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Mental Health and Wellbeing – Closure of St Helens Private Hospital

Dr Rosalie Woodruff MP

Dr Rosalie Woodruff MP  -  Monday, 5 June 2023

Tags: Mental Health, State Budget

Dr WOODRUFF - Premier, I've listened closely to your responses in parliament to the questions we've asked, and I'm listening to what you and Mr Webster are saying now. I suppose what I hear is you never address the reality that on 23 June, the majority of services that are provided to people – life-saving services to many - will not be available anywhere else in the public health system. They just will not be.

People who are patients, and people who are psychiatrists working there now, they want you to say those words. They want you to be honest about the fact that we're in a desperate situation, and you are there with them and you're open to every option. Why aren't you being honest about the fact that there will not be TMS available for months or years because you can't whistle up the places?

Why aren't you being honest to the two psychiatrists who, between them, have 38 years of experience and maybe 3000 patients, and who have told us, publicly, that they're closing their books because there is nowhere else for them to deliver their services?

Can you be honest and say, yes, this is a terrible situation, we don't have the solutions, we want to hear your ideas?

Mr ROCKLIFF - We're working on the solutions, Dr Woodruff. I have been very honest around the real challenges that this situation has presented. I have spoken many times about it and I'm very concerned. We are extremely disappointed in Healthscope. Discussions are underway about establishing the TMS chairs for the two private providers, including the Hobart Clinic, as I think Dale mentioned.

In the longer term, TMS services are also being considered within the north and the north west mental health precincts. ECT is a medical procedure used to treat psychiatric conditions and involves the administration of a carefully controlled electric current to the brain. ECT aims to reduce the severity of depressive and psychotic symptoms.

ECT is available within the public health care system in Tasmania, delivered in the Tasmanian health service, and via the Hobart Day Surgery, with the patients under the care of the Hobart Clinic. I'm advised that the capacity of these services, as an example, can be expanded to match any increase in demand.

The Hobart Clinic, I'm advised, are in discussions with private psychiatrists and the Department of Health about the transition of inpatient and day programs from St Helens Private Hospital to their centres in the Hobart CBD and Rokeby.

We acknowledge also that some of the patients who would normally receive inpatient treatment and care at St Helens will not necessarily have the level of acuity typically seen in public inpatient services as St Helens is not a gazetted facility. Their needs and preferences regarding their treatment and care may be better provided within alternative subacute or community based environments, such as the newly opened 12 bed Peacock Centre, the Hobart Clinic, the Mental Health Hospital in the Home, Detox at Home or other settings.

In addition to these options, a further 27 beds will come online with the completion of a new St Johns Park facility in Newtown in 2025.

Dr WOODRUFF - Please give us the dignity of not parroting things you've already said. We only have another 35 minutes left to ask these questions. We've heard all this before. You know yourself there's a gap between 23 June 2023 and 2025.

Dr John Saul, the head of the AMA, called out the sort of rubbery numbers that you're using on St Johns Park, and he said:

When you look at the 2019 master plan, we were looking at 85 beds being promised for the repat development.

When you look at this proposed St Johns facility, all that's mentioned so far is an additional 15 beds and 12 beds for eating disorders, and you've been announcing that every year, I think, since I've been an MP.

What he says is we've lost 31 beds at St Helens and, sadly, the numbers don't add up. When Mr Webster says this cohort of patients are not necessarily those that would come to a public health hospital, I'm telling you, they may well be, because of the desperation of not having services on 23 June.

What are you going to do about it?

I would love to hear you really reaching into the suggestions that have been offered, like from Dr Tim Lane, about getting medi-hotels for some of those mothers who are receiving treatment at the moment. He says it very clearly: they do not need a paediatric ward in a hospital. Have you investigated that option?

Mr ROCKLIFF - We're working on a range of options. We understand the seriousness of the situation, Dr Woodruff. It is a huge challenge and we want as much care to continue as practicably possible. You mentioned Dr Saul, who I have a lot of respect for. He mentioned bed numbers and what he thought may well be the situation. Mr Webster would you update the committee on that.

Dr WOODRUFF - It is a huge loss of beds.

Mr WEBSTER - There is no loss of beds with the move from repat to St Johns Park. Dr Saul has mixed up different options. We were always Roy Fagan to repat, now we're moving it to St Johns Park. Same number of beds. The repat was going to have the mental health in-patient unit from the Royal. The same number of beds will move out to St Johns Park.

The 15 mental health beds and eating disorders beds are in addition to those that are in the master plan and were planned originally for repat, now planned for St Johns Park. We haven't reduced them from 85 to 15. We have moved them from the repat site to the St Johns Park.

Dr WOODRUFF - But they're negative 31 beds that are no longer at St Helen's.

Dr WOODRUFF - Premier, in relation to the St John's Park precinct which apparently is going to be completed in 2025.



Mr ROCKLIFF - One stage will be.

