A message from our Board Chair Lorna Gelbert in response to a Letter to the Editor from the Alexandra Standard on the 10th April 2019.
Letter to the Editor – Alexandra Standard
On behalf of the Board of Alexandra District Health, I wish to respond to the matters raised by Mr Robert Scott in Letters to the Editor published last Wednesday 10 April 2019. The Board is very concerned that Mr Scott is not presenting an accurate picture of the services being provided at ADH or the calibre of the people involved in governing and managing this health service.
Appointment of CEOs
Mr Scott’s comment that the Board has had a ‘need to continuously change CEOs’ suggests the Board has acted capriciously in its duty to ensure stable leadership of the organisation. This is not so. When our long serving CEO left the organisation in November 2015 the Board carried out a comprehensive search for a new CEO who would be the right person to take the Health Service into the future. An interim CEO was appointed while that search continued. A CEO was then appointed who, unfortunately was unable to remain in the position beyond six months. An Acting CEO was then in place until Debbie Rogers was appointed as CEO on 23 January 2017. Debbie has now been in that role for over two years and the Board is extremely happy with her ability to provide stable, quality leadership. Debbie has brought her considerable talents to the position with the result that ADH is a highly functioning health service providing safe and high quality care to this community. In the recent accreditation rounds, ADH passed all facets of the accreditation process without any recommendations.
Lack of faith in ADH?
I cannot possibly say why an injured person exercised his choice to attend his doctor rather than the hospital however, in my experience many injured people do attend their GPs at first instance. Mr Scott simply assumes that the patient did so because he ‘apparently’ lacked faith in ADH.
ADH does not have a resident medical practitioner but that has always been the case. A local GP is on call every day. ADH provides excellent urgent care through its highly skilled nursing staff. Urgent Care patients are therefore treated safely and quickly by the nursing staff with the support of the on-call GP.
In the most recent quarterly survey conducted by the Victorian Agency for Health Information (October-December 2018), 100% of adult patients attending ADH reported positive experiences of the care they received while in hospital (up from 98% the previous year); 100% of patients reported receiving assistance within a reasonable time (up from 98% the previous year); 97% of patients reported that they always had confidence and trust in the nurses treating them (up from 94% the previous year); and 99% of patients reported that doctors, nurses and other health professionals caring for them explained things in a way they could understand (up from 98% the previous year).
I could go on but space does not permit. Suffice to say that ADH scored in the 90s on nearly every other category surveyed. It should be noted that the number of respondents to this survey has increased significantly in the past year. It should also be noted that in nearly all categories surveyed, ADH was ranked either the top or in the top five of small rural hospitals in Victoria and continues to strive for improvement. ADH’s performance is exceptional when assessed independently by its patients and when compared with its peers.
No Patients at the Hospital?
On the morning of Saturday 30 March 2019 after patients due for discharge left the hospital, it is true there were no in-patients in the ward for the rest of that weekend. This is a most unusual phenomenon but it is really a question of timing. It was, however, business as usual during that weekend in Urgent Care with 20 people receiving care and, as from the following Monday it was business as usual in the wards.
Physiotherapy and Occupational Therapy
There is no waiting list for occupational therapy services. Unfortunately there is a long waiting list for physiotherapy services. Physio services are triaged which means urgent and acute cases are dealt with as a priority. The CEO is currently looking at activity targets and demand across our entire Primary Care area with the aim of ensuring we can meet the needs of our community in a timely way.
Clinical Services Plan
During March 2018, ADH carried out a Murrindindi-wide community engagement process to ascertain the health needs of the community for the next three years. At those meetings, Board Directors and ADH Executives rotated around tables of participants so each group would have the opportunity to ask questions of a number of different representatives from ADH both at the operational and governance levels. Meetings were held in Alexandra, Marysville, Eildon and Yea. What came out of that engagement process was a three year Clinical Services Plan for ADH and, through collaboration with Yea Hospital and the Darlingford Upper Goulburn Nursing Home a similar three year Murrindindi-wide plan was developed, its objective being to provide an enhanced range of Murrindindi-wide services where feasible which will also avoid duplication of services and cost where possible.
The ADH Clinical Services Plan was launched in August 2018 with an open day at ADH. The event was advertised to the community with notices placed in the Alexandra Standard and other local newspapers, newsletters, on the ADH website and Facebook page. A summary of the final Clinical Services Plan is on the ADH website and a hard copy is available from Reception upon request.
Debbie Rogers and her team are developing a comprehensive Action Plan which will work towards achieving the objectives set out in the Clinical Services Plan.
Mental Health and Obstetrics Services?
With the best will in the world, ADH cannot be all things to all people. We are, after all, a small rural health service with limited resources. The ADH Board recognises the need for mental health services but ADH cannot at present provide those services because to do so requires staff with special skills and a physical environment that caters for the needs of people with mental illness. Instead, ADH partners with Goulburn Valley Health to ensure the availability of mental health services and we continue to work through the technological difficulties of providing a Telehealth service from ADH. Hopefully this is not too far away.
Many years ago the then ADH Board made the decision to no longer to provide obstetrics at ADH. The decision was based on a decrease in demand for those services in the Murrindindi area together with the lack of availability of an obstetrics workforce (GP obstetrics and GP anaesthetics). The current Board agrees with and endorses that decision. It should be noted though that we are currently providing an outreach pregnancy clinic for women booked to birth at Mansfield Hospital and domiciliary care for local women who have birthed elsewhere. For the future, ADH is looking to provide inpatient post-natal care as recommended in the Clinical Services Plan.
The range of services that ADH provides is impressive. Space does not permit me listing all of those services but I invite readers to view the list on ADH’s website. As well as acute medical and surgical services, there is a wide range of primary health services that are dedicated not only to supporting those members of our community with ongoing health needs but also directed to preventative health measures.
There are currently seven Directors on the Board of ADH. All Board Directors are appointed by the Minister for Health for either two or three year terms with a statutory maximum tenure of nine years. Each year, ADH invites applications for Board positions in an advertisement in the Alexandra Standard, local Murrindindi news media and on its website. Board appointments are made through a centralised, rigorous process operated by the Department of Health and Human Services and recommendations for appointment must be approved by the Department and the Minister. Through this process, the Department ensures necessary skills and expertise are represented on the Board including a Registered Clinician, Corporate and Clinical Governance, Financial, Legal, Patient Experience and Human Resources.
The current Board has Directors who fulfil all of those skills plus management, building and construction and local government. They are a dedicated group of Directors who strive constantly to provide good governance and support for the CEO and executive team. They are also continually mindful that we remain true to our Vision and Mission and the Strategic Plan that was set for the health service through community and stakeholder engagement.
The Alexandra district is indeed fortunate to have such a high quality health service. The Board and the Executive are committed to striving for continuous improvement to ensure the health service can meet the health needs of our community now and in the future.
Lorna Gelbert - Chair
Alexandra District Health