Centenary Hospital's 'code yellow' is over for now but 21 midwife roles remain vacant

Staffing issues at the Centenary Hospital for Women and Children have abated for now after a weeks-long ‘code yellow‘ was cancelled on Wednesday morning (13 September).

The existence of the operational response, which was triggered by a lack of available midwives, was revealed by the Canberra Liberals during question time in the Legislative Assembly.

Health Minister Rachel Stephen-Smith also confirmed that 11 midwives had left their positions at Calvary Public Hospital Bruce before it became the North Canberra Hospital – 10 chose to take redundancy and one left for personal reasons.

Shadow Health Minister Leanne Castley said this meant some Canberrans were unable to access medical birthing care.

She detailed the experience of one woman who had contacted her office after experiencing a miscarriage. Her GP had told her to attend Centenary but she couldn’t be provided with assistance.

Apparently, the response she received was, “Well, it’s Thursday”. She ended up going to Queanbeyan Hospital for help.

Ms Castley said this wasn’t good enough.

“The ANMF [Australian Nursing and Midwifery Federation] warned the government that the loss of even one midwife would have implications on a ward or clinic, yet the Labor-Greens government blundered ahead [with acquiring Calvary Public Hospital Bruce] anyway,” she said.

“Instead of increasing flexibility, as was claimed, the government’s takeover of Calvary has caused a mass exodus of midwives, which has contributed to the strain on frontline staff … in our public Women and Children divisions.

“The ACT now has two Women, Youth and Children divisions, in both the north and south, that have been stretched due to this government’s inability to manage our health system and retain our talented midwifery staff.”

Ms Castley argued the existence of the extended code yellow proved the government was mismanaging Canberra’s hospitals and health staff.

“These staff shortages, people leaving our system, the code yellows actually mean, at the end of the day, that Canberra women and children are missing out,” she said.

“We’re talking about staff, human beings that are overworked and are leaving our Canberra Health Services (CHS), that has caused an internal disaster.”

Health Minister Rachel Stephen-Smith disagreed with this assessment.

She said this particular code yellow was in relation to both staffing shortages and increased demand at Centenary and had allowed for an operational response by CHS.

“What calling the code yellow enabled was the emergency arrangements under the enterprise agreement to be brought into play; that means that there’s a capacity to call in additional staff, support those staff and to make other arrangements,” Ms Stephen-Smith said.

“[It also allows CHS to] stand up a health emergency operations centre, which was stood up for this period.”

She confirmed the code yellow was stood down on Wednesday morning and that other emergency arrangements had been discontinued last Friday.

There are currently 325 midwives at Centenary and 112 at North Canberra Hospital.

Just under 21 full-time equivalent (FTE) positions are available in midwifery at Centenary, and just under six FTE positions in the same unit at North Canberra.

The staffing gaps have been plugged with agency staff who can be paid up to $100 an hour.

As the enterprise bargaining agreement for the ACT’s nurses and midwives is ongoing, Ms Stephen-Smith admitted people leaving the sector to take up agency roles was a challenge.

“And then, of course, because we’re short-staffed, we have to take on those agency staff,” she said.

The Health Minister also disagreed with Ms Castley’s assessment that code yellows were rare and signalled an internal disaster.

She explained they happened all the time.

“A code yellow is called probably a few times a week for various different matters, so it can be anything from a substantial staffing challenge to a lift is stuck or a nurse duress button isn’t working or an IT issue,” Ms Stephen-Smith said

“So these codes are called on a regular basis so the hospital can respond.”

According to CHS’s emergency management plans, a code yellow is activated when infrastructure and/or other internal emergencies impact service delivery standards both “internal and external to buildings”.

Code yellow enables the hospital to mobilise resources in response to “extraordinary circumstances” at short notice.

A Canberra Health Services spokesperson said maternity services at both were experiencing workforce shortages, but the code yellow helps manage current demand while prioritising the care provided for women, children and their families alongside the safety and wellbeing of staff.

“To manage current demand across both maternity services, the teams are working together to manage activity across both hospitals,” they said.

“We are also utilising long-term highly qualified agency midwives as required to support staff and ensure ongoing quality care for women and their families while we actively recruit to these vacancies.”

Code yellows are part of the Australian standards for planning for emergencies in healthcare facilities.