Question – Closure of the St Helen’s Private Hospital and Mother and Baby Unit
Questions asked by the Hon Meg Webb MLC on 15 May 2023 and answered by the the Hon. Jeremy Rockliff MP, Premier and the Minister for Mental Health and Wellbeing on 27 June 2023.
In regards to the closure to St Helens Private Hospital and the announcement of three psychiatric beds to be made available at the RHH for mother and baby patients:
- What is the proposed referral process for these three beds and what is the expected wait time between referral and admission?
- Will the skilled nurses (currently employed in Healthscope) be invited to work in this service?
In regards to the proposed solution for paediatric and medical patients (previously admitted to the Mother and Baby Unit at St. Helens) being admitted to the paediatric ward at the RHH:
- What is the referral process for these beds?
- What is the capacity the paediatric ward can offer for those beds?
- Which doctors and nurses will be responsible for the care of these patients?
Given that the current solution for non-psychiatric patients being admitted through the RHH paediatric ward is not desirable for a number of reasons including but not limited to:
- An inappropriate environment for the purpose of sleep and settling
- Poor accommodation for families
- Concerns regarding infection control
- The needs of the paediatric unit to access their ward fully for medical and surgical admissions
- An association for some mothers with traumatic birth experiences at the RHH
- Lack of uniquely skilled nursing staff in mother and baby unit services
- What other interim locations can the Government support as a better home for an interim unit?
- Will the Government ensure the current skilled nursing staff is offered employment in an interim service?
In regards to a long-term solution, such as a proposed model of care comprised of community based holistic outpatient and inpatient services, with a focus on primary care and early intervention:
- Will the Government support a proposal for a state-wide community based Mother and Baby service?
- What services would be included in this model?
- Would the Government commit to funding this model through the Tasmanian Health Service and seek assistance for additional Federal funding?
- What stakeholders have currently been consulted regarding the current community need for Mother and Baby services?
- Would the Government commit to including skilled nurses and GPs in the design of a Mother and Baby service?
Answer:
Mother and Baby Unit
The Tasmanian Government, Healthscope and other providers are working collaboratively to minimise the impact on patients once Healthscope’s St Helen’s Private Hospital in Hobart disappointingly shuts its doors in late June.
We are establishing a new three-bed public Mother and Baby Unit (MBU) for mothers experiencing psychiatric conditions (this cohort represents 33.5 per cent or 2.7 beds of a fully occupied 8-bed St Helen’s MBU).
The public MBU will be located at the Royal Hobart Hospital (RHH) which will see the continuation of this important service and an increase from two publicly funded MBU beds to three.
The selected location for the interim public MBU offers several advantages, including:
- Spacious rooms with private ensuites
- Access to living and dining areas
- Inclusion of kitchenette and laundry facilities within the unit
- Enhanced security and separation from the rest of the ward
- Proximity to existing PIHMS services, Women’s and Children’s Services, and ancillary services
- Adherence to infection control requirements
Considering these factors, the chosen location is deemed suitable as an interim measure, providing a purpose-built space that replicates several features of the St Helen’s MBU in a public setting.
The unit will be separated from the main part of the ward, and the feel of the unit will be optimised to help mothers feel a sense of safety and comfort in a nurturing environment.
The unit will be staffed by specialised and skilled nursing staff with expertise in trauma-informed care and mother and baby unit services.
We are also having discussions with other providers about their ability to establish this service in the future.
Referrals for admission to the public MBU will follow the current protocol.
General practitioners (GPs), psychiatrists, paediatricians, and Child Health and Parenting Services (CHaPS) can request referrals through Access Mental Health.
Once a referral is made to Perinatal and Infant Mental Health Services (PIMHS), an assessment will be conducted to determine eligibility for admission to the MBU.
Individuals who are clinically deemed appropriate for the MBU will be admitted.
It is anticipated that individuals will have prompt access to the MBU without any significant wait time.
Other admissions – for example, those who are experiencing physical maternal exhaustion (this cohort represents 21.5 per cent or 1.7 beds of a fully occupied 8-bed St Helen’s MBU) and those who are experiencing physical issues such as feeding and settling (this cohort represents 45 per cent or 3.6 beds of a fully occupied 8-bed St Helen’s MBU) – will be accommodated in the RHH paediatric ward and other alternative settings that can provide a more home-like atmosphere.
Our paediatric and adolescent wards, consisting of 50 beds, have ample capacity to accommodate infants with clinical needs, as evidenced by their average occupancies of approximately 40 percent.
We are working to streamline admission processes to ensure they are seamless and stress-free for families who require care.
We also recognise the importance of a long-term solution involving a community-based model of care that emphasises primary care and early intervention for mother and baby services.
More than half of the admissions to the St Helen’s MBU are for specialised support in mothercraft and parenting and would benefit from a service of this type.
While the Tasmanian Government provides state-wide services such as CHaPS and programs through Parenting Centres that align with PIMHS, it is important to note that the establishment of a comprehensive community-based service focused on primary care and early intervention is the responsibility of the Australian Government.
The Australian Government has allocated $26.2 million over four years to deliver 12 new perinatal mental health services nationally under the National Mental Health and Suicide Prevention Agreement.
We welcome the involvement of Primary Health Tasmania and the Australian Government in fostering collaboration between primary care and public services to meet the needs of our community.
We are facilitating the referral of interested stakeholders to representatives from Primary Health Tasmania and relevant organisations such as the Perinatal and Child Mental Health Section in the Australian Government Department of Health and Aged Care.
Workforce Impacts
We highly value the wealth of experience and expertise that the St Helen’s Private Hospital staff possess, and we are committed to retaining as many staff as possible to ensure continuity of care and a seamless transition.
We are working in close collaboration with Healthscope and health unions to provide comprehensive support and resources to staff members who express interest in joining our team.
To expedite this process, the Secretary and Chief People Officer of the Department of Health have approved the fast-tracked appointment of St Helen’s staff to our casual employment registers. Interested staff members have been provided with an information package containing relevant details.
A recruitment campaign was launched on Thursday 25 May 2023, and includes a SEEK advertisement and a dedicated landing page on Jobs Tas.
Healthscope, in accordance with their industrial obligations, is responsible for offering redeployment opportunities or providing payouts of entitlements to their employees.
See more of Meg’s Questions to Parliament.
