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Doc: NSHN/14/23533
Dear Senior Medical Staff
RE: An open letter in response to a proposed vote of no confidence in NSLHD Board
We write in response to the Medical Staff Council Executive’s proposed motion of no confidence in the
Northern Sydney Local Health District Board. We are sending this letter to the same list of clinicians to
which the notice of the extraordinary meeting on Monday 22 December has been sent. We hope you will
all read it and consider the contents with open minds.
We recognise that the Medical Staff Council, as acknowledged by the MSC Chair, has no constitutional
power and that its primary role under the NSLHD By-Laws is to advise the Chief Executive and the Board in
medical matters. This vote has been suggested as a way of bringing the RNSH MSC view of infrastructure
and facility planning to the attention of the Minister for Health. The decision to invoke the Board is both
frustrating and disappointing. As we have previously stated the Board is not responsible for the divestment
or acquisition of Crown Land.
It distracts from the real business at hand, which has always been about securing important support
services (including staff and patient accommodation and childcare) that staff, patients and carers tell us are
necessary on campus.
Worryingly, this decision and the misinformation associated with it, undermines the confidence of patients,
community and staff. Therefore, the Board must respond to the allegations in the motion outlined below.
1. “The Board’s failure to disclose the planned divestment of campus land over the entire duration of
the campus master planning process. This process extended from early 2012 until September 2014
when, without notice or consultation, the “Expression of Interest” (EOI) process for the sale or longterm lease of the southern campus land was announced. There is no mention of sale or long-term
lease in the masterplan document which was developed during the campus master planning
process.”
The clinical representatives on the working group made an excellent contribution in developing the
masterplan, thoughtfully organising the campus into zones for the future. That process was complete in
2013 and that is the masterplan that we are now working to.
The reason why there is no mention of sale or long-term lease in the masterplan document is because it
was never the remit of the Masterplan Executive Working Group (MEWG) to decide how the support
services within Zone 8, or indeed how any of the services within many zones would ultimately be delivered.
The MEWG was responsible for determining the use of the land, which they did. It was this land use,
represented by the zonal map, which was endorsed by the Board and provided to the Minister for approval.
Northern Sydney Local Health District is located on the traditional lands of the Eora Nation
All correspondence to be emailed or sent to:
[email protected]
PO Box 4007
Royal North Shore Hospital LPO
St Leonards NSW 2065
Tel (02) 9462 9955
Fax (02) 9463 1029
Northern Sydney Local Health District
ABN 63 834 171 987
2
A newly established Masterplan Advisory Review Committee (MARC) will now be established and will
include senior clinicians and representatives from nursing, allied health and consumers.
The RNS MSC Chair was in attendance at a Board meeting on 2 September 2014 where it was announced in
a presentation by Health Infrastructure that Government Property NSW would lead an Expression of
Interest process to determine if there was interest from the private sector to deliver these support services.
That process remains underway and no recommendations or decisions have been made.
2. “The Board’s failure to consider the long-term future of the campus in endorsing the sale or longterm lease of the southern campus land and not providing an opportunity for alternative funding
options to be explored.”
This is absolutely not true. Major decisions on campus are always considered in the context of what’s best
for patients, staff and community, now and into the future. The entire purpose of the masterplan is to plan
for the long term future of the campus. It is incorrect to continue to suggest that there is not enough space
for clinical services when the masterplan more than doubles the space into the future. There is also
planned additional capacity at Hornsby Ku-ring-gai Hospital and at the Northern Beaches Hospital to cater
for the patients within the Northern Sydney Local Health District. Treating patients more appropriately
closer to home in new purpose built facilities at these sites will free up space at RNSH to undertake the
specialized work for which the Hospital is renowned.
Government policy has consistently supported the leverage of taxpayers’ dollars with private investment
when appropriate. The southern zone has been identified by the masterplanning process (including
clinicians) as suitable for childcare, patient and carer accommodation, health administration and a range of
additional community services, which the Board has unequivocally supported. The NSW Government has
considered that these services may be better delivered by those who deliver these services as core
business. Hence alternative funding options have to date not been required as the government has decided
to test the market via an EOI process.
People are being led to believe that the area planned for support services is taking space away from clinical
services. This is not true. The working group specified that particular area (8 per cent of the total campus)
for support services.
3. “The Board’s misrepresentation of the views of the clinician representatives on the MEWG to the
Minister of Health and to the broader RNSH staff, by implying they either i) supported the proposed
sale or long term lease of Zone 8 of the southern campus or ii) “signed off” on the divestment by
endorsing the campus masterplan. This was clearly not the case as outlined in the letter written by
the aforementioned clinician representatives to the Chair of the Board, dated October 10 2014.”
We dispute this. As stated above, there was no intention to imply in communications about the clinicians’
support of the masterplan zonal map that this included the proposal to divest or lease the land. Again,
agreeing to the sale or lease of the land was never the remit of the MEWG and it was noted at the RNSH
Masterplan briefing to staff *on 23 September 2014 that the clinicians were opposed to any sale of land
“to protect future service provision”.
