The WA Government is proceeding with plans to build the state’s new Women and Babies Hospital on the Fiona Stanley Hospital site in Murdoch, rather than in the QEII precinct in Nedlands, despite opposition from community groups and the Australian Medical Association.
Construction of the new hospital is scheduled to start in 2024. It is being built to replace the current King Edward Memorial Hospital which is in Subiaco, the suburb adjacent to Nedlands. In 2020 the McGowan Labor Government announced the new hospital would be built at QEII, but in April 2023 said it would be built in Murdoch instead.
In October The West Australian, WA Today and ABC reported that they had received a draft internal postition paper from someone in the Child and Adolescent Health Service (CAHS) and a letter signed by 145 doctors raising concerns about the move.
The chief executive of CAHS, Valerie Jovanovic, was quick to dismiss the draft position paper however, telling the ABC: “This document is not endorsed by the Child and Adolescent Health Service executive or board. CAHS understands the decision to relocate the project to the Fiona Stanley Hospital precinct, given the myriad of risks outlined in the business case.”
The media outlets that received the doctors’ letter reported that it warned the move could cause “death or disability to neonates in need of time-critical care”.
The new Murdoch location is 20km south of Perth Children’s Hospital (PCH), which is on the QEII site, and the time it will take to transfer patients from the new hospital to QEII could vary from 20 minutes to more than two hours depending on the time of day and road conditions.
Asked about the relocation, Premier Roger Cook said: “Already many children get born at Fiona Stanley Hospital. In fact, it’s one of our busiest obstetric services in WA. So having the Women and Babies Hospital located close to there is not in itself a bad thing.”
But building the new hospital at QEII would have offered ‘tri-location’, with the new facility neighbouring PCH and Sir Charles Gairdner Hospital, which are both tertiary hospitals and both in the QEII precinct. The leaked draft position paper reportedly highlighted a preference among medical professionals for tri-location.
This claim is supported by a statement released by the Australian Medical Association (WA) in July that said: “The location of the replacement King Edward Memorial Hospital must be determined by clinical requirements, reflecting international best-practice standards for healthcare delivery …In particular, this entails its tri-location with tertiary or quaternary Adult and Paediatric hospitals to ensure the sickest patients can receive timely, life-saving care.”
Western Australia is currently the only state in Australian without tri-located hospitals.
Asked about tri-location and the QEII site, Premier Cook said: “We consider the location of the Women and Babies hospital on the QEII site an important objective. It’s been that way since the Reed Review back in the early 2000s. But the fact of the matter remains that QEII is a very difficult site to build on. We saw that with the PCH construction, and in fact, we should have actually had the Women and Babies Hospital built there before we moved the children’s hospital. Now history has simply dealt us a different hand and so we have to make do with the situation that we have.”
The Experts
The relocation announcement shocked many in the health industry, including the Australian Medical Association (AMA), Australia Nursing Federation (ANF) and patient advocacy groups like Helping Little Hands (HLH), who have all since said that there was a lack consultation by the Government prior to the announcement in April.
“Doctors were absolutely blindsided by the change of intended location of the new Women’s and Babies Hospital,” AMA (WA) President Michael Page said.
He added: “There’s been a lot of intense work by doctors working closely in this field to create a plan [for the QEII site] that would work for generations of Western Australians. So when a political infrastructure-based decision was made without any consultation or even forewarning to doctors in the state, who were so heavily invested in the process up to that point, it was incredibly disappointing, disrespectful and insulting.”
He said the decision had created a rift between clinicians and the Government in WA, which is going to take some time to repair and effort to repair, as “we’ve seen, so far, insufficient effort by the Government to repair the relationship.”
ANF (WA) Secretary Janet Reah agreed that there had been a lack of consultation and said: “Nurses and midwives know what they are doing. They know their job and they know the patients that they care for, and to have no consultation with the stakeholders that are the most key – doctors, obstetricians, midwives, nurses and indeed the community – really smacks of a almost dictatorship approach by this Government.”
The other concern raised by the ANF was shortages in the healthcare workforce posing an ongoing risk to critical staffing of hospitals. At the top of the list of critically short staff are the state’s midwives, who are essential to maternity hospitals.
Family concerns
Families with lived experience of the anguish of time-critical travel for newborns can shed light on what this move may mean in the long term.
Sarah and Brad Girvan’s son Noah required immediate transportation from King Edward Hospital to Perth Children’s Hospital when complications arose.
Mrs Girvan said: “If Noah hadn’t actually been transferred so quickly … he would have died.”
She explained: “Had they not been able to transfer him in that really short amount of time, that decision would have been taken away from us regardless, and he would have been palliated and he wouldn’t be here right now.”
Helping Little Hands is a charitable organisation that provides support to families of premature babies, like the Girvans.
Founder Joanne Beedie said: “We are strongly advocating right now for the reversal of this decision to move the new Women and Babies Hospital from the Nedlands site to Murdoch as this is something we believe so passionately about.”
