Why expanding the Tweed Heads Hospital is not an option
THE moment you enter the Tweed Heads Hospital, the urgent need for a new building is obvious.
Mould is visible on the roof, while at the reception, an out-of-place looking temporary wall is used as a discharge area for patients due to a lack of space.
This is the harsh reality the hospital's hard-working medical staff work under every day.
"It's somewhere to put patients because the area where they used to go is now full of beds," Intensive Care Unit Director and Medical Staff Council co-chairman Dr Mike Lindley-Jones says.
On Monday, every single bed in the building was full, placing the hospital on bypass mode and forcing ambulances to skip the hospital and continue on to the Gold Coast.
Patients regularly have to wait on ambulance trolleys in the Emergency Department until beds become available.
"We just can't fit any more patients in," Dr Lindley-Jones said.
In the hospital's Intensive Care Unit, critically ill patients and those on life support have limited privacy.
The patients do not have their own rooms separating them, meaning when someone is provided with a life and death decision, it can be heard by the entire room.
"The modern standard is single rooms which is what the new hospital will have, but this just isn't a modern hospital," Dr Lindley-Jones says.
A cramped storage area which can't fit vital supplies means the walls of the ICU are lined with expensive medical equipment.
Soiled linen is stored in a basket in the corridor.
Keeping the hospital "safe and operational" is the mantra now being used by medical staff so they can "survive" until 2022, when the new Tweed Valley Hospital is expected to be completed.
If the new hospital site was moved to Kings Forest as proposed by NSW Labor, it is anticipated planning approvals would need to start all over again, while a lack of sewerage pipes, roads, and access to electricity could also pose a problem.
"That's why we're so anxious about the timing and any delays for the new hospital as we feel we're a long way behind in terms of being able to cope," Dr Lindley-Jones said.
A demountable "hut" to accommodate 17 patients was built onto the side of the hospital last year, but Dr Lindley-Jones said the additional beds were simply "a drop in the ocean".
"It hasn't made much of a difference to be honest," he said.
A further two portable operating theatres are being built to deal with the region's rapidly growing population, along with a portable extension to the emergency department and two extra beds in intensive care.
"These are key areas which we are just putting a small amount of capital into to keep this place safe and operational while we wait for the new hospital," Dr Lindley-Jones said.
The new Tweed Valley Hospital will have 450 beds, compared to approximately 200 in the existing hospital, a number Dr Lindley-Jones said was hard to determine due to some being day beds.
In 2010-2011, a clinical service plan to renovate the hospital was formulated and endorsed by the hospital board in 2012.
A masterplan to redesign the hospital was released in 2013 which explored five sites including a Greenfield option, but they were eventually ruled out "due to zoning, flooding, height restrictions and proximity to flight paths", along with financial constraints.
In 2015, the NSW Government committed $48 million to rebuild the existing site in a staged process.
Dr Lindley-Jones was one of many professionals on the planning committee.
"We sat down with good intentions to try and rebuild the site and realised after several months of meetings, which included engineers, architects and health planners, that rebuilding the site was going to be incredibly expensive and we were going to end up with a sub-standard hospital," Dr Lindley-Jones said.
"At the moment it's very much a rabbit warren with bits tacked on here and there, and it would become even more of a rabbit warren with extensions all over the place."
Dr Lindley-Jones said the cost estimates in the original masterplan were "massively underestimated", while building on the site of a functioning hospital would cause other problems.
"It's quite a disruption, drilling and so-forth can't take place if there's an operation taking place due to the vibrations, it creates problems for both the builders and the clinicians," he said.
Independent auditors later determined that spending $48 million on rebuilding the current hospital would result in an "inadequate end result" which had no potential for expansion and would need to be re-renovated again in five years.
A 2013 report from Health NSW noted the "operational challenges of managing noise, vibration and access restrictions during construction", while flooding was also considered a problem due to road access being cut for those living south of the Tweed River during a one in a hundred-year flood.
A further report by Health Infrastructure in 2016 stated a renovated hospital did not have the "capability, technological innovation and sufficient build infrastructure to meet the needs of a growing and ageing population".
According to a site selection summary report released last year, the existing site was not considered by Health Infrastructure and rejected due to inadequate space, flooding issues and the need to build "critical hospital infrastructure" above the Possible Maximum Flood level.
The existing masterplan also projected the refurbished hospital would only be able to service the community until 2022, while a Greenfield site would meet service demand to 2031 and beyond.
So when the NSW Government decided to fund a whopping $534 million into a hospital on a Greenfield site in 2017, it was met with praise and relief by the Tweed Heads Hospital medical staff.
"When we looked into it more closely we realised expanding the existing hospital would be too difficult to do and to be honest, this was a decision that was obvious to everyone involved in the planning," Dr Lindley-Jones said.
"It was never going to work and was never going to deliver a modern fit-for-purpose hospital."