Northern Sydney Local Health District is located on the traditional lands of the Eora Nation
All correspondence to be emailed or sent to:
[email protected]
PO Box 4007
Royal North Shore Hospital LPO
St Leonards NSW 2065
Tel (02) 9462 9955
Fax (02) 9463 1029
Northern Sydney Local Health District
ABN 63 834 171 987
3
4.
“The Board’s failure to acknowledge the concerns of the MEWG clinicians, or that their views had
been misrepresented, and to provide a response to the letter described in point 3, above.”
There have been numerous communications, including staff briefings sessions, face to face meetings,
emails and letters. The Board and NSLHD management have spent a great deal of time responding to
requests and questions from the MSC Executive and remain happy to do so.
During these interactions, the Board has heard the opinions of the working group clinicians and continue to
reinforce that the campus has more than adequate space for clinical services, which appears to be their
concern.
The Board Chair responded to a letter dated 14 September 2014 from the Chair of the RNS Medical Staff
Council, but acknowledges that no formal response was provided to a further letter dated 10 October 2014
and signed by the clinician representatives on the Masterplan Executive Working Group (MEWG).
This was because as a response to the second letter was being prepared, a meeting was arranged at Royal
North Shore Hospital at which the Minister, Health Infrastructure’s CE and the Chair of the MEWG had
agreed to address staff of the LHD. The Minister also agreed to meet the MSC Executive in private after this
meeting and we anticipated that the issues raised in this letter would be canvassed at that meeting, as we
believe they were. We apologise if this was considered inadequate. No slight was intended and we
apologise if any was taken.
5. “The Board’s failure to acknowledge, and take responsibility for, the communication failures around
the divestment strategy. This failure was further compounded by the attempt to blame the MEWG
clinicians for failing to communicate the details of the campus masterplan to the broader nursing
and allied health staff – an accusation that was both disrespectful and baseless.”
The Chief Executive has apologised for the fact that only Divisional Heads, and therefore doctors, were
represented on the working group. Going forward, allied health, nurses, other staff and community will also
be represented on MARC. The Terms of Reference for MARC working groups will be clearer about
participants’ role in cascading communication.
6. ‘‘The Board’s provision of incorrect information regarding the land divestment – the MEWG
clinicians were assured by the Chair of the MEWG that there was no plan to divest campus land.
There has been no explanation for why the MEWG was given this incorrect information.”
This statement is strongly disputed by the Chair of the MEWG. There is no recollection or documentation
that supports this allegation, and minutes and copies of presentations state that divestment may be
considered into the future. As stated previously, it was not the remit of the MEWG (as per the Terms of
Reference) to decide how services would be procured. This is clearly not under the purview of the Board
but rather considered at a higher level of government.
RNSH is one of the best resourced hospitals in the state, with more than $1.3 billion investment in clinical
facilities.
Northern Sydney Local Health District is located on the traditional lands of the Eora Nation
All correspondence to be emailed or sent to:
[email protected]
PO Box 4007
Royal North Shore Hospital LPO
St Leonards NSW 2065
Tel (02) 9462 9955
Fax (02) 9463 1029
Northern Sydney Local Health District
ABN 63 834 171 987
4
Those who continue to misrepresent the position of the Board and its members and more broadly
disseminate inaccurate information about the future of Royal North Shore Hospital, by way of no
confidence motion and otherwise, will continue to cause unwarranted uncertainty and anxiety in the local
community and undermine public confidence in, and the reputation of, the Hospital, the Local Health
District, its Board and the members thereof.
This has repercussions for our patients and their carers, and our staff and the damage to our collective
reputations is incalculable.
The Board therefore has an obligation to consider all appropriate options to protect public confidence in,
and the reputation of, the Hospital, the LHD Board and individual members thereof.
We therefore request that those involved cease spreading these incorrect claims.
We all have the best interests of the patients and staff of Royal North Shore Hospital in mind as we plan for
the future. Surely, with the same goal in mind, we can find a way to agree on how best to achieve this.
We look forward to briefing staff and the community about progress in bringing support services to the
campus, including the outcomes of the Expressions of Interest process in 2015.
In keeping with the NSLHD Board’s continuing commitment to transparency in its governance of the LHD,
this letter will be uploaded to the NSLHD website and staff intranet.
Yours sincerely
Professor Carol Pollock on behalf of the NSLHD Board
Date: 17 December 2014
*RNSH Masterplan briefing for staff
http://intranet.nslhd.health.nsw.gov.au/Redevelopment/RNS/scampus/Documents/Presentation%20%20RNSH%20Master%20Plan%20-%20Staff%20Briefing%2023%20September%202014_FINAL.pdf
Northern Sydney Local Health District is located on the traditional lands of the Eora Nation
All correspondence to be emailed or sent to:
[email protected]
PO Box 4007
Royal North Shore Hospital LPO
St Leonards NSW 2065
Tel (02) 9462 9955
Fax (02) 9463 1029
Northern Sydney Local Health District
ABN 63 834 171 987