Sharing Mrs Girvan’s frustration at the lack of consultation Mrs Beedie said: “We are so angry at the lack of consultation, the lack of understanding and the lack of insight into the dangers of a move to the Murdoch location.”
Asked what he would say to mothers whose children are in need of time-critical care Premier Cook said: “In many cases they will continue to receive the same level of care they need. By having the Women and Babies Hospital located closer to Jandakot airport as well, we know that women in childbirth facing complications in regional Western Australia, will actually receive care much sooner. So there are advantages to the new location.”
In response to this, Dr Page said: “I’d like to see the detail on exactly how that statement can be justified. But the reality is regionally-based patients do deserve the same level of health care as metropolitan patients and everything possible needs to be done to support that, but I’ve yet to see any firm evidence that the Murdoch site is preferable for those regional patients.
“Those patients will still need to travel from Murdoch to Perth Children’s Hospital if there is a complication requiring a child to be admitted to a tertiary children’s hospital.”
Charlotte Buxton whose son Angus was born prematurely, is concerned about what the relocation would mean for families like hers, who have had to endure daily trips to the hospital and the financial and mental toll it has taken on her family. She said: “We live north of the river and I was travelling over an hour each way, every day for those four months to see Angus.
“I can’t even comprehend how we would manage if we were to have another high risk pregnancy or baby needing to be cared for long term at the Women and Babies Hospital at the Fiona Stanley site.
“With the cost of fuel, and being a single income family with another child at home, the distance would either put us in huge debt just in terms of travel or cause higher risk by going through a hospital closer to home that’s not equipped for obstetric complications.”
The politics
Announcing the move in April, then-Premier Mark McGowan and health minister Amber Jade Sanderson said the reasons for the move included concerns about infrastructure at the QEII site, additional costs exceeding $229 million and time delays in completion and disruptions to staff and patients at Sir Charles Gairdner Hospital.
Standing firm in the decision, Premier Cook said last month: “I think this is the best outcome, not only from the state in terms of making sure we can develop a hospital much sooner than we could have at QEII, but also just making sure that we can have that hospital in an unconstrained site so we can anticipate further development of Women and Babies Hospital services.”
Asked about the AMA’s comments, he said: “What we need to do is to continue to work with our clinical teams to ensure that the location of the hospital doesn’t represent a disadvantage, particularly given that it will be some distance from our children’s hospital.”
Refuting the Government’s reasoning for chosing the Murdoch site, Dr Page said: “I’m yet to see good evidence that any other locations were properly evaluated by Government, clearly the business case focused on a very complicated plan for the QEII site, I haven’t seen any evidence that other options were properly considered before being rejected.”
Asked how the AMA foresees the long term cost, he said: “I’ve seen no evidence that there’s been any real attempt to cost out the inefficient nature of the current plan over years or decades. That’s what really needs to be done to work out if this is a truly sensible decision and if it’s not going to actually cost the state more in the long run. I think there’s a reasonable case, on the face of it, that this will be a very expensive decision in the long run.”
Liberal Leader and Shadow Health Minister for WA Libby Mettam is calling for the Government to revoke the decision and has said that this will become a part of her campaign for the 2025 WA state election.
She said: “After decades of research and bipartisan support, it was shocking to hear the decision of the Minister for Health earlier this year: An announcement, a captain’s call, which was made behind closed doors without any consultation with the clinical experts or industry who have been following the progress of the Women and Babies Hospital for the QEII site at Nedlands.”
If elected Premier of WA, she has declared that she will rip up all papers and contracts pertaining to the relocation at Fiona Stanley Hospital and reinstating it back at QEII in Nedlands.
Now that WA has fixed election dates the WA election will be held on March 8, 2025, while commencement of the construction for the new Women’s and Babies Hospital in Murdoch is scheduled to start in 2024.
Referencing the draft position paper leaked from CAHS in October, Ms Mettam said: “We’ve received more evidence that the captain’s call made by the Minister for Health will lead to death and disability for some of the state’s most vulnerable babies.
“This level of concern is not just from a few unhappy doctors. These are the top paediatricians, neonatologists and specialists within the government’s own agency. This report which has been leaked from the government’s own department, highlights the extreme risk and level of concern.”
Health Minister Amber Jade Sanderson declined an interview but said in a statement on November 2, 2023 that consumers and advocacy group representatives would attend engagement sessions during November to have their say on the new Women and Babies Hospital, in the second round of community consultation for the project.
She said consumers with diverse range of experience had been selected to provide their insights and that the sessions would focus on the benefits, challenges and opportunities for the project and workshop practical suggestions for the delivery.
She added that more than 750 people had registered their interest in helping to shape the new hospital, following an expressions of interest process.
More information on the Government’s plans for the hospital is available here: womenandbabieshopital.wa.gov.au
