Many questions have been raised over why the Territory felt it needed to have a transition period at all ahead of the compulsory acquisition of Calvary Public Hospital Bruce (CPHB) – and the answer has been laid bare in court documents.
In it, he outlined why the Territory felt it needed to have a lead-in time for the takeover.
Mr Peffer said the Northside Hospital Transition Project Steering Committee (TPSC) had identified several risks in developing mitigation strategies around the acquisition.
A number of those were rated “high” or “extreme”, with several relating to CPHB staff.
These were the risk of ineffective payment of new staff, the risk of CPHB’s staff having a “poor experience” with the transition, which could result in an unengaged workforce, higher attrition levels, poor culture or impacted wellbeing, and the risk of failing to onboard new staff before the project ‘go live’ date which could result in the inability to collect employee data in a “streamlined and efficient manner”.
Mr Peffer said his view was that one of the most significant clinical risks to the Transition Project was around the payment of CPHB staff.
“Based on my experience, if CPHB staff were not paid after CHS takes over operation of CPHB, CHS would likely lose the trust of the CPHB workforce,” he said.
“If CPHB staff were not paid, the quality of care provided at the hospital could be compromised, with staff attention potentially being diverted away from patient care.
“The key driver of this risk eventuating would be a lack of information from Calvary in sufficient time to fully onboard new staff, including in relation to time-capturing methodologies to avoid underpayment of staff.”
In an effort to manage this, the Territory set up voluntary forms for staff to provide their information ahead of the acquisition date.
The Transition Team also hasn’t been allowed to directly contact CPHB employees until the court orders had ceased.
Workforce information sessions have been held offsite, with about 200 staff having attended or individually sought information as of 3 June.
Mr Peffer viewed the transition period as a chance to engage with staff to boost the “safe and orderly transition” of CPHB to CHS.
“During the transition period, we intend to work very closely with middle managers to ensure we have adequate numbers of staff and the right mix of skills,” he said.
“We will track employees’ conversions as seen in key roles not coming across. We will be working with managers on the ground to identify what this will mean for the next roster so that we can fill in shortfalls.”
Mr Peffer also outlined the short transition period had been chosen as it was felt this would serve in the best interests of “safe and continuous provision” of health care services at the hospital, which he has also explained in an email to CHS staff.
“For CHS to assume responsibility for the operation of CPHB, it does not require every single detail about the hospital, the land and its assets,” Mr Peffer said.
“The Territory only requires information about the critical systems and the critical operational information.”
He argued other aspects of the acquisition could occur over the next 12 months.
Mr Peffer’s affidavit also outlined some of the frustrations being experienced by CHS in relation to CPHB being able to adapt when The Canberra Hospital was under strain.
The Canberra Hospital is the trauma referral centre for the ACT and surrounding NSW region, and is a level 6 principal referral hospital, while CPHB is a level 4 public acute group A hospital.
Mr Peffer said there was a “substantial difference” between what they could provide.
“CHS is the healthcare provider of last resort as it provides the safety net for CPHB and other smaller hospitals in the region,” he said.
He outlined frustrations between the two hospitals when Canberra Hospital has had to activate additional beds on short notice, such as when CPHB went on ambulance bypass in May 2023.
Mr Peffer said CPHB had, at times, refused to activate capacity at short notice.
“Instead, it has required that commercial negotiations be undertaken before increasing supply in the health system,” he said.
“In my experience, this model of split public health service delivery results in inefficiencies and restricts the ability of the public health system to respond dynamically to public health requirements, including in emergency situations.”
He also said there had been difficulties in transferring people requiring non-acute care from Canberra Hospital to CPHB to free up more urgent beds.
“As a consequence, the Canberra Hospital regularly admits patients requiring generalist or non-acute care to the specialist hospital when it would have been more efficient from an operational perspective for these patients to be transferred to the level 4 hospital,” Mr Peffer said.
Calvary Health Care’s application for an injunction on the hospital’s transition was dismissed by the ACT Supreme Court on Friday (9 June).