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St Helens Private Hospital - Effect of Closure

Dr Rosalie Woodruff MP

Dr Rosalie Woodruff MP  -  Wednesday, 10 May 2023

Tags: Health, Hospitals

Dr WOODRUFF (Franklin) - Mr Speaker, I move -

That the House -

(1) Notes on 2 May 2023, Healthscope announced the impending closure of the St Helens Private Hospital, with operations ceasing in June 2023.

(2) Recognises the invaluable contribution to our health services of the 39 mental health beds provided by the hospital, including eight dedicated Mother Baby unit beds.

(3) Understands that the Mother Baby mental health unit at the St Helens hospital is the only such facility currently available in the state.

(4) Further understands the vital nature of the specialised mental health services delivered by the hospital such as Transcranial magnetic stimulation (TMS) and Electroconvulsive therapy (ECT).

(5) Further recognises the vital role that the hospital has played in the provision of these mental health services to the Tasmanian community, especially to our veteran community and emergency services community.

(6) Calls on the Rockliff Government to commit to examining the viability of purchasing and upgrading the facility to ensure the vital services of this facility carry on and provide continuity of care to the community.

Most people in Tasmania would not have heard of St Helens Private Hospital, but many thousands of Tasmanians nonetheless rely on that service for their mental health and wellbeing. It is a place that guides them through a process of recovery. For some people it is literally a lifeline. It keeps people safe from harm and safe from very dark places.

It was a shock for staff and patients and for their families to hear out of nowhere that the private provider Healthscope was pulling up stumps. Staff got no notice: they heard on the day everyone else heard. That was just over a week ago now. It was the same day that the Premier was making an announcement about the stadium. So, we have two much talked about facilities, and, here we are today, raising this issue because there is something that can be done here and more importantly, there is something that must be done here.

Before I start I recognise in the Chamber Madison and her mother Linda. It is great that they can be here to join us to today. Madison is one of the hundreds of people who receive regular treatment at the St Helens clinic. There are 31 beds devoted to mental health treatment at St Helens, and eight beds specifically for mothers and their babies and recovery.

However, it is with the therapy groups that some of the most important work is done at St Helens. The therapy groups have thousands of patients, thousands of people who use those groups. They are very structured groups. The experience that Madison and others have passed on to me is utter distress and fear from patients and from staff at the prospect of that treatment and care, that recovery process, being removed altogether.

I have spoken to medical professionals from St Helens. They have told me that they have patients sobbing, really scared, because they do not know what is going to happen at the end of June. It is very soon.

In our view, Healthscope is utterly abandoning any responsibilities as a provider of health care and they are treating it, just as we have come to see the majority of private health care providers treat their businesses, as investment opportunities. When Healthscope made the announcement it was to make the point that it is not a viable investment opportunity any longer.

Healthscope has had an opportunity to do something, to adopt an asset management program. They have owned that premises for more than 20 years. They could easily, like any functioning business or organisation, put the maintenance of that building one their asset register, and they clearly have never done that.

We have had staff say that they have utterly absented themselves, especially in the period since Brookfield, the Canadian healthcare firm took over Healthscope in 2019. They have completely absented themselves from doing any of the most basic fixing work. There is no surprise that the building is in decline.

It is also very clear from talking to staff and patients, as we have, that the opportunity of St Helens Private Hospital to provide first-class treatment and care for people in mental health distress and who need mental health support and addiction support is enormous. It is the sort of place that people could look forward to having a fantastic recovery journey because it is not a clinical environment. It is not a formal health facility in that clinical and rather cold way as they need to be. That is not what people need.

We heard from Dr Tim Jones, who is a specialist GP at the Glebe Hill Family Practice and he works at St Helens Private Hospital in the mother and baby unit. He said putting three mothers and babies beds into the paediatric unit at the Royal Hobart Hospital, as the Premier is proposing, is a start but a busy paediatric unit is already stretched. It is hardly meeting its capacity on most days, let alone in colder months. He said it is not going to be the safe and private environment that families need to work through some of their issues.

It is also not the place that women who have suffered traumatic birth experiences would want to return to. They actually do not want to be in a hospital environment at all and often the relationship between postnatal depression and traumatic birth delivery is very strong. That is one of the many reasons why returning to a hospital environment for nurturing and healing is entirely inappropriate. It is not the response that is needed. It is important to have somewhere for these people to go, but it is not the response that we need for the medium to long term.

It is also three beds out of 39. We are really concerned that the Government has only spoken about mums and bubs. Everyone cares about mums and bubs.

