Ms CARTER - 2004-06-15
When you ‘categorically’ - and I am using your word – denied that the Intensive Care Unit at Alice Springs Hospital was closed, was that a deliberate attempt to mislead the media and the public, or had you been misinformed by your staff?
ANSWER
Madam Speaker, I welcome the question because it gives me a chance to clear up this matter, which did make its way into the media debate at one stage.
The first thing Territorians have to understand is that there are levels of care within the intensive care area of critical care. In fact, there are three levels of intensive care that are defined by the Australian and New Zealand Joint Faculty of Intensive Care Medicine. Basically, Level 1 is providing immediate resuscitation and short-term cardio-respiratory support for critically-ill patients. It also plays a major role in monitoring and prevention of complications. Level 2 leads to a high standard of general intensive care, including complex multi-system life support. Level 3, the tertiary level, is virtually the highest possible level of ongoing intensive care that the hospital can produce.
The introduction of an intensivist into the Alice Springs Hospital has the effect of going from Level 1 to Level 2 of the intensive care levels. Co-existing within the unit in Alice Springs is the High Dependency Unit, and that is, again, another level of care that hospitals try to provide in the critical care area. It provides a level of care that is intermediate between intensive care and general ward care. Patients can be admitted to HDU from an operating theatre, for example, for post-operative care and monitoring …
Dr Lim interjecting.
Dr TOYNE: There seems to be a bug bouncing around over there, Madam Speaker. … also from the general wards if the severity of the illness escalates. In our Intensive Care, High Dependency Unit in Alice Springs, at the moment, we have a combination of high dependency and Level 1 intensive care. With the intensivist, we will have Levels 1 and 2.
Jeff Byrne, the hospital manager, and I were both asked the same question during the media scrutiny of what was going on. When I was asked the question, I said: ‘Yes, we have patients in there on high dependency care. We have also moved up to Darwin a patient from the ICU who needed more high-level care with the loss of the intensivist at that stage’. That was interpreted, I believe, to say that I was claiming the unit was still open. Well, it was still open, because it …
Mr Dunham: Oh, so you have apologised for nothing?
Madam SPEAKER: Order!
Dr TOYNE: …is a combination unit of high dependency and ICU. That was what I said. Jeff Byrne also said it was open, based on the fact that it had both high dependency and some of the Level 1 ICU care available to it for any patient who was admitted there for those levels of care.
I can certainly report that, following Tarun Weeramanthri’s visit to the hospital, in fact, the staff themselves have some confusion about when the units are open or not open. It is probably the wrong question to be asking in that the real question is: what level of care is available within that unit, given that there were real nurses working there, there were real doctors working there, there were real specialists in the hospital who could come in and enter the care process as needed. Care was going on in that unit throughout the whole period of this debate. The only issue was: what level of care?
I do not believe I have misled anyone. I know for a fact, from speaking to the nurses who were working there, the hospital management and to my executive, that care was going on in that unit throughout the course of this debate. The only issue is what level of care there was at various stages.
ANSWER
Madam Speaker, I welcome the question because it gives me a chance to clear up this matter, which did make its way into the media debate at one stage.
The first thing Territorians have to understand is that there are levels of care within the intensive care area of critical care. In fact, there are three levels of intensive care that are defined by the Australian and New Zealand Joint Faculty of Intensive Care Medicine. Basically, Level 1 is providing immediate resuscitation and short-term cardio-respiratory support for critically-ill patients. It also plays a major role in monitoring and prevention of complications. Level 2 leads to a high standard of general intensive care, including complex multi-system life support. Level 3, the tertiary level, is virtually the highest possible level of ongoing intensive care that the hospital can produce.
The introduction of an intensivist into the Alice Springs Hospital has the effect of going from Level 1 to Level 2 of the intensive care levels. Co-existing within the unit in Alice Springs is the High Dependency Unit, and that is, again, another level of care that hospitals try to provide in the critical care area. It provides a level of care that is intermediate between intensive care and general ward care. Patients can be admitted to HDU from an operating theatre, for example, for post-operative care and monitoring …
Dr Lim interjecting.
Dr TOYNE: There seems to be a bug bouncing around over there, Madam Speaker. … also from the general wards if the severity of the illness escalates. In our Intensive Care, High Dependency Unit in Alice Springs, at the moment, we have a combination of high dependency and Level 1 intensive care. With the intensivist, we will have Levels 1 and 2.
Jeff Byrne, the hospital manager, and I were both asked the same question during the media scrutiny of what was going on. When I was asked the question, I said: ‘Yes, we have patients in there on high dependency care. We have also moved up to Darwin a patient from the ICU who needed more high-level care with the loss of the intensivist at that stage’. That was interpreted, I believe, to say that I was claiming the unit was still open. Well, it was still open, because it …
Mr Dunham: Oh, so you have apologised for nothing?
Madam SPEAKER: Order!
Dr TOYNE: …is a combination unit of high dependency and ICU. That was what I said. Jeff Byrne also said it was open, based on the fact that it had both high dependency and some of the Level 1 ICU care available to it for any patient who was admitted there for those levels of care.
I can certainly report that, following Tarun Weeramanthri’s visit to the hospital, in fact, the staff themselves have some confusion about when the units are open or not open. It is probably the wrong question to be asking in that the real question is: what level of care is available within that unit, given that there were real nurses working there, there were real doctors working there, there were real specialists in the hospital who could come in and enter the care process as needed. Care was going on in that unit throughout the whole period of this debate. The only issue was: what level of care?
I do not believe I have misled anyone. I know for a fact, from speaking to the nurses who were working there, the hospital management and to my executive, that care was going on in that unit throughout the course of this debate. The only issue is what level of care there was at various stages.
Last updated: 09 Aug 2016