Child bypass cases must go to Westmead as Randwick scraps roster – The Age

Children requiring heart and lung bypasses will have to go to The Children's Hospital at Westmead after anaesthetists at Sydney Children's Hospital, Randwick, scrapped the emergency cardiac anaesthetist roster.

Chairman of Randwick's medical staff council Dr Michael Solomon said anaesthetists and other specialists required to perform bypass have repeatedly warned the hospital's administration they were losing skills because of a lack of elective cardiac surgeries at the hospital.

Anaesthetists at Sydney Children's Hospital, Randwick, have scrapped the emergency cardiac anaesthetist roster.Credit:Peter Rae

It is the latest development in the ongoing conflict over childrens heart surgeries in NSW.

NSW Health is yet to announce a decision on the future of cardiac services in the state despite a review and a round-table discussion earlier this year, but there has been tension between the Randwick and Westmead hospitals over this issue since their administration was merged almost 10 years ago.

Dr Solomon said Randwick staff were not "playing games" with the government, but the roster decision showed a lack of cardiac surgery had wide-ranging implications for the hospital.

"The people involved are not comfortable providing the service from a safety point of view, thats the issue," Dr Solomon said.

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The emergency roster does not just cover out-of-hours cases, but any case requiring bypass that comes into the hospital, he said. Dr Solomon said bypass is often used for serious cases that are not purely heart-related.

"What it means is if a child turns up to the emergency department or a child currently in the hospital becomes gravely ill where they need to go onto bypass, they will have to be taken to Westmead because there is no roster now for an emergency like that to be treated safely at Randwick," he said.

"Its like a pack of cards thats been crumbling, it affects trauma, it affects neurosurgery."

Bypass surgery involves an artery and a vein being connected to a machine that puts oxygen back into the blood, temporarily taking over the job of the heart and lungs. While the job of an anaesthetist is to put people to sleep, Dr Solomon said bypass changes the physiological environment and requires specialised skills.

"Elective cardiac surgery provides regular bypass cases," he said. "Anaesthetists and perfusionists [who operate the bypass machine] were telling the administration they weren't getting the cases to look after and losing skills, and it's getting to the point where it's not safe."

Medical staff informed the Sydney Children's Hospital Network, which oversees both children's hospitals, that the roster would wind up on Monday.

However a spokeswoman for the network said the Randwick hospital was committed to delivering safe, world-class care to children and at no time has the hospital failed to maintain an emergency cardiac anaesthetic roster.

This roster is in place to ensure specialist anaesthetists are on hand 24 hours a day to care for children requiring emergency cardiac surgery, the spokeswoman said. The Sydney Childrens Hospitals Network and the NSW government are committed to having two world-class paediatric tertiary referral hospitals, with more than $1.3 billion invested in redevelopments at both Sydney Childrens Hospital, Randwick, and The Childrens Hospital at Westmead.

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Cardiac surgeries at Randwick have dwindled; Dr Solomon said there had been one cardiac surgery performed at the hospital this year. Medical staff have repeatedly said losing cardiac surgery will compromise other services at the hospital.

However, clinicians at Westmead believe there will be better patient outcomes if all heart surgeries are performed at the one hospital.

A decision on the future of childrens cardiac services was due within weeks of Julys round-table discussion of the issue. However in November NSW Health said the decision had been delayed until a statewide review of paediatric services could be completed.

Rachel Clun is a journalist at The Sydney Morning Herald.

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Child bypass cases must go to Westmead as Randwick scraps roster - The Age