A top surgeon has warned Tasmania will be sent “back into the dark ages” if Hobart Private stops offering certain procedures due to its potential takeover by a Catholic healthcare provider.
But the health minister is adamant there will be no service gap, as her department tries to work out how it will ensure the services continue to be offered in the state.
Healthscope’s receiver announced plans to sell Hobart Private to Catholic healthcare provider Calvary Health Care in December, following the financial collapse of the company.
The Australian Competition and Consumer Commission (ACCC) is due to make a decision on the sale within weeks.
If the sale goes through, it will mean Calvary owns every private overnight hospital in Hobart and Launceston.
While Calvary’s ownership would ensure the Hobart Private continues operating, there are concerns about the loss of some services.
Dr Nanda Kandamany says Tasmanians wanting gender affirming top surgery could need to travel interstate. (Supplied)
Dr Nanda Kandamany is the only surgeon in Tasmania who performs gender-affirming top surgery — he uses Hobart Private because it’s the only hospital that will support it.
But as a Catholic provider, Calvary does not allow gender-affirming surgery, and Dr Kandamany fears the service will have to shut down.
“This is going to set things back 50 years or so,” Dr Kandamany said.
“I think we’re going back into the dark ages with the potential takeover.“
In his six years offering the service, Dr Kandamany has helped more than 100 Tasmanians.
“This is life-changing surgery,” he said.
“[But now], these patients will not have any other hospital to go to in Tasmania, so they will have to travel interstate.
“We have to find a solution.“
Calvary operates multiple private hospitals in Hobart and Launceston, and could soon create a monopoly in the two cities. (ABC News: Pete Curtis)
Calvary also does not allow pregnancy terminations, IVF and certain contraceptive procedures, like vasectomies or inserting IUDs, at their hospitals.
These are all services currently performed at the Hobart Private with limited or no availability in the public system.
Vital to avoid access delays
Gynaecologist Dr Kirsten Connan works out of both Calvary and Hobart Private.
She said if there are no private hospitals in Tasmania offering certain contraceptive procedures, it would reduce “the opportunity for women to access their contraceptive choice and care”.
Dr Kirsten Connan says delays in accessing abortion can result in women passing the timeline for eligibility. (ABC News: Brian Tegg)
Dr Connan said the loss of private inpatient abortion services would particularly impact high-risk women and those with complex medical needs, and the public system could not fill the gap.
“We know that there are often wait periods that limit the ability for women to get into the clinic, and then there’s a delay going from the clinic to theatre,” she said.
“I know of examples where that has meant that by the time they are eligible and able to access a surgical termination of pregnancy, they’ve actually passed the threshold that’s available under the public system.”
This could then require women to be sent interstate, where they lack social supports, Dr Connan said.
“There are very few women who would ever choose to have a termination of pregnancy … we want to make sure we can provide women with reproductive choice.“
Minister wants to ensure continuity
Tasmania’s Health Minister Bridget Archer has instructed the Health Department to ensure “there is no service gap” if Calvary takes over.
Health Minister Bridget Archer wants to ensure there is no service reduction if Calvary takes over the Hobart Private Hospital. (ABC News: Ebony ten Broeke)
But she said it was “tricky” given the sale process was ongoing, meaning the department did not yet know which services it needed to negotiate over with Calvary.
“The department is having a range of conversations with other providers about what potential contingencies there might be if they end up being services that Calvary decides they don’t want to provide,” Ms Archer said.
“If an alternative private provider wasn’t able to be found for a particular service, the department [is] then looking at how we may then be able to not necessarily offer it in the public system as public, because there would be no changes to the way Medicare is used, but whether there might be private-in-public options to accommodate that.
“Obviously, we would like Calvary to continue to offer whatever range of services that they are able to offer or potentially new services.“
Labor health spokesperson Sarah Lovell said it was promising to hear the health minister would not allow a shortfall in services, but she questioned how the public system would facilitate the extra services while finding cuts in the health budget.
“It is concerning when you’ve got the Treasurer cutting $700 million from the health budget and yet they’re having to essentially absorb services that will no longer be provided in the private system anywhere in the state,” she said.
“We need to understand how that’s going to work and what funding they’ll be allocating towards making sure those services can continue.“
Public system already under pressure
While supportive of the health minister’s efforts, some healthcare providers are wary of any increase of demand on the public system.
Kelly Bruce says the public system is already under significant pressure. (Supplied)
Women’s Health Tasmania chief executive Kelly Bruce believes additional capacity would need to be built into the Royal Hobart Hospital if it is to cope.
“We appreciate that the government is trying to ensure that there are confirmed and continuing pathways for these services … and appreciate the government stepping in during what we see as market failure,” she said.
“But we are also concerned about the additional burden of picking up these procedures in the public hospital, knowing already there is a long waiting list for surgeries in Royal Hobart Hospital.“
Dr Connan said it was important to have a functioning private and public system and losing any part of the private system would add more burden on the public.
“They will need access to theatre, they’ll need extra theatre staff, they’ll need extra service providers … they’ll need extra spaces in clinic and it will all require extra funding,” she said.
“If the state government can commit to that, that’s great, but we haven’t been able to meet the demand at all times in the current system.“
The Royal Hobart Hospital is regularly under sustained pressure, resulting in limited access to beds. (ABC News)
Ms Archer said people shouldn’t be concerned that they won’t be able to access services they can now.
“There are obviously ideal ways [to keep services going], but importantly, I think reassuring people that we will ensure there is not a service gap.”
Healthscope announced earlier this year it would restructure itself into a not-for-profit operating 31 hospitals.
That process is ongoing.
The sale of Hobart Private was already underway when the restructure was announced.
The ACCC is assessing the sale and will need to take into account potential loss of services and Calvary’s monopoly in the state, but also the fact there was no other interested buyer.
A decision on the sale is expected on July 28, although it may choose to enter a longer period of assessment.
Calvary Health said it could not comment on the services it might offer through Hobart Private while the sale process was underway.
“We continue to work with the regulator to meet the requirements of the bid,” a spokesperson said.