Hospital defends number of beds

11.45am

Auckland District Health Board (DHB) denies the city's new hospital will not have enough beds and says it is just being run in a different manner than before.

Auckland Hospital orthopaedic trauma director Bruce Twaddle has been censured after he last week criticised the lack of beds at the new Auckland City Hospital.

On Friday Mr Twaddle was called before Auckland Hospital general manager Meng Cheong to account for reported and televised comments saying restrictions on resources were compromising patient care.

Executive director of the Association of Salaried Medical Specialists, Ian Powell, has labelled the questioning of Mr Twaddle a "witch-hunt", saying his contract allowed him to speak out about concerns over patient safety.

DHB interim chief executive Garry Smith today responded, saying the new hospital would have enough resources to cope.

Mr Twaddle's comments that upset managers were published on October 3, the day before the new hospital opened.

He said his service was being reduced to 50 beds, from 54, despite caring for 70 patients. The extras would be put in non-orthopaedic wards, which was not ideal.

"The restriction of resources that we will continue to face compromises the care we can give to our patients," he said.

Mr Smith said today the new facility, once completed, would have 1062 beds -- about 75 fewer than were currently available -- but had the potential to move up to 1206 beds.

The new service would be run differently and medical staff had to adjust to that.

"... the significant issue about the new hospital is that it's designed to be able to open and close beds based on demand," he told National Radio.

"There are two things happening, there's the new facility that has been design-built to be able to expand and retract ... and the other thing ... is that there has been a move of services to other DHBs.

"So you are not actually comparing like with like when you are purely looking at bed numbers."

For example, the current 54 orthopaedic beds would change to 50 base beds plus four in the assessment and planning unit.

"What we're moving to is a new facility that works in a different way to optimise the use of our resources," Mr Smith said.

"All services flex ... based on demand, and orthopaedics at the moment in Auckland, only performs predominantly acute surgery. That will change next June, when we have elective surgery as well."

Mr Twaddle has previously criticised what he considers insufficient orthopaedic resources. But tensions between him and the board go back to a Sunday programme last year when the chairman, Wayne Brown, ridiculed him during an attack on doctors, for which he later apologised.

After the show, Mr Twaddle said alienating staff was counter-productive and Mr Brown should be fired.

Mr Smith said the board and Mr Twaddle had been in discussions about the changes since planning began four years ago.

Some of the issues raised by Mr Twaddle were valid points that the board was considering, including his assertion there could be unacceptable waits for operating theatres.

Mr Smith said the clinical board had discussed the problem and wanted to work with Mr Twaddle on it.

He accepted Mr Twaddle's right to speak out about safety concerns but said there were appropriate ways he could do that.

"I can't be drawn on Mr Twaddle's (case specifically) because of privacy issues, but can I say that there is no outright ban on staff speaking out on patient safety issues," Mr Smith said.

"There is a policy within our organisation and processes that we expect when people speak on behalf of Auckland DHB, that we work through with our clinical leadership model and our clinical board."

Ten Auckland City Hospital orthopaedic surgeons have signed a letter to Mr Cheong, objecting to the handling of staff criticism.

It was believed intensive care specialists Dr Les Galler and Dr Gill Hood were given formal warnings over their assertions, on a Sunday television current affairs programme in April of ill-preparedness for the severe acute respiratory syndrome (Sars) outbreak.

- NZPA