Upgrading central city hospitals would safeguard against disaster - Brisbane Times

"Just 50 beds are set aside to look after about 500,000 citizens by day". Photo: Joseph Fell

Sydney got the quinella during Tuesday morning peak hour: multiple bus breakdowns causing gridlocked roads and a crane collapsing and bursting into flames at the University of Technology.

Which leads me to pose the question: how prepared is this city for a disaster? Terrorism is not the only threat to our nation's safety. Buildings collapse, fires break out, earthquakes, tsunamis and viral pandemics can all strike in a matter of moments. Our elite members of the state and federal police forces, ASIO, Emergency Management Australia and the NSW Fire Brigade spend a lot of time planning how they would cope with either a man-made or a natural disaster in the central business district of our city. But what would you - the commuter - do in the case of a September 11 in Sydney? More importantly, how would you fare?

In 1980, Sydney Hospital, the only hospital within easy reach for people in the city or, in a crisis the only hospital reachable at all, was a 400-bed teaching hospital. In the mid 1980s, the Wran government imposed senseless and drastic cuts to this icon of health care. Today, Sydney Hospital has just 100 beds of which 50 are dedicated to the world-renowned Sydney Eye Hospital.

And so there are just 50 beds set aside by government to look after about 500,000 citizens by day and 70,000 by night. Even worse, Sydney Hospital has been denied an intensive care unit since the early 1990s.

Then in 2005, just three months after the London terrorist bombings had occurred, NSW Health took away the general and orthopaedic surgeons from Sydney Hospital. These are the very two categories of specialists who would be most needed at any hospital having to manage the victims of a catastrophic event.

The inevitable gridlock on Sydney's roads, which follows even the most minor traffic hiccough, would make other nearby hospitals unreachable in the so-called crucial ''golden hour'' following any CBD catastrophe.

Although the police, fire and ambulance services know how best to interact in a disaster, the CBD public hospitals around Australia - and possibly even the defence forces - have been less involved in preparing for co-ordinated responses to emergencies.

In the face of massive casualties arising from World War II, the federal government reacted sensibly by creating Repatriation General Hospitals where injured survivors of war could be treated and where universities could foster teaching and research. Essentially, one Repat hospital was developed for each capital city. In Sydney it was at Concord.

The world has moved on according to most experts. But there is an urgent need for Australia to prepare its capital cities to handle potential disasters, with an approach that parallels the earlier Repat hospital system.

The national security rebranding of a public hospital in the CBD of each capital city would dramatically improve the capacity to deal with potential disasters.

Such a hospital does not need to be an ''aircraft carrier'' but it would need to be a rapidly responsive, high technology ''frigate'', with a specially trained crew and critical liaison with all the other essential disaster services, including the ABC (the national disaster broadcaster).

In Sydney it would be Sydney Hospital. In Melbourne it would probably be St Vincent's.

These national security hospitals would also need to coordinate with each other as potential disasters in any one city could easily necessitate the involvement of services at many interstate, even off-shore, hospitals.

Of all Australia's capital cities, Sydney is in the worst plight.

The NSW Minister for Health, Jillian Skinner, has told us the $300 million redevelopment of Blacktown and Mount Druitt hospitals was needed because of the growing population in those parts of Sydney. But central Sydney is growing, too. In the CBD, the resident population has risen from about 5000 in 1980 to about 70,000 today. These figures are additional to the half million people who populate the CBD every working day.

If the NSW government was to spend just two-thirds of the $300 million it has recently given to Blacktown and Mount Druitt, it could restore Sydney Hospital to a 200-bed hospital with 12 operating theatres and an intensive care unit. The restoration of general surgery and orthopaedics would let it easily and capably resume its proper functioning as the primary district hospital for the Sydney CBD, whilst also enabling a national security role in any disaster scenario.

Dr John Graham is a formerChairman of the Sydney Hospital medical staff council.