Source : the age
Ambulances carrying patients needing urgent psychiatric care will be redirected to hospitals with available beds rather than the closest, and the NSW government will co-ordinate a crisis workforce to plug holes left by about 200 resigning doctors under emergency settings akin to those seen during the COVID pandemic.
Hospitals across Sydney and NSW are scrambling to prepare for the looming exodus of 203 of 295 public sector psychiatrists next week, after the Minns government refused to give them a pay rise to prevent them from fleeing the system for better wages on offer interstate.
Deb Willcox, chief executive of the Sydney Local Health District, told staff on Monday that the government’s emergency response to the resignations was similar to that during the COVID pandemic. Credit: Rhett Wyman
Staff at Sydney Local Health District, which comprises five inner-city hospitals including Royal Prince Alfred, Concord and Canterbury, were told in a briefing on Monday that the district was at grave risk of losing the ability to provide electroconvulsive therapy (ECT) “given the vast reduction in qualified practitioners to supervise the treatment”.
The procedure involves a trained doctor delivering electric currents through the brain while the patient is under general anaesthetic, causing a brief seizure. It can be a life-saving and urgent treatment for patients in the grips of psychosis, catatonia and other treatment-resistant neurological disorders.
The procedure was performed 7721 times in NSW last year, Medicare statistics show.
Clinical director Dr Andrew McDonald told staff the service, based at Concord Hospital, would have “significant difficulty” remaining open, but existing patients regularly receiving the treatment would be prioritised.
“It’s highly vulnerable,” McDonald said in a leaked recording of the staff briefing.
The service has capacity to treat 15 patients a week at the mental health unit, and also runs twice a week at Concord’s general operating theatres for patients who need closer anaesthetic supervision, said two psychiatrists working at the hospital who were not authorised to speak to the media.
Another psychiatrist working across the health district told the Herald many people living in the community with complex mental health disorders needed regular “maintenance” ECT to function.
“These are the people with the most severe mental illness in the community, and are also the most vulnerable, and in precipitating that relapse of that illness … their symptoms may become so severe that they may then be a risk to themselves or others,” they said.
Sydney LHD chief executive Deb Willcox told staff that NSW Health would be centrally co-ordinating the hiring of locum psychiatrists and diverting ambulances to hospitals with beds available, instead of the nearest service.
Willcox compared the arrangements to those in place during COVID, echoing NSW Health secretary Susan Pearce, who on Saturday said co-ordinating resources across hospitals and agencies had been “critical to our response to the pandemic”.
Almost 50 psychiatrists have tendered their resignations from Sydney LHD, which offers services including acute emergency patients, early psychosis intervention, and maternal mental health.
Sydney LHD and Mental Health Minister Rose Jackson have been approached for comment.
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