The Weatherill Government must extend its woefully inadequate consultation period for its planned health cuts following a strong challenge to its plans for the care of our sickest babies from a leading obstetrician
The former head of Obstetrics at Flinders Medical Centre, Emeritus Professor Warren Jones AO, has cast grave doubt over the accuracy and viability of the Weatherill Government’s plan to transfer the most acutely ill newborns (known as Level 6 neonates) from Flinders to the Women’s and Children’s Hospital1.
Last week, the Health Minister Jack Snelling said that 10 to 15 babies a year may be transferred from Flinders. Professor Jones estimates that there are around 260 potential transferees each year.
“Once again the Weatherill Government has been caught misleading the public regarding the impacts of its planned health cuts,” said Shadow Health Minister Stephen Wade.
“Yesterday, 14 Noarlunga doctors debunked the Weatherill Government’s plans for emergency care plans, today Prof Jones is exposing their claims on neonatal care.
“The Labor Government’s cynical strategy is backfiring – you can’t reassure people by starving them of critical information when leading clinicians are continually exposing the dangers of the Government’s proposals.
In a post on the ‘Save the FMC NICU’ page, Professor Jones wrote:
“The public attempts by the Minister and his advisers to minimise the effects of the proposed closure of the FMC Level 6 Neonatal Intensive Care Unit (NICU) have resulted in a confusing portrayal of the numbers of babies likely to be transferred out of the Unit. The numbers 10 or 15 “very small babies” have been bandied about in attempts to allay community fears.
In fact, the number is around 260 potential transferees, and includes not only low birth weight/pre-term babies, but many others who require Level 6 care.
Professor Jones went on to highlight that the threat to the Unit is a threat to Flinders Medical Centre maternal and neonatal services as a whole:
The gradual, but relentless, erosion of the workload of the Unit will result in its closure. This, in turn, will lead to loss of staff, loss of medical and nursing training posts in obstetrics and neonatal care, otherwise unnecessary transfer/referral of complicated obstetric cases to the WCH, and ultimately, downgrading of Maternal/Neonatal services from Tertiary to Secondary status.
This scenario is an inevitable result of the Transforming Health recommendation to close the FMC Level 6 NICU.”
The Weatherill Labor Government’s Transforming Heath plan also breaks a clear commitment to maintain a full-service Neonatal Intensive Care Unit (NICU) at Flinders Medical Centre.
In a release on 20 February 2014, Premier Weatherill declared “Labor will re-develop the neonatal unit at Flinders Medical Centre to make sure our sickest babies get the best possible care.”
Yet, the Transforming Health Proposals Paper states:
The new Women’s and Children’s Hospital will co-locate and become integrated with the new RAH.
Flinders Medical Centre will continue to provide care for all but the most extremely sick babies. The most acutely ill newborns (known as Level 6 neonates) will be cared for at the Women’s and Children’s Hospital, ensuring medical staff can specialise and share expertise for this small number of highly vulnerable babies.1
“The only way for this health reform process to get back of track is for the Government to transform its approach – if they are serious about improving health care, if they are serious about consulting with the community, the Minister must release full details of all the proposals in the paper, extend the time for consultation and develop a credible strategy to engage clinicians and communities,” Shadow Health Minister Stephen Wade said.
The Minister needs to be clear about:
- the neonatal facilities planned for each of the spine hospital sites;
- any new rules as to when a birth could not be planned to be at FMC; and
- the maximum level of care that would be available at FMC before he says that a baby must be transferred to WCH.
In another Save the FMC NICU post last night, Professor Jones explained the term “Level 6 neonate”:
“Level 6 care is what is generally known as Neonatal lntensive Care (NICU). A Level 6 Unit provides care for babies with a gestational age of less than 33 weeks or with a body weight of less than 1500G who require invasive ventilation (endotracheal) or non-invasive ventilatory support.
"Other problems requiring Level 6 care are listed below. Some of these are associated with ventilatory support or convalescence from it. Others have one or more of these problems unrelated to a need for respiratory support:
- Arterial lines
- Centralvenous Iines and parenteral nutrition (hypomotile gut or hypoglycaemia)
- Chest drain (collapsed lung)
- Peritoneal dialysis or exchange transfusion (rare)
- Persistent low oxygen levels (unusual)
Overall, there are 260 babies who need care each year in the FMC Level 6 Neonatal Intensive Care Unit.”
Emeritus Professor Warren Jones AO, former Head of Obstetrics at FMC, was a founding Professor of Obstetrics and Gynaecology at Flinders University and is a pioneer in assisted reproduction and the immunology of reproduction.
1: Delivering Transforming Health: Proposals Paper, February 2015, page 31