‘Couldn’t you be proactive?’: Departing doctor speaks out
The coronavirus pandemic might deliver what Gladstone Hospital's outgoing director of surgery has been requesting for years.
Dr Stefaan De Clercq arrived six years ago with the intention of building up the city's health service.
The hospital was a Level 3, meaning it could deal with simple operations such as low-risk caesareans and appendix removals.
"When I arrived here, I thought this Level 3 is ridiculous, this needs to be a Level 4 hospital," he said.
He felt a city the size of Gladstone that runs on heavy industry should be serviced by a higher level of healthcare, including an intensive care unit.
The hospital has gone through a series of directors of medical services, and Dr De Clercq has asked them all the same question.
"What are you going to do if there is a catastrophe here, who is going to help us?" he said.
"Nobody could give me an answer to that."
At the time he was thinking of an industrial accident such as a gas leak, but the fast-spreading virus is at least as serious.
"You may get an ICU because there is this pandemic now," he said.
"Do you really have to wait until something like that happened, couldn't you be proactive?"
Queensland Health has confirmed that hospitals across the state, including Gladstone, have plans to ensure adequate supplies, equipment and staff to respond to local outbreaks of COVID-19.
There were three new cases confirmed in Central Queensland yesterday.
Queensland Health would not confirm where in the Central Queensland Hospital and Health Service they were and said contact tracing was underway.
The district includes Rockhampton, Gladstone and Biloela.
"Part of Central Queensland Health's COVID-19 planning includes standing up a temporary ICU capacity in Gladstone if and when required," a spokesperson said.
"All hospitals in the Central Queensland Hospital and Health Service region are able to divert symptomatic patients to separate, designated areas for testing."
It's understood CQHHS began preparing its COVID-19 response in January and Queensland's hospitals are prepared to triple emergency department capacity if required.
Queensland Health can also relocate staff from low-impact health services and place them where demand is critical.
Gladstone Hospital is currently upgrading its emergency department to a $42 million facility that will more than double the size of the current ED.
In the opinion of Dr De Clercq, there were better ways to spend that money.
"We need wards, we need an ICU, we need new theatres - everything that comes through that ED is going to hit a wall," he said.
"It just becomes a landing place to be shipped out to Rockhampton or Brisbane."
He said purchasing the Mater Hospital could have delivered extra beds, bigger operating theatres and an ICU to Gladstone.
Working with then-director of anaesthetics Dr Anthony Eidan about a year ago, Dr De Clercq said there was a time he was operating at a higher level.
"We were working at Level 4; patients were coming from Rockhampton to this hospital to get their treatment," he said.
"The budget was saved for CQHHS that financial year, helped by Gladstone's higher-level activity."
There was investment in equipment because it was proved it was needed, but the local health service was not upgraded with an ICU or bigger theatres.
"I thought now they're going to purchase the Mater for us," he said.
That didn't eventuate, and when consequently Dr Eidan left, Dr De Clercq said the service level dropped back.
He's proud of improvements made at Gladstone over the journey and said Queensland Health as a whole was one of the better public health providers worldwide.
But operating in a Level 3 hospital as a specialist means few opportunities to practice complex surgeries and the risk of getting deskilled.
"I'm not completely negative, I've built up a department, but they didn't give me what I really needed," he said.
He'll move to Bundaberg with the intention of developing a bariatric surgery department, one of his specialities.
"With the coronavirus situation we tend to forget that the obesity problem of Australia, and particularly regional Australia, remains the biggest long-term threat to our national health, for which a surgical solution through public health is still not offered," he said.