Dr WOODRUFF - The eating disorder and the other 15 beds, is that right? Okay. It does sounds as though it is nice; it's got this parkland and green spaces and so on, which should be a nice place to recuperate and heal. However, it has also been promised to Kickstart Arts. Josh Madgwick, who is with Kickstart Arts, has been working for some time now on a trauma history interpretation. You are probably aware that that precinct has a very dark past, dating back to the 1830s. It was the original location of Queen's Orphan Asylum and it housed Aboriginal children and children from poor families, in squalid conditions, between 1833 and 1879; 46 years of horror. Then it housed the New Town Invalid Asylum and was a treatment centre for tuberculosis and people with polio. It has the two historic buildings which, I understand, were handed in 2018 to Kickstart Arts and they were going to do a trauma history.

Can you tell me what's happened to that commitment to Kickstart Arts, and how they say, according to reports on the ABC, that they do not know what is happening with the redevelopment of the heritage buildings that they are going to occupy; they have not been informed of any plans to move them out; they put considerable time and effort into revitalising those buildings. What is happening?

Mr ROCKLIFF - We have committed $2 million to the master plan, which will engage with all key stakeholders in the community on the various stages, including the eating disorders service. I might throw to Dale first.

Mr WEBSTER - If you are familiar with the site, the 2025 building, that is stage one, is in fact on the upper side above the where the obelisk is; it is on the top side of that. It is a site that had sheds et cetera, which were demolished and it has been cleared now for a couple of years. The DA has gone through the process, and we have gone to tender on that building. It is nowhere near the historic buildings on the site. The closest is a hall that is occupied by the Friends of St Johns; that is the closest building to the 2025 mental health building.

All the other buildings are not buildings, they are coloured blocks on a site, so that we can go through a consultation process about what goes into the future. It is a master plan over a long period of time, but the commitment for the St John's mental health building and eating disorders service has been in existence now for a number of years and, as I said, it is well-advanced, to the point of going to tender.

Mrs MORGAN-WICKS - We have a lease with Kickstart Arts in relation to about four buildings on the site, noting that nothing in the proposed master plan vision is impacting on those particular buildings or on the tenancy of Kickstart Arts. We will engage with them as co-tenants in relation to the site and what the impact is going to be. As part of that master plan, we have clearly outlined the significant and dark history of the site; but, importantly, health has had a relationship with St John's Park, with the buildings, and with the property itself for a very long time. As part of this, we are trying to push this forward as a positive redevelopment of the site, that we can invest in and achieve a further 50-100 years use of the site - noting that, at the moment, we believe the use is not optimised.

Dr WOODRUFF - Thank you. There is obviously a crossed wire with Kickstart Arts about their understanding about the announcement that was made about the-

Mr ROCKLIFF - Definitely be engaging with Kickstart Arts, yes.

Dr WOODRUFF - Yes, good. I don't know the history of this, but it is said that more than 400 children have may been buried there at the orphanage. It certainly would have been the case, they would not have been taken very far when they died, in the 1830s. That is a horrific, traumatic part of Tasmania's history that needs to be deeply investigated and respected, and not covered over or in any way ignored in the process.

Mr ROCKLIFF - I could not agree more.

Mrs MORGAN-WICKS - That's why conservation management plans are so critical and liaising with the Friends of the orphanage. We are very aware of the locations of the burial land that is there, and the impacts on the site. That is being taken into account by the architect that we have had involved, who has also been closely involved with the Friends of the orphanage and key stakeholders. We are very sensitive to that heritage, but we also note that this is a site that does need to have its history called out but sensitively shared with the community. It is an ideal location to actually have sensitive trauma-informed care provided for the Hobart community.

Dr WOODRUFF - Thank you. Minister, do you have a time frame for stage 2 and 3 of the development? When do you expect them to be completed?

Mr ROCKLIFF - We will work through that in the master plan process. The idea of investing in the master plan is to do just that, and then stage the redevelopment over a period of time. Hopefully at the completion of the master plan we will have very clear ideas and time frames for stages.

Dr WOODRUFF - Thank you. Do you accept that stage 1 - which, if I am correct, is due to be finished at the end of 2025, you said?

Mr ROCKLIFF - The first part of 2025.

Dr WOODRUFF - Do you believe there is any risk that this would be completely disrupted with your plans to build a stadium? You have these ideas that you can build a billion-dollar stadium in four years, when you cannot build ambulance stations around the state. It is a heroic idea, and one of the many concerns is that it will suck everything out of the construction sector around the state.

Mr ROCKLIFF - It is a very long bow.

Dr WOODRUFF - Not really. Actually, I think it is a very short bow. Anyone who is involved in construction would know this. Are you confident that construction will be completed on time?

Mr ROCKLIFF - Yes, I am confident. We have some major construction with the Bridgewater Bridge. I mentioned this morning, Dr Woodruff, the infrastructure budget of the last budget was I think $5.6 billion. This one is just under $5 billion over the next four years, so I am very confident we will do our absolute best.

Dr WOODRUFF - You can ring-fence the budget- but you cannot ring-fence the tradies. You cannot do everything immediately, with a limited number of people in Tasmania, can you?

Mr ROCKLIFF - We come out to tender. Health have had good success to bring on infrastructure, so I am confident. Thank you.