In an email to department heads and medical staff, Bathurst Health Service general manager David Wright announced on Wednesday that “from 3 June 2013 the Surgical Ward will be staffed to 15 beds” – a cut of five beds.

Members of the Bathurst Medical Staff Council say there has been no consultation about the cuts and that it is “purely about saving money”.

Council member Dr Ian Elbourne said there was no evidence of any cutbacks to the “top heavy bureaucracy”.

“We’re not hearing from [Western NSW Local Health District] CEO Scott McLachlan that there is any serious addressing of that side of things,” he said. 

“He’s just deflecting the issue to those under him.”

Dr Elbourne said, in terms of use of resources, Bathurst does better than “big brother” [Orange].

“On a population basis, we receive a tiny fraction of the funding Orange receives, but we do more work than they do,” he said.

“For example, our casualty unit is half the size but does two thirds of the work.

“Orange is a monster that grows without any restraint, and we have to ask whether we have any future here.

“Our populations are the same, but our hospital is tiny by comparison.

“It would be politically unacceptable for our hospital to be downgraded – people would oust the local member, no matter how popular he was.

“The reality is that, by trimming the edges, they can kill it a different way.”

Dr Elbourne stressed that he didn’t want to see Bathurst hospital “become Orange”.

“We want Bathurst to remain generalist – small enough that we maintain the current culture and attract the right sort of people,” he said.

Dr Elbourne said he has some sympathy for Mr Wright.

“The bureaucrats in Dubbo have told him to save money and have told him how they want him to do it,” he said.

“There has been no consultation with the staff.”

Dr Elbourne said there has been a change in the way Bathurst Base Hospital is funded.

“Funding used to be based on the amount received the previous year, now funding is based on what is done at the hospital,” he said.

“Bathurst is an unfortunate facility in terms of its size.

“It’s not as small as Rylstone, Oberon or Lithgow, which are funded differently because of their exceptional status, and not as big as some of the bigger hospitals which get paid more for performing the same work.”

Dr Elbourne said an example of this was Bathurst’s intensive care unit.

“Our intensive care unit has the lowest rate of death by sepsis [infection] anywhere in the state,” he said.

“Despite this, funding for each bed in the unit is $10,000 less per day than that received by Orange.”

Dr Elbourne said he understood there was no intention to “sack anyone”.

“There are eight to 10 vacancies across the hospital, so the intention will be to crossfill from existing positions,” he said.

IN his email announcing the cuts to the surgical ward beds, Bathurst Health Service general manager David Wright noted that the hospital’s “performance in regard to patient throughput and patient flow has improved significantly in 2012 and 2013”.

“Similar numbers of patients are being admitted but are staying for shorter periods of time,” the email said.

“As a result of this improvement, demand for hospital inpatient beds has decreased, resulting in a limited use of the Hospital Surge capacity in 2013.

“While there has been sustained improvement to patient flow, Bathurst Health Service is facing an underlying deficit in which immediate action needs to be taken to decrease expenditure, further improve patient flow, and promote efficient patient management practices.”

The Western Advocate contacted the Western NSW Local Health District for confirmation of the cuts and to seek an interview.

In an email response, the following comments were made, with a note to attribute them to general manager of Bathurst Health Service, David Wright:

“From 3 June 2013 the Surgical Ward in the hospital will be staffed to 15 beds with a capacity to surge if activity requires additional beds to open.

“There will be no impact on direct patient care as a result of this change and beds will continue to be staffed according to the NSW Nurses and Midwives Award.

“The Bathurst Health Service is always looking at improving the way care is provided to patients by identifying opportunities to improve the long-term sustainability of services. Performance is continually improving with admitted patients staying for shorter periods of time and utilising fewer beds.

“The Health Service is consulting with staff and the NSW Nurses and Midwives Association about the changes.

“There will be opportunity for those impacted by the strategy to be deployed to other areas of the hospital.

“The improved utilisation of beds at Bathurst has been due a number of factors including:

An increase in the number of medical registrars working at the hospital;

Improvements to the hospital’s admission policy meaning that patients are admitted under specialist medical teams;

Improvements in the management of palliative care patients;

Recruitment to several key medical and nursing roles.”