❓ WA Parliamentary Question on Notice regarding Level 5 & 6 services, trauma centres, and cardiothoracic surgery at Fremantle, Sir Charles Gairdner, and Royal Perth Hospitals. The response provides details on service levels and future plans.
AnsweredQoN 3104Legislative Assembly
QuestionView source ↗
(1) What are the current Level 5 and Level 6 (Tertiary) services available at:
(a) Fremantle Hospital;
(b) Sir Charles Gairdner Hospital (SCGH); and
(c) Royal Perth Hospital (RPH)?
(2) In relation to trauma centres in Western Australia, I ask:
(a) what is the evidence behind the decision to now have 2 major trauma centres for the population of Western Australia when the initial Trauma Report following the Reid Report strongly recommended that there be 1 major trauma centre for Perth, so as to concentrate expertise thereby improving outcome, with other metropolitan hospitals having metropolitan trauma centres; and
(b) was the Victorian Trauma Plan considered in that evidence, given its long term implementation and success based around 1 major trauma centre (the Alfred Hospital) serving a much larger population than Western Australia?
(3) What Level 5 and Level 6 (Tertiary Services) are proposed to remain at Royal Perth Hospital given it will also be a major trauma centre?
(4) Will Level 5 and Level 6 (Tertiary Services) include neurosurgery, given the Health Department has received a report from a neurosurgery working party recommending one neurosurgical service at SCGH until the population of Western Australia increases sufficiently for a second service at Fiona Stanley Hospital in approximately 2025?
(5) Using just one discipline, cardiothoracic surgery, could the Minister provide figures for 2006–2007, 2007–2008 and 2008–2009 for the following:
(a) the cost per patient treated and cost per Diagnosis Related Group for:
(i) Fremantle;
(ii) SCGH; and
(iii) RPH;
(b) the workload per service (i.e. the number and type of cases) and the capacity (i.e. how many cases can be done in a year) at:
(i) Fremantle;
(ii) SCGH; and
(iii) RPH;
(c) the number of bypass procedures for each consultant surgeon (to ensure that case loads achieve minimum standard) at:
(i) Fremantle;
(ii) SCGH; and
(iii) RPH; and
(d) the costs and service/consultant workloads benchmarked to national averages (as per the National Demonstration Hospital Program) at:
(i) Fremantle;
(ii) SCGH; and
(iii) RPH?
(a) Fremantle Hospital;
(b) Sir Charles Gairdner Hospital (SCGH); and
(c) Royal Perth Hospital (RPH)?
(2) In relation to trauma centres in Western Australia, I ask:
(a) what is the evidence behind the decision to now have 2 major trauma centres for the population of Western Australia when the initial Trauma Report following the Reid Report strongly recommended that there be 1 major trauma centre for Perth, so as to concentrate expertise thereby improving outcome, with other metropolitan hospitals having metropolitan trauma centres; and
(b) was the Victorian Trauma Plan considered in that evidence, given its long term implementation and success based around 1 major trauma centre (the Alfred Hospital) serving a much larger population than Western Australia?
(3) What Level 5 and Level 6 (Tertiary Services) are proposed to remain at Royal Perth Hospital given it will also be a major trauma centre?
(4) Will Level 5 and Level 6 (Tertiary Services) include neurosurgery, given the Health Department has received a report from a neurosurgery working party recommending one neurosurgical service at SCGH until the population of Western Australia increases sufficiently for a second service at Fiona Stanley Hospital in approximately 2025?
(5) Using just one discipline, cardiothoracic surgery, could the Minister provide figures for 2006–2007, 2007–2008 and 2008–2009 for the following:
(a) the cost per patient treated and cost per Diagnosis Related Group for:
(i) Fremantle;
(ii) SCGH; and
(iii) RPH;
(b) the workload per service (i.e. the number and type of cases) and the capacity (i.e. how many cases can be done in a year) at:
(i) Fremantle;
(ii) SCGH; and
(iii) RPH;
(c) the number of bypass procedures for each consultant surgeon (to ensure that case loads achieve minimum standard) at:
(i) Fremantle;
(ii) SCGH; and
(iii) RPH; and
(d) the costs and service/consultant workloads benchmarked to national averages (as per the National Demonstration Hospital Program) at:
(i) Fremantle;
(ii) SCGH; and
(iii) RPH?
