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RAH Respiratory Service remains in limbo

AMA(SA) Media Release | 10 August 2018 

The Australian Medical Association (SA) is speaking out as the Royal Adelaide Hospital Respiratory Service remains in limbo. “After over two years of promises and talks, SA Health is yet to provide a Sleep Laboratory at the new RAH,” says AMA(SA) President Associate Professor William Tam.

“This is very concerning given the hundreds of hours of work that the senior clinicians, nurses and scientists have given to providing the Executive with numerous reports and evidence to justify such an important part of their service.”

Not only that, an Independent senior respiratory expert review, commissioned by CAHLN Executive, is being ignored even though it wholeheartedly supports the opinion of all clinicians working in the Chest Clinic.

“This is most disappointing,” says A/Prof Tam. “The mistakes of Transforming Health look like continuing, if clinicians’ advice is ignored when it comes to delivering vital medical services to the community”.

“The Sleep Laboratory provides important assessments for patients with a range of respiratory problems to ensure they can live their lives without risk of dying in their sleep. It delivers care to hundreds of patients in rural SA, as well as serving many more in the city as part of their nationally recognised program.”

“Importantly, the service also provides critical assessment for patients who are acutely unwell in the new RAH; for example, patients who have had a stroke or suffering heart failure. To even consider not having a sleep laboratory as part of the total respiratory service in our flagship hospital is a nonsense.”

“If there is no on-site sleep lab, there will be a major risk to patients with respiratory failure, ventilatory requirements and complex sleep disorders.”

“There are also significant research and training ramifications. Respiratory trainees, as well as sleep trainees, require an on-site sleep lab for accreditation. The sleep lab work is closely integrated on a daily basis, and is not something which can be learnt and achieved by an ‘isolated block’ rotation to The Queen Elizabeth Hospital, as has been proposed. Rotation for super-specialised training is sometimes done, but this is a different situation as sleep medicine is core work.”

“Continued rotation for the sake of rotation further adds to the inefficiencies currently being experienced in CAHLN. Given the budget implications announced earlier this week, we cannot see how introducing more inefficiency can be contemplated.”

“Indeed, if this decision was allowed to stand, the new RAH would be the only accredited respiratory physician training hospital in Australia without such a facility. How can we allow this to happen?” says A/Prof Tam.

The AMA(SA) has been working hard alongside our members and other health professionals for over two years while the move of the Chest Clinic to the new hospital has been planned. “We have examined the evidence for the inclusion of the sleep lab and it is compelling, very compelling,” says A/Prof Tam.

This is not just the view of the AMA(SA), this has been substantiated by Professor Matthew Naughton, a well-respected respiratory physician working interstate who was commissioned to look at this very issue by the CAHLN Executive. To ignore his advice and seek yet another review is not only a questionable use of tax payers’ funds, but says something about the decision-making processes in SA Health. “External reviews are fine and necessary, but how many do you need to have to make a decision?” asks the AMA(SA) president.

The AMA(SA) met on Wednesday with the Senior Executive and Health Minister Stephen Wade to discuss the importance of moving the Sleep Laboratory into the new RAH. The Minister is aware of the seriousness of this situation as the waiting list for these patients grows.

“Currently we have a single lab at The Queen Elizabeth Hospital, and the waiting time at that clinic, we understand, is around 12 months. This is a serious and growing problem that has an agreed, sensible and viable solution … we need this resolved now and the AMA(SA) calls on the government to keep the previous promise to move the whole of the respiratory service to the new RAH,” says A/Prof Tam.

10 August 2018 | Contact: Eva O’Driscoll 8361 0106

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