3 hours ago
2
It opened to patients just three months ago, but doctors at the new Footscray Hospital fear they will soon have to wind back cancer services for some of the sickest Victorians.
Under a Health Department specialist centralisation plan, oesophageal surgeries will no longer take place at the new hospital, with patients instead required to travel to Geelong Hospital or Peter Mac for these procedures.
Surgeons, patients and Western Health – which runs the $1.5 billion hospital – have hit out at the proposal, saying it will force vulnerable patients and their families to travel long distances for treatment and lead to fragmented care.
A leaked document from Western Health to the Health Department states that losing the ability to perform these treatments will also create an “access gap” for patients who present to the emergency department needing oesophageal surgery.
The surgery is often performed to treat oesophageal cancer, as well as a life-threatening condition called Boerhaave’s syndrome which involves the spontaneous rupturing of a person’s oesophagus. While this emergency surgery normally has a 50 per cent mortality rate, no deaths have been recorded at Footscray Hospital.
More than 1200 people have signed a petition calling on the Allan government to retain oesophageal cancer surgeries at Footscray Hospital.
“The removal or relocation of oesophageal cancer services from Western Health will have serious and potentially fatal consequences,” the petition reads.
“Patients will be required to travel long distances while seriously unwell.”
One surgeon, who was not authorised to speak publicly, said it made no sense to cut the state-of-the-art services so soon after the hospital had opened.
“This is fundamentally an issue of equity. Access to healthcare should be fair,” he said.
“Why are we telling our community that they can’t be treated here? Sending them elsewhere forces them into a foreign environment.”
The surgeon said the department was pursuing a process of “surgical rationalisation” and he feared this would be the first of many changes.
Opposition health spokeswoman Georgie Crozier said the cuts were a cruel blow to people in the western suburbs.
“These cuts make no sense when the resources are there, and now they are making patients travel further for care,” she said.
Australian Medical Association Victorian president Dr Simon Judkins said the proposal was part of a broader Health Department push to centralise medical experts into hubs, though he said Footscray Hospital was already delivering high-quality care to patients.
“You need to have a certain amount of activity with the right number of people and expertise to get the best outcomes,” Judkins said.
“If they have the capacity, skills, and expertise to do these surgeries safely, then the argument to remove these services is flawed.”
Oesophageal cancer is rare in Australia, with 1781 new cases diagnosed last year. People diagnosed with the condition have a 26 per cent chance of surviving for five years compared to their counterparts in the general population.
Western Health’s four specialist oesophageal surgeons perform up to 14 oesophageal surgeries every year, with all outcomes meeting international benchmarks. However, the number of surgeries is expected to rise significantly as the new hospital treats an increasing number of patients from one of the fastest-growing and most culturally diverse parts of the state.
The hospital’s catchment area also takes in some of the state’s most socioeconomically disadvantaged postcodes, where there are higher rates of smoking and alcohol consumption, which are risk factors for oesophageal cancer.
A Health Department spokeswoman said it had commissioned a review to explore whether there were ways to improve the delivery of highly complex surgical care to boost outcomes for patients. She said this would be informed by clinical evidence and advice from Safer Care Victoria.
“There are no changes to services at Western Health,” she said.
Western Health was contacted for comment, but referred questions to the department.
Last June, Dragi Grozdanovski underwent an 11-hour surgery at the old Footscray Hospital to remove a cancerous tumour growing in his oesophagus – the 25 centimetre pipe that connects the throat to the stomach.
He spent three days in the intensive care unit before being moved to a general ward.
“The aftercare was so incredible that I ended up writing the doctors and nurses an email to thank them,” he said. “Even in those dark, depressing moments when you have tubes coming out of everywhere and you think you’ve had enough, they lift you back up.”
A steady stream of family members visited the 68-year-old corporate chauffeur every day, travelling from neighbouring suburbs. He’s concerned that forcing patients to travel across the city or to Geelong for this treatment will isolate them from one of the most important parts of their recovery: family support.
“When you are at your absolute lowest, that family support is what pulls you through,” said Grozdanovski, who is now in remission.
“If you ship patients to the other side of town or down to Geelong, you exclude the family from that care.”
The oesophageal surgery centralisation proposal follows a budget-saving shake-up of Eastern Health last year, which involved Maroondah Hospital losing orthopaedic and urology services to Box Hill Hospital, but gaining plastic surgery and becoming a hub for breast surgery.
One aspect of the proposal – a plan to axe paediatric services – was overruled by former health minister Mary Anne-Thomas.
Surgeons say these changes have complicated treatment for patients who have arrived at the emergency department of Maroondah Hospital, only to be transported elsewhere for surgery.