AnswerView source ↗
Answered
10 August 2010
Responded by
Minister for Health
Response time
56 days
(1) The specific capabilities that determine the role delineation level of a clinical specialty would vary depending on the specialty. A Level 6 service is a tertiary or higher level service that can provide a centre of excellence and principal referral capabilities. A Level 5 service is one that can provide care to highly complex cases that do not necessarily require tertiary or principal referral resources and expertise.
(a) The current Level 5 services available at Fremantle Hospital (FH) include the surgical services for Vascular and Trauma as well as mental health inpatient services for older persons.
In addition, the current Level 6 services available at FH include Emergency Services, Rehabilitation Services, Disaster Preparedness, Adult and Older Persons mental health services and a broad range of surgical, medical and clinical support services as detailed in [see tabled paper no ].
(b) The current Level 5 services available at Sir Charles Gairdner Hospital (SCGH) include the surgical services for Trauma, Rehabilitation services and Adult Mental Health Services including emergency and inpatient care.
In addition, the current Level 6 services available at SCGH include Emergency Services, Disaster Preparedness, the full range of medical services, all surgical services except for Burns and Gynaecology and all adult clinical support services as detailed in [see tabled paper no ]..
(c) The current Level 5 services available at Royal Perth Hospital (RPH) include rehabilitation services and Adult mental Health services for inpatients.
In addition, the current Level 6 services available at RPH include Emergency Services, Adult Emergency Mental Health Services, Disaster Preparedness, and the full range of surgical services except for Gynaecology, all medical and all adult clinical support services as detailed in [see tabled paper no ].
(2) (a) The State Government's election commitment was to maintain RPH as a tertiary hospital. As such, it is Government policy to retain RPH as a 400 bed tertiary facility with major trauma capability and it has remained as such within the scope of the latest version of the Clinical Services Framework 2010-2020. The Government undertook to maintain the role of the Fiona Stanley Hospital with respect to trauma.
(b) Yes, the Victorian Trauma Plan as well as trauma plans of other jurisdictions were considered.
(3) All current Level 5 and Level 6 (tertiary) services currently in RPH are proposed to remain except for Oncology, Radiation Oncology and Rehabilitation. Medical services in Palliative Care and Infectious Diseases and surgery services for Burns patients will become L4 services. [see tabled paper no ] provides more detail.
(4) The Level 6 services will include neurosurgery in a similar model to that which currently exists. Although neurosurgery is currently conducted at two sites, SCGH and RPH, this arrangement reflects a single neurosurgical service provided at two sites delineated into care for trauma cases at one site and for non-trauma cases at the other.
(5) (a) [see tabled paper no ].
(b) [see tabled paper no ].
(c) (i) Average 39
(ii) Average 33
(iii) Average 45
The number of bypass procedures performed by each consultant surgeon at each hospital varies greatly. The average number of bypass procedures per consultant surgeon in 2008/09 in each of the three facilities is given above. These numbers do not include the work of surgeons who did less than 10 bypass procedures in that hospital, in that year. In considering these numbers, some factors must be noted:
Ø The surgeons perform a range of other procedures related to by-pass surgery; and
Ø Many consultant surgeons are only engaged on a part time basis. They may work across the public and private sector and may therefore perform many more procedures per annum than this average indicates.
(d) (i - iii)
The National Demonstration Hospital Program does (NDHP) not provide cost or service/consultant workload figures benchmarked to national averages.
There is some literature around workloads that go back further in time than the NDHP which finished in 2003. Some of the information is provided below. It must be noted that these statistics cover work in both the public and private sectors.
The 1998 Australian Institute of Health and Welfare medical labour force survey results show that the average hours worked by cardiothoracic surgeons in WA was 60.7 hours per week, which was lower than the national average of 64.1 hours per week. Results ranged from a high of 73.5 hours per week in New South Wales to 50.6 hours per week in Queensland (Source - The cardiothoracic surgery workforce in Australia: Supply and Requirements 2000 - 2011).
The Australian Medical Workforce Advisory Committee Survey of the Cardiothoracic Surgery Workforce: 2000, shows that the average number of coronary artery bypass procedures performed per year per surgeon for WA was 207 procedures, which was lower than the national average of 211 procedures. Results ranged from 171 in Victoria/Tasmania to 254 in New South Wales/Australian Capital Territory. (Source - The cardiothoracic surgery workforce in Australia: Supply and Requirements 2000 - 2011).
