Fifty senior doctors are vying to be cardiologists at Canberra Hospital, the Health Minister says, as the cardiology unit comes under fire.
On Monday, five private cardiologists sent the minister a letter saying "there has been a marked deterioration in the last 12 months" in cardiac care and "has deteriorated to standards far below national and international guidelines".
"Patients ... at present have no option other than pay for such services in the private sector," the letter said.
Staff shortage after alleged bullies stood down
Four senior cardiologists were stood down in April 2022 after an independent review alleged the doctors had bullied other staff and contributed to a toxic workplace culture.
ACT Health Minister Rachel Stephen-Smith on Friday said: "It's been quite a disruptive time over the last year or so, but the staff have really pulled together."
The process of hiring new specialists has been protracted partly because of legal issues presented by some of the suspended cardiologists, Canberra Health Services chief executive Dave Peffer said.
Three of the four are still technically employed by the hospital.
An advertisement on recruitment site Alumni had four specialist cardiology positions open for Canberra Hospital, with a final application date of March 10.
"We do follow a very methodical process of giving everyone an opportunity to respond to any allegations," Mr Peffer said on Friday.
"And at times, that also includes legal representation which can slow the process down further, and that has been the case with a number of these."
The hospital has also struggled to employ enough specialists on locum, or short-term contracts, he said.
"We've looked to always maintain the [full-time equivalent requirements]. At times that has proved challenging, and that's not unique to us here in Canberra," he said.
"It is challenging to pick people up and have them relocate on a short-term contract."
Long waiting lists nothing new
There were long waiting lists before the four senior cardiologists were stood down, Canberra Health Services clinical director of medicine Ashwin Swaminathan admitted.
"There was a wait list preceding the suspension of cardiologists last year and we're working hard to reduce that," he said.
"In many cases we have, and in some cases they are not the same as they were a year ago, so I share concerns. We don't like wait lists."
The letter from the private cardiologists said there should have been better strategies to manage increased pressure on the department.
"What we did not observe was enactment of a considered and 'ready-to-run' operational plan to ensure that cardiology department services were not unduly impacted [by the suspension of staff," it said.
"The cardiology department still operates with reduced clinician numbers."
When asked why the cardiologists were stood down even as the hospital struggled with long waiting lists, Ms Stephen-Smith said it was pivotal for patient and staff safety.
"There was no world in which we could sit back, get those independent reviews and not do anything about it ... it was very clear that some serious action needed to be taken. It was understood that that action would be disruptive," she said.
"Ultimately, this was not only better for staff in creating a safe workplace, but would flow on to improve outcomes for patients."
Minister's advice to CHS
While three of the stood-down cardiologists were still nominally employed by Canberra Health Services, Ms Stephen-Smith supported the idea of hiring staff in additional roles for "future-proofing".
"I really want Canberra Health Services to be thinking proactively about how we ensure that we're future-proofing the organisation in terms of staffing, not just doing the minimum we need and then ending up spending more on expensive locums and agency staff," she said.
"The Northside Hospital, but also the Canberra Hospital expansion ... we're already planning for recruitment to that as well, and that does include an increase [in] cardiac services."
The private cardiologists said "poor managerial decisions" by ACT Health, Canberra Health Services and hospital senior staff was to blame for "the current parlous state of cardiology services at The Canberra Hospital".
Ms Stephen-Smith said she "absolutely" still had confidence in management.
