In 2022 Ramsay Healthcare opened Australia’s first women’s-only hospital “dedicated” to trauma-related mental health issues in Wollongong.
Ramsay Clinic Thirroul was supposed to be a “gamechanger” designed specifically to provide women – often survivors of family and sexual violence – the safe environment needed to be able to escape the flight or fight stress response and begin to recover through a program of therapies.
But the facility run by Australia’s largest private hospital operator has since dropped the emphasis on care “dedicated” to trauma patients on its website, now describing itself as providing a range of “women’s mental health services”.
It is now a general female-only psychiatric unit which – like many other Ramsay facilities – has a public-private contract with NSW Health, allowing it to take public patients who do not have access to public beds.
The changes to the hospital come against the backdrop of the mass resignation of New South Wales public-sector psychiatrists which has led to the state government asking Ramsay facilities to take public mental health patients.
A tale of two admissions
When Olivia* stayed in the facility for the first time in March 2024 to receive treatment for PTSD from childhood trauma, she described the experience as “very helpful and I felt I gained a lot out of it”.
But when she returned in February to be admitted for the second stage of the program, she says the experience left her “struggling more than I did before I was admitted”.
She was unaware that the clinic had begun accepting women detoxing from drugs and alcohol.
“For those such as myself whom have PTSD surrounding drugs and alcohol from childhood trauma, this makes this a place that doesn’t fit my needs of feeling safe and less vulnerable [while] having treatment,” she said.
Olivia said there were a few patients detoxing there and she was “majorly triggered and abused” by one of them on the second-last day of her stay.
When Olivia was sitting with a nurse completing her discharge paperwork, this other patient demanded to speak with the nurse “but not in front of ‘that’, referring to me”, she said.
“I found myself highly in flight mode and before I knew it I was heading out the driveway walking towards the street and towards the train station. This triggered the emotional flashbacks and lack of safety from the abuse my brother implemented on me in my younger years.”
Ramsay said it was not previously aware of Olivia’s concerns but took them seriously and would welcome the opportunity to speak directly to her.
Olivia said while she understood women detoxing from substances needed support and help, she was not sure she would seek help again from the clinic after the way things ended.
‘An urgent ongoing need’
A psychiatrist and another staff member who resigned from Ramsay Clinic Thirroul told Guardian Australia the psychiatrists who began the venture and the team who wrote the program for the hospital have all since resigned.
Guardian Australia understands more than half of the patients admitted lately were under a drug and alcohol specialist as the trauma specialists had either already left or were planning to leave.
Rose Jackson, the NSW mental health minister, told the upper house on 27 March she was aware Ramsay Clinic Thirroul was no longer providing specialised trauma care and had reverted to a general women’s mental health facility, in response to questions from Dr Amanda Cohn, the NSW Greens’ spokesperson for mental health.
Jackson said as it was a private facility, this was not a decision made by NSW Health.
“I have received correspondence and representations in relation to not just the fact of that very specialised care not being available for those women any more, which does concern me, but also some broader issues relating to the change that has occurred there,” the minister said.
Cohn told the parliament that the change to the Thirroul clinic left NSW without a specialist inpatient trauma service for survivors of family violence and sexual assault, which she said was “an urgent, ongoing need”.
“One of the most important components of trauma‑sensitive or trauma-informed mental health care is continuity of care,” she said. “It is reliability, predictability and a long-term relationship so that people do not have fragmented care.”
She added that mental healthcare in the state had become increasingly fragmented.
The NSW public sector has a longstanding shortages of psychiatrists, with a pre-existing vacancy rate of more than a third of permanent staff specialist positions. The NSW branch of the Royal Australian and New Zealand College of Psychiatrists wrote to the state government on 13 October 2023 detailing the workforce crisis with difficulties in recruitment, training and retention.
After 16 months of negotiations with the government failed to reach a solution, the remaining public sector psychiatrists started resigning en masse in January in a dispute that remains before arbitration in the NSW industrial relations court.
Before the psychiatrists threatened resignation, Ramsay Health Care Australia had been advocating for their available private hospital beds to be used to address unmet public demand.
In a submission to the NSW special commission of inquiry into healthcare funding dated October 2023, the chief policy officer for Ramsay wrote: “RHCA [Ramsay Health Care Australia] encourages governments to partner with the private system to support delivering essential services given the private system has the capital and workforce to address government dilemmas, such as mental health and elective surgery demands.”
A spokesperson for the Illawarra Shoalhaven local health district, which provides public health services for the Wollongong area, said the district had a longstanding agreement with the Ramsay clinic to be available to support the provision of non-acute mental health services if the need arose but that had not been required so far.
Dr Pramudie Gunaratne, the NSW chair of the Royal Australian and New Zealand College of Psychiatrists, said: “We are starting to see workforce shortages in private hospitals too, which limits the ability of these hospitals to take on additional patients.
“These public-private partnerships are not only incredibly expensive for the taxpayer, they are also unsustainable given the current workforce issues and we have serious safety concerns for patients and staff as these facilities are generally not equipped with the infrastructure and staffing to care for patients with high acuity needs.”
A Ramsay Health Care spokesperson said: “Ramsay Clinic Thirroul is a women-only mental health facility specialising in trauma-informed care. Since opening more than two years ago, the clinic has supported women with complex PTSD, often alongside other mental health or physical health conditions …
“Ramsay Clinic Thirroul remains committed to providing high-quality, personalised care in a safe, respectful environment for women experiencing trauma.”
*Name changed to protect anonymity