Notice: This document is created or edited using unregistered or evaluation copy of rtLib valid for testing or development purposes only. To use it for productive or any other purposes please register it. You may purchase the license on
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(a) The current Level 5 services available at Fremantle Hospital (FH) include the surgical services for Vascular and Trauma as well as mental health inpatient services for older persons.
In addition, the current Level 6 services available at FH include Emergency Services, Rehabilitation Services, Disaster Preparedness, Adult and Older Persons mental health services and a broad range of surgical, medical and clinical support services as detailed in [see tabled paper no ].
(b) The current Level 5 services available at Sir Charles Gairdner Hospital (SCGH) include the surgical services for Trauma, Rehabilitation services and Adult Mental Health Services including emergency and inpatient care.
In addition, the current Level 6 services available at SCGH include Emergency Services, Disaster Preparedness, the full range of medical services, all surgical services except for Burns and Gynaecology and all adult clinical support services as detailed in [see tabled paper no ]..
(c) The current Level 5 services available at Royal Perth Hospital (RPH) include rehabilitation services and Adult mental Health services for inpatients.
In addition, the current Level 6 services available at RPH include Emergency Services, Adult Emergency Mental Health Services, Disaster Preparedness, and the full range of surgical services except for Gynaecology, all medical and all adult clinical support services as detailed in [see tabled paper no ].
(2) (a) The State Government's election commitment was to maintain RPH as a tertiary hospital. As such, it is Government policy to retain RPH as a 400 bed tertiary facility with major trauma capability and it has remained as such within the scope of the latest version of the Clinical Services Framework 2010-2020. The Government undertook to maintain the role of the Fiona Stanley Hospital with respect to trauma.
(b) Yes, the Victorian Trauma Plan as well as trauma plans of other jurisdictions were considered.
(3) All current Level 5 and Level 6 (tertiary) services currently in RPH are proposed to remain except for Oncology, Radiation Oncology and Rehabilitation. Medical services in Palliative Care and Infectious Diseases and surgery services for Burns patients will become L4 services. [see tabled paper no ] provides more detail.
(4) The Level 6 services will include neurosurgery in a similar model to that which currently exists. Although neurosurgery is currently conducted at two sites, SCGH and RPH, this arrangement reflects a single neurosurgical service provided at two sites delineated into care for trauma cases at one site and for non-trauma cases at the other.
(5) (a) [see tabled paper no ].
(b) [see tabled paper no ].
(c) (i) Average 39
(ii) Average 33
(iii) Average 45
The number of bypass procedures performed by each consultant surgeon at each hospital varies greatly. The average number of bypass procedures per consultant surgeon in 2008/09 in each of the three facilities is given above. These numbers do not include the work of surgeons who did less than 10 bypass procedures in that hospital, in that year. In considering these numbers, some factors must be noted:
Ø The surgeons perform a range of other procedures related to by-pass surgery; and
Ø Many consultant surgeons are only engaged on a part time basis. They may work across the public and private sector and may therefore perform many more procedures per annum than this average indicates.
(d) (i - iii)
The National Demonstration Hospital Program does (NDHP) not provide cost or service/consultant workload figures benchmarked to national averages.
There is some literature around workloads that go back further in time than the NDHP which finished in 2003. Some of the information is provided below. It must be noted that these statistics cover work in both the public and private sectors.
The 1998 Australian Institute of Health and Welfare medical labour force survey results show that the average hours worked by cardiothoracic surgeons in WA was 60.7 hours per week, which was lower than the national average of 64.1 hours per week. Results ranged from a high of 73.5 hours per week in New South Wales to 50.6 hours per week in Queensland (Source - The cardiothoracic surgery workforce in Australia: Supply and Requirements 2000 - 2011).
The Australian Medical Workforce Advisory Committee Survey of the Cardiothoracic Surgery Workforce: 2000, shows that the average number of coronary artery bypass procedures performed per year per surgeon for WA was 207 procedures, which was lower than the national average of 211 procedures. Results ranged from 171 in Victoria/Tasmania to 254 in New South Wales/Australian Capital Territory. (Source - The cardiothoracic surgery workforce in Australia: Supply and Requirements 2000 - 2011).
Notice: This document is created or edited using unregistered or evaluation copy of rtLib valid for testing or development purposes only. To use it for productive or any other purposes please register it. You may purchase the license on
http://www.rtlib.com
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