There has been no attention from the Premier about the vast majority of people at the Hobart Private Hospital and they are people in mental health recovery. There are 111 patients there now who have TMS, transmagnetic treatment, and that is life-saving. It keeps people from suicide and self-harm. It provides people with an opportunity for recovery. Typically it is prescribed as a treatment for people who have tried other treatments and they have not been successful. It is very effective treatment. It is high-quality treatment. There has never been a question asked about the quality of the treatment that is provided. There does not seem to be any question that St Helens Private Hospital is in anyway incapable of providing high-quality treatment.

The question is what is going to happen? What is going to happen to those more than 2000 patients who are on the books of the senior psychiatrist, who has spoken out in the media. She is Dr Marzena Rybak who has, I understand, more than 2000 patients on her books.

The psychology rooms which are the most critical part of the work for many people has more than 1000 patients on its books. They provide long-term recovery. They provide therapy groups which keep people sober and well; that keep people in mental health distress from self-harm; that provide dialectical behaviour therapy (DBT). DBT is very effective and it is a part of people being able to live a functioning life. There is no other place for these people to go. There is nowhere else in Tasmania that provides long-term recovery.

There are many places that do excellent work in mental health: The Peacock Centre and its peer-led programs are important. That is not a place that provides this sort of expert therapy group, it just is not. The Hobart Clinic on the eastern shore has one TMS machine. St Helen's has five. There is nowhere else for people to go; 111 people who receive a session of TMS for five days in a row, typically returning within a four to six week time frame. Those people have nowhere else to go. There are no psychiatrists for them to go to and even if there were, they cannot provide a TMS service.

What will happen at the end of June is that those people will have nowhere to go and when they are in mental health distress, if they are lucky they might get to a GP who will be able to do nothing to help them. That person will refer to a psychiatrist who does not exist. Then they may end up in the emergency department, which is already in a ramp situation. Although we commend the Premier for attempting to find the Mother and Baby Unit in the Royal Hobart Hospital, it is a fact that those three beds that are being created as a mother and baby unit are not new beds. They will displace inpatients, so there is a loss of three beds to the Royal Hobart Hospital. We are not arguing priorities here. We are just stating the facts.

It is a lose-lose situation for everyone. It seems to us that the obvious way forward here is to investigate taking over that property. Healthscope has owned it for more than 20 years. They bought it from Mayne, which is another company. Healthscope has been taken over by Brookfield. Staff have told me that it is not surprising that the building is run down to the level it is because they have not invested and done standard upgrades for years. When Healthscope announced that they were pulling out, they said that they were closing it because they had concerns about the quality of the infrastructure for mental health patients. They blamed it on the heritage-listed building but they are the ones that stopped doing any maintenance on the building years before.

Healthscope is also being untruthful when they are saying that demand for services is dropping. They have noted that as another reason for why they are pulling out but it is not about a lack of demand. In fact, demand is increasing. They have not been keeping their staff up to the numbers needed. I understand at the moment there are 97 staff at St Helens Private Hospital - 97 educated professionals - doctors, nurses and other staff - who will not have a job. All those skills will dissipate to go where? They will not have the facilities to work at. There are not 39 beds elsewhere in the system for them to go to and work at.

It is true that some of the psychiatrists may start up a new practice but that will not involve the sort of long-term recovery therapy groups which is providing so much feeling and relief and healthcare for - we do not know the exact numbers -- seemingly more than 1000 people who are on the books for those groups. Those people meet in small groups of 10 to15, weekly, for three hours. It is an enormously successful program.

When we asked the Premier this morning about whether he would consider looking at the site as a purchase for the public health system, he said:

We are not contemplating buying St Helens Private; it is a landlocked, ageing, heritage-listed hospital facility that is not fit for purpose; Healthscope and private healthcare is not fit for purpose for public sector services either. It is simply not fit for purpose.

That does not stack up with anything I have heard from any of the staff or patients at all. I just fact-checked this with Madison. We had a conversation specifically about this. The point was made very clearly: it is about refurbishing and upgrade. Structurally, the building does the job it has done for 20, 30, 40, 50 years. It is a rock-solid building. There is nothing with a heritage-listed building. In fact, it is exactly the sort of place, if it were lovingly done up, that people would really feel very comfortable going to for mental health recovery. That is exactly the sort of place that we should be providing for people. That is what first-class healthcare would look like in the mental health sector.

We do not want people in mental health stress to go into a clinical, institutional setting. We do not want what the Premier seemed to be referring to: a 21st-century health environment for patients. It is not contemporary, it is not modern. I put it to you, Premier, since you are in the Chamber: that is entirely appropriate to have contemporary and modern surroundings for a hospital but it is not what you need when you are in mental health recovery. You want a beautiful heritage. You want one that has been painted, that has had the roof replaced, that has new electrics.

