Risk seen in hospital plan

John Chambers.
John Chambers.
Having too wide a mix of patients in a hospital ward will increase the risk of complications, Dunedin Hospital ear, nose and throat specialist Martyn Fields says.

Mr Fields is opposed to the idea of managing complex patients in generalist wards.

The idea has been suggested in a Dunedin Hospital rebuild strategic plan.

At present, ENT patients share ward 5B with neurosurgery, neurology, ophthalmology and maxillofacial patients.

"There is a good reason why these specialties are placed together - we are all focused on the neck up. This means that we often have cases that overlap and require each other's skills and working as a team.

"This also applies to the nursing staff, who provide valuable additional skills when looking after head-injured patients, or those with airway and swallowing issues, for example,'' Mr Fields said.

Martyn Fields.
Martyn Fields.
The Otago Daily Times understands it is possible the "neck up'' specialties might be cared for in a generalist ward, depending on the outcome of the process.

"The idea of having a whole mixture of patients on a generalist ward does not make sense and will increase the risk of complications.''

Mr Fields believes that if the rebuild disadvantages the Dunedin School of Medicine, it will affect the city's ability to retain experienced specialists.

The Christchurch earthquake served as a reminder of the danger of over-centralisation, he said.

"Maintaining the medical school and a tertiary hospital in Dunedin should be considered essential by politicians and the public,'' Mr Fields said.

Emergency department specialist Dr John Chambers said he feared the new hospital would be smaller than it needed to be.

Placing too much emphasis on technology links and new "models of care'' could lead to wrong assumptions, he believed.

"It is essential that a new facility is fit for purpose, and has enough beds to meet patients' actual needs in the coming decades.

"Surely, if anything, there must be some spare capacity to meet any unanticipated growth in demand.

"There is danger of trying to be too analytical and, in the process, getting it all wrong.''

Dr Chambers was one of the board members who was dismissed by Health Minister Jonathan Coleman last June.

The Otago Daily Times is seeking the background information that formed the basis of the controversial strategic plan.

Last week, the Ministry of Health said it needed extra time, until September 5, to comply with the Official Information Act request.

The ministry said it needed the extension to consult the report writers, Sapere Research Group, and to collate the information.

eileen.goodwin@odt.co.nz

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