Former health chief criticises ICU bed reduction at new Dunedin Hospital

Work is under way on the new Dunedin Hospital, which will now feature 20 intensive care unit beds instead of the 30 originally planned. Photo / RNZ / Tess Brunton

• Health New Zealand has cut the number of ICU beds for the new Dunedin Hospital from 30 to 20.
• Dr John Chambers warns fewer ICU beds could lead to surgery cancellations and prolonged emergency department stays.
• Health Minister Simeon Brown says the changes are based on updated demand modelling and the total number of beds remains unchanged.

By Tess Brunton of RNZ

A former health chief says cutting the number of available intensive care beds planned for the new Dunedin Hospital is taking chances with the region’s health.

Thirty intensive care unit beds were originally planned, with capacity for a further 10 beds.

But Health New Zealand has cut the number of ICU beds to 20 on opening, with room to increase to 40 beds in the future.

Health Minister Simeon Brown said the total number of ICU beds had not changed and the Government was committed to getting a new Dunedin Hospital built.

After months of uncertainty and delays, it was welcome news when Brown confirmed the fate of the new Dunedin Hospital, albeit a scaled-back version, in January.

Now, months later, he has been facing flak for not revealing the new build would not have as many ICU beds when doors open.

The former head of Dunedin Hospital’s emergency department, Dr John Chambers, said the public was in the dark about the ICU beds, which were critical to how a modern hospital functions.

Fewer beds could impact patients, he said.

“There’s nothing worse for a patient than to have their complex surgery cancelled because of a lack of intensive care beds for post operative care, and similarly in the emergency department, there’s nothing worse having to keep a very ill patient in the emergency department for prolonged periods of time because there’s no bed in intensive care,” Chambers said.

He was also a former Southern District Health Board member and said the current hospital had struggled with its intensive care unit, which had partly prompted the call for a new build.

Chambers said it had taken years to refit the current unit, causing many surgery delays or cancellations, so it was not enough to simply leave space for more beds.

“What you don’t want to do is open a hospital and then be depending on it failing to open up more beds,” he said.

“This whole business of using a shell-type model to plan for the future means that at any point in the future, the argument will have to be made that we need more intensive care beds because we’re not coping.”

In January, Health New Zealand advised the then-Health Minister Dr Shane Reti about proposed new bed modelling that would reduce ICU bed numbers while increasing the number of other bed types, particularly medical surgical or ambulatory beds.

Officials found the proposal met forecast demand on opening and followed a consistent nationwide approach to demand modelling.

But Chambers wants to see the original plan go ahead.

“If anything, you should plan in some spare capacity to cope with surges, to cope with unexpected increases in population,” he said.

“To try and cut it so fine is just taking too much chances with the healthcare of a population.”

Changes guided by more up-to-date modelling, says Health NZ

Labour Party leader Chris Hipkins said the entire lower South Island depended on the hospital so it needed to be built as promised.

“The National Party lied to New Zealanders about the Dunedin Hospital rebuild before the election when they said they were going to do the full-scale Dunedin Hospital rebuild. They have backtracked on that several times,” Hipkins said.

“This is just the latest broken promise when it comes to Dunedin Hospital.”

Images of the concept design of the new Dunedin Hospital have been released.

In response, Brown said the Labour Party had failed to deliver on the new Dunedin Hospital while in office and now the Government was getting on with it.

“The new Dunedin Hospital will future-proof the provision of timely, quality healthcare for the people of Dunedin and the surrounding Otago and Southland regions,” he said.

The total number of ICU and high dependency unit beds had not changed from the detailed business case, Brown said.

Health New Zealand head of infrastructure delivery Blake Lepper said the changes to bed numbers and types had been guided by more up-to-date national modelling and a recent assessment on expected demand.

The current proposal had the same number of beds overall and part of the shell space would be used as an interim workspace, he said.

“The additional spaces earmarked for future fit out have been informed by the updated modelling and current thinking about models of care,” Lepper said.

“We will continue to work with our staff, our regional colleagues, and our wider stakeholders in planning how best to provide the health services our community needs now and into the future.”

Work on the new Dunedin Hospital’s inpatient building was expected to resume from mid-year.

– RNZ