Hospital faces 'day of reckoning' as CEO disappears and ED overwhelmed

Major reshuffle proposed at Mildura hospital as ED struggles without locum staff In short: Mildura Base Public Hospital is proposing a restructure of its executive team following the mysterious departure of its CEO last month. One executive position was made redundant before the changes were made public. What's next? An ED nurse says a decision to reduce locum and agency staff is resulting in adverse patient care, but the health department disputes that claim. A major Victorian hospital is looking to restructure after the mysterious departure of its chief executive while its emergency department struggles with a reduction in locum and agency staff. The Mildura Base Public Hospital (MBPH), one of the largest employers in north-west Victoria, has been under the control of an acting chief executive since Terry Welch left the organisation without notice one month ago. The hospital is yet to confirm the reason for Mr Welch's departure. The ABC can reveal one of MBPH's seven executive directors, Heath Kendall, accepted a redundancy package from the hospital last week. Mr Kendall oversaw the hospital's corporate and community affairs, as well as the MBPH Foundation, a fundraising body. The move comes ahead of a proposed restructure to reduce the number of executives from seven to five, which the hospital said would strengthen accountability and improve decision-making. However a number of staff, past and present, have voiced frustrations about MBPH's handling of Mr Welch's departure and its expenditure on non-clinical positions, which staff said had contributed to budgetary pressure. A nurse who spoke on the condition of anonymity said Mr Welch's departure coincided with a noted reduction in the number of locum doctors and agency nurses available in the emergency department. They said nurses were working double shifts as a result, resulting in more staff calling in sick due to burnout. "Honestly, I think that the bottom line is that it will be affecting patient care," the ED nurse said. "Staff in ED have been exhausted and sort of feeling pushed to their absolute limit for quite some time now." An internal memo about staffing from earlier this month said new recruiting arrangements were designed to keep the hospital "financially sustainable". The memo, seen by the ABC, said reliance on agency and locum staff had been "higher than planned and considerably above historical levels". According to the hospital's latest annual report, MBPH has more than $41 million in payable liabilities, a figure that almost doubled from the previous financial year. MBPH has categorically denied suggestions of a hiring freeze, but would not comment specifically about changes to the number of agency or locum staff employed. A senior medical professional from the region, also speaking on the condition on anonymity, said the hospital was facing "a day of reckoning". "Since the hospital's change back to public management, a lot of non-clinical staff have been employed, causing budget blowouts with no consequential improvements for patient outcomes," they said. "It's a day of reckoning. You can't put on a whole heap of non-clinical staff when the focus should really be on patient outcomes and access to care." Frustration remains MBPH services the Sunraysia region, which has a population of almost 80,000. It is among the regional Victorian hospitals struggling to cope with emergency department numbers, with some patients often spending longer than 24 hours in ED. Acting chief executive Matthew Jukes would not be drawn on the reason for his Mr Welch's exit, which he said was a matter for the hospital board and Victorian health department. "The challenge we obviously have is the consultation processes sometimes need to remain confidential as part of the employment matters," Mr Jukes said. "And, unfortunately, sometimes it's just not appropriate for us to comment on individual employees." A government spokesperson said Mr Welch's departure was a matter for MBPH and its board. Mr Jukes said the proposed changes to the executive would not affect the hospital's ability to serve the community. "No changes are being made to the patient services that are provided as part of what we're doing," he said. "Financial sustainability is one consideration, but it's not the sole purpose of the proposal. "No final decision has been made, as we're working through the consultation process with the affected employees and the relevant unions." Mr Jukes said the hospital had introduced "oversights and some controls" regarding recruitment as part of a focus on a sustainable, local workforce. He would not comment on whether fewer locum or agency staff were being employed due to budgetary constraints. "We have made really important progress towards reducing our reliance on high-cost workforce, which is typically your fly-in agency and locums," Mr Jukes said. "We still recognise that they are an absolutely integral part of us being able to deliver service, and we'll have to continue and will continue to engage in external workforce to be able to deliver our service. "But absolutely our priority is to build a workforce that is sustainable and local." Liberal MP Georgie Crozier raised MBPH's staffing issues during Question Time in state parliament last Wednesday, stating she had been informed the hospital would be without locum staff for six months due to budget constraints. A Victorian Health Department spokesperson said MBPH was strengthening the "oversight of workforce and recruitment decisions" to ensure spending is responsible. "There is not a freeze on locum doctors or recruitment at Mildura Base Public Hospital, and there is no impact on patient care of the hospital's ability to deliver services," the spokesperson said. The Victorian branches of the Australian Nursing and Midwifery Federation and Health Services Union have been contacted for comment. The MBPH board has also been contacted for comment. Loading... [Image text:] Elise Terry