been spat on, shouted at, had their tyres slashed, [and been] unfairly vilified,” he told the inquiry. “The hospital is held to a higher standard than any other hospital in NSW.”

AMA NSW president Dr Kathryn Austin said any suggestion the hospital would become a fully public operation was “a slap in the face” to a community promised 20 years of high-level private healthcare.

“It is also a betrayal to more than 200 senior Northern Beaches Hospital doctors who recently voted unanimously to retain private health services,” Austin said, referring to a recent Medical Staff Council meeting.

Austin said it was disrespectful that staff had not been informed about their hospital’s future and that they were relying on chatter and hearsay.

“This is not a step forward,” she said. “The voices of the community and dedicated clinicians have been trampled and both deserved better.”

Australian Salaried Medical Officers Federation NSW president Dr Nicholas Spooner said the transition to public control would be critical to addressing long-standing understaffing, overwork and exhaustion issues.

“The people of NSW expect their government to lead, invest and deliver in public health, not delegate it to private providers who only care about profits,” Spooner said.

Healthscope is responsible for delivering services to public and private patients under the hospital’s model. The company went into receivership in May during negotiations to hand back Northern Beaches Hospital and sell its 37 other Australian hospitals.

In April, a NSW auditor-general’s report found the hospital failed to act on warnings about risks to patient safety and outcomes, while a separate independent probe found staff had a “heightened awareness” of the hospital’s contract with the government, which could create tensions between financial imperatives and clinical priorities.

NSW and federal governments have ruled out any bailout for Healthscope’s owner, Canadian-American investment firm Brookfield, which owes $1.6 billion to lenders. Health Minister Ryan Park has said the hospital will not lose any of its 488 beds or its status as a level-five tertiary hospital.

The premier’s office declined to comment.

With Alexandra Smith

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