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Cardiology boss slams “covert downgrade” of QEH

The head of cardiology at the Queen Elizabeth Hospital has accused Labor of failing to live up to its promises for his unit, penning an extraordinary open letter that accuses the State Government of misleading the public.

Feb 12, 2018, updated Feb 12, 2018
Photo: Tony Lewis / InDaily

Photo: Tony Lewis / InDaily

And Transport Minister and western suburbs MP Stephen Mullighan says he is inclined to correct the record over a statement he sent to a constituent regarding the cardiology unit, last month.

Cardiology head John Horowitz claims medical services have been “covertly” downgraded at the QEH despite Premier Jay Weatherill committing his government to maintaining key functions at the hospital and announcing a $270 million capital upgrade mid-last year.

“The current continuing downgrade of the QEH makes a mockery of the government’s pledge to restore important specialist services at the hospital,” reads the open letter, co-authored by prominent Transforming Health critic emeritus professor Warren Jones.

The letter warns Health Minister Peter Malinauskas to “review the covert downgrading of the QEH” or risk the ire of residents of Adelaide’s western suburbs at next month’s state election.

Horowitz, the director of cardiology at the QEH and professor of cardiology at the University of Adelaide, accuses Malinauskas of failing to live up to promises and presiding over declining staffing levels, insufficient funding and a failure to replace ageing equipment at the cardiology unit.

But Malinauskas says recruitment to allow for a full 24/7 service at the unit was underway, that new equipment for it had been procured – and more was to come – and that the first stage of the redevelopment of the QEH would begin in the coming month.

“The purpose of this open letter is to inform residents of the western suburbs of Adelaide that your public promises of full restoration of services at the Queen Elizabeth Hospital are not being kept,” Horowitz’ and Jones’ letter reads.

“In fact, the damage to these services is ongoing on a stealthy but continuous basis (… and) evidence for any restoration at the Queen Elizabeth is essentially non-existent: in fact the opposite is true.

“To date, no specifics of the plan for the ‘enlargement’ of the QEH Emergency Department have been made public apart from the advertising of such a move.”

The letter says that a “partial curfew” was imposed two months ago, preventing the admission of heart attack patients to the QEH after hours and at weekends.

Patients are instead diverted to the Royal Adelaide Hospital instead out-of-hours.

“The basis for this diversion is the contention that out-of-hours anaesthetic cover at QEH is now suboptimal; a situation caused by your department,” the letter says.

“What this means, Minister, is that you have restricted access to treatment of emergency cardiac patients at QEH.

“This is an unprecedented act by a politician.”

The letter also contests local MP and Transport Minister Stephen Mullighan’s claim in a letter to one of his constituents in January, that the QEH had “not had a 24/7 cardiac service for a number of years”.

The senior cardiologist writes that the unit had “always” been an unrestricted 24-hour service “until the recent curfew was imposed”.

In a statement to InDaily this afternoon Mullighan conceded he would correct the statement.

“The information I provided to my constituent was based on advice previously provided to me by SA Health some time ago and I’m more than happy to correct it,” he said.

“It’s disappointing that Warren Jones, who as we know is assisting Nick Xenophon’s SA Best team at the election, is continuing to denigrate the Labor Government’s fully funded commitment to upgrade the cardiac facilities at the QEH as well as the fully funded and tendered $270 million third stage of the QEH redevelopment.”

Further, the open letter says that four senior cardiologists and research staff have relocated to hospitals in the eastern states over the past 18 months because no appointments have been available to them at the QEH.

“Worse has happened regarding junior medical staff, nursing, cardiac technologist and scientist positions, and absolutely no efforts have been made thus far to replace these individuals.

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“Since the Premier’s announcement 7 months ago, no real effort has been made to replace ageing equipment in the cardiac catheterisation laboratories, vital for treating heart attacks and other immediate intervention conditions.

“With tenders for this equipment not yet called for, the June/July advertised date for the restoration of services is nothing short of a fantasy.”

Horowitz told InDaily that over the past two years senior cardiologists, junior medical staff, cardiac technologists and scientists had been lost from the QEH.

“It’s important to appreciate the full scale of this,” said Horowitz.

“I just want the place to be functional.

“The staff are doing a great job – it is functional (but) we’re being asked to do more than we really should be asked to do.”

However, Malinauskas told InDaily this afternoon the Government had announced details of its QEH redevelopment late last year, and that its recruitment efforts for the cardiology unit were well underway “to enable the restoration of 24/7 emergency cardiac cover at the QEH as soon as possible”.

“This recruitment process is nearly complete,” he said.

“Nurse staffing within the angiography/cardiac services is at appropriate levels.

“Recruitment for permanent staff is in process with applications closing at the end of this week.”

He said Horowitz was “part of the project group leading the work associated with the cardiac service” and that four additional echo technicians had already been recruited.

“They are going through an orientation program and once completed these additional staff will add to the pool of technicians working between TQEH and RAH,” he said.

“Recruitment for the additional staff to support the after-hours service will require four full-time equivalent anaesthetic training registrars, who cannot be recruited until June when the next intake of registrars occurs.

“The first stage of the QEH redevelopment is due to begin in the coming month, starting with the demolition of two houses on the site to enable the 500 space carpark build to begin.”

He added that an “extensive audit” of all cardiology equipment had been completed and as a result: “Two ECG machines for cardiology have already been procured, with final decisions over cardiology upgrade requirements currently awaiting agreement by cardiology clinicians, including Professor Horowitz.”

Horowitz was restored as director of cardiology in August last year following an eight-month suspension over an allegation of bullying.

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