There is a big difference between a hospital and a mental health recovery centre. We do not need to have a one-size-fits-all cookie-cutter approach, particularly in this area. We implore the Premier to look beyond that narrow frame and perhaps to understand that the resources and the energy that he has put into the stadium over the last year would be exactly what Tasmanians expect him to put into finding good public health facilities.

We have something that is sitting there. It is on the table. It is a conversation we have to have. We have to be having it deeply and widely. There should be a proper cost-benefit assessment. Yes, it might cost money to do up the building but, gee, it costs a lot of money to build it from scratch. It sure does. It takes years and years.

When the Premier's office was asked about what other places could be available for a person to go to a therapy group, his office said there is a place in North Hobart, a facility that is opening. Then the question was asked when it would be ready. Not until 2025. These are people who are at St Helen's who are living from day-to-day and as one staff member said, this is what is keeping them alive. Their regular TMS treatments are keeping them alive. As a member of Living Well Women, one of the groups there, Pip Swan said:

It's devastated all of us, many of us were in tears, we are in shock, disbelief, at the fact that we are having our safety net, our hospital, taken away from us. We've been running that group for 15 years now, in the same room, and to think that's going to shut down is damaging all of us.

There has never been a mention from these patients about the types of rooms they are meeting in. We absolutely agree they need to be fixed up. It is so typical of a private health company that looks at investment opportunities rather than at people's health and wellbeing, that they would leave it without any maintenance, any effort, just to run down, to milk what they can, probably waiting for property prices to go up to a point where it makes it worthwhile to dump it and move on somewhere else.

They are abandoning people and it is shameful that they are doing that. Pip Swan also said that many of the women in her group accessed other treatments at the hospital, including transcranial magnetic stimulation, and that is the only approved and effective therapy for treatment-resistant depression. It is for a very particular group of people who have needs that have attempted to be met by other medications and other treatments but have failed. TMS can be successful for those people.

It is not just the people who are on that service, it takes months and months to get into St Helens at the moment. Madison said that she only got accepted to come into a group in May, but she had been on a waiting list since October. Other people at the moment talk about being on a waiting list for more than a year. It is not just the people there who will not have a service in a month's time, it is all the people who are on the waiting list, the thousands of people on the patient record list of the health professionals working there, the psychiatrists and the psychologists, who will also not have anywhere to go. It is very concerning to think about what will happen for them.

Some people are fighting back. I commend the strength of the people who have put petitions together. There is an online petition titled 'St Helens Private Hospital Hobart needs a lifeline' and, as of today, 2659 people have signed that. It raises the issue of what is happening and the number of staff who are working there, the thousands of patients with serious and ongoing mental health conditions, also the Australian defence veterans who use that service and frontline emergency service workers. It is a whole range of people in the community, but it is a very important and a specific service for our veteran and emergency worker communities. They include nurses and ambulance officers, police officers and firefighters. The mother and baby unit is unfortunately the only focus the Premier has taken so far and that is a shame, because all those other people are equally worthy and deserving of government support and our attention.

We do not accept that this is the end of the road and not worthy of investigating. It is something the Premier has avoided doing. To be frank, it has been a year of relentless focus on the stadium and it is hard not to think why the Government did not see this coming.

Ms O'Connor - The part-time Health minister.

Dr WOODRUFF - Well, he has not been available to put his full energies into the most important issue for the majority of Tasmanians, a health service which is there for them and a public one at that. At the moment, the people who are patients will just be left to fend for themselves. There is no direction for people who are getting mental health services from St Helens. I think the Premier has mentioned talking to NGOs about their capacity, but we know they are over capacity. We know the opportunity for them to take up some of the slack is zero because there is no extra fat in the mental health system or in the health system and especially not in the community sector.

It is not good enough to palm it off to the community sector. It is the direct responsibility of the Government. We implore the Premier to look very seriously at this and to support this motion today, which is simply to do a proper examination of the viability of purchasing and upgrading the facilities to make sure these vital services carry on and provide continuity to the community. Is there an opportunity to step in and lease the building in the short term? There obviously is an opportunity to buy the building and to seriously consider the role that this important facility can play. It is perfectly located near the Repat centre, close to the CBD, very accessible to families and to patients. That is the perfect place to keep a service like this. We cannot have a situation where people are left to free range with no support and no direction about where to go other than to toddle off to your GP, because GPs are overloaded and cannot provide the therapy groups and the specialist TMS services that people need.

On behalf of all the patients and staff at St Helens, the people who have contacted us and the people who are desperately hoping that the Premier will do something real to recognise the high-quality service they provide and to keep that continuity of care, we ask the Premier to support this motion and do a proper investigation into purchasing that site and bringing it into the public health system.

Ms O'Connor - Hear, hear.