Loss of psychogeriatric beds from Dunedin hospital ‘crucial’ issue

Dunedin and Christchurch are the only places in the South Island to offer this type of care, and there is a long waiting list of unwell and at-risk people. Photo / George Heard

The loss of 12 psychogeriatric beds from the new Dunedin Hospital amid dire need is a “crucial” issue for the ageing community, an expert warns.

Consultant psychogeriatrician Professor Yoram Barak said an ageing population and a lack of other inpatient beds dedicated to mental health services for older people (MHSOP) in the lower South Island would mean extra strain on the sector.

This follows comments from Local Advisory Group chairman Pete Hodgson that the cut was “entirely sensible”, made in his opinion piece for Saturday’s edition of the Otago Daily Times.

Speaking to the paper yesterday, Hodgson acknowledged the increasing number of older people and said he was not going to argue with a clinician.

In December, the Government addressed a $200 million budget blowout by announcing a project funding boost of $110m, along with a $90m saving in costs achieved by making changes to the hospital design.

This included the loss of half the planned MHSOP beds, leaving the new hospital with 12 — the same number as the current hospital.

In his article, Hodgson said the reduction from 24 beds in the final design had been made because managers and clinicians were asking whether some patients would be better off being cared for in the community.

“These patients are sometimes very unwell and need close care, but equally, a hospital isn’t a great place for someone to spend a whole lot of time.”

They were the only beds cut from the hospital design, and in contrast, Southland Hospital had no MHSOP beds.

While this was too few, Dunedin probably had too many, and shell space meant more could be added in future.

Barak said he and other MHSOP consultants were surprised and concerned at the comments.

“We are all appalled by the implication a reduction is in any way a reasonable or a good idea.”

When the hospital design was discussed with them, they asked for 36 beds.

However, planners thought 24 would be enough, although this was less than the minimum requirement of World Health Organisation guidelines.

The reduction to 12 beds was a “crucial” issue for the ageing community, and he was not reassured by shell space.

“With the growing older adult population, the improvements in life expectancy for people with severe mental illness and the increasing numbers of people struggling with dementia, there is a dire need for 24 MHSOP acute inpatient beds.”

Between half and two-thirds of the people occupying these beds were there under the Mental Health Act.

They were a risk to themselves and others.

In such cases, there was no community solution.

“The great majority are here involuntarily — legally, they have to be inpatients.”

Dunedin and Christchurch were the only places on the South Island to offer this type of care, and there was a long waiting list of unwell and at-risk people.

When all dedicated MHSOP beds were occupied, patients in need of one would “very frequently” occupy a bed elsewhere in the hospital.

However, he was unsurprised that this issue was being ignored, because of the costs involved.

Te Whatu Ora Southern did not respond to the request for comment by the ODT deadline yesterday.