The continuing downgrading of Katoomba Hospital, the removal of frontline clinical staff with an incongruous simultaneous increase in executive management positions at the hospital is a symptom of wider problems in the NSW Health Department. We just need to look at basic facts to realise there is a huge problem.
Fact No. 1: NSW Health has now had five Health Ministers in four years. Doesn't that tell us something?
Fact No. 2: These continual failures and changes in leadership in the NSW Health Department have all been since the NSW Area Health Services were amalgamated into supersized Area Health Services. As recently as 2002, Katoomba Hospital used to be part the "Wentworth Area Health Service" covering Penrith and the Blue Mountains. When the Area Health Services were amalgamated, Katoomba Hospital became part of "Sydney West Area Health Service" which now includes hospitals and community services in an area covering Auburn in Sydney to Portland 150km away.
Fact No. 3: About every 15 years, some new bright spark comes up with the idea of amalgamating the Area Health Services, it becomes a dismal failure, and about fifteen years later they are divided up into smaller Area Health Services again.
Fact No. 4: Amalgamating the Area Health Services does not save any money. Lets say you were the Manager of Critical Care in the Old Wentworth Area Health Service. When the the Area Health Services were amalgamated, your position became redundant and you had to apply for the new position of Manager of Critical Care. If you were not successful in your application for the job, the Area Health Service declares you a "Displaced Person" and is obliged to find you "meaningful employment". That "meaningful employment" may be counting paperclips in the "Quality Unit", but you will still be paid at the rate you were paid in your previous position as Manager of Critical Care. So now two people are being paid for the one position.
Fact No. 5: The five NSW Health Ministers in four years coincides with the amalgamation of the super-sized Area Health Services. Coincidence? Synchronicity? Or is is it just because it has been a dismal failure.
Fact No. 6: Sydney West Area Health Service is now doing a "realignment" of services, doing away with the Network Streams (in typical Newspeak, management is firm in insisting that its not a "restructure" but a "realignment"- which has a new structure....sigh). Yet more "Displaced Persons" on the way?
What are the side effects of all this? Well, centralized management of a Super-sized Area Health Service cannot possibly effectively manage smaller regional facilities so their solution is to centralize services into major hospitals and make all the regional hospitals "train stops on the way" to where the central services are. Problem is, Katoomba Hospital is an hour by ambulance to Nepean Hospital- hence babies born on the highway. Which brings us to Fact No. 7: Katoomba is NOT a suburb of Sydney. I should know, I live here. For all other purposes (eg, postal services) Katoomba is treated as a regional area. If I get a piece of large equipment delivered from Sydney I have to pay for delivery charges outside of Sydney. Yet Katoomba Hospital is not allowed to be called a Rural Hospital, Rural Hospitals are entitled to more funding to attract doctors.
The management of Katoomba Hospital have failed to advocate for the Hospital and instead are the lackeys of the failing Sydney West Area Health Service whose CEO has received two votes of no confidence from Doctors at Westmead Hospital.