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Northern Territory Department of Health Library Services Historical Collection

DL HIST 36 2 . 1 1 DAR 1979

.. ~~~--~~s:;:c,;cj..---=-·-"-" ___ ., __

~-f~!1~li~~lf l~lii

^TH

SERVirr---"-""""""---~---"::;~T~'"F'-

' 3 0820 00019953 4

79/400

4 J ~ 1979

The Secretary

Departant

ot

Heal th

RE DRAJ"f POLICY DOC11.KiliT - DARWIN HOSPITALS GROUP

Enclosed is the document with amendments proposed at the meeting convened by you on 19-20 Decaber 1978.

D.J. S:,a.in

Caauarina Bospi tal Seo:retary

B/C Mr L. Beynon

Attention: Nr D. Hyde and A. Lowe

D.J. Spain

Casuarina Hospital

CENTRAL LIBRARY - 1 SEP 1998

TERRITORYHEALTHSE ES

2

lie.ton

CTrAmw

~ T tn 197 4 1 t vaa planned. that Caf!JWU"ina Hoepi tal vow.cl

M 0Glli!llliaaiou4 ia J ~ , 1977 vith ;8} beds and 117 baa1d.neu. Allowing

75

NNiMU

tor

n,n,borna 'ihe authorifMd bed111hte vau1 to be

425

i n o l ~ lat.mud.'fll

Can

Unit bed.a. Endtmoe to the Parliaaeata.r,' \lorka COllllilld.ttN _..iaapd. a tuthar 220 Nd.a and. a rehabilitation cntre being coftfllU'1&Cted 1a Stap 2 wh1ob w.e to o ~ e in 1980.

I\ V88 alao illtended to coneu,aot 0'1:wr heal th tacili ties ll'UOh a.a tM Cen'b81 L&laon:tor;r, a C11ntra.l Toolmioal MaintsDBaee \tlorkahop, .Harry Chan

~ . . . !'or the A8rit Belen Phillippe Child Real th Unit, A.H. Bapbrey . _ . to

~ l T

BQdioa]Jp9d Childrea, ad n Aborigim.J. Heal th workers

~ Y i l l a p .

fbe O.tnl La.l,on.tor,' bu bee redued. in scope ^and planDK tn

•'tap•

vitla . _ !inst etap now due tor ooapletion in Deoaber, 1979. the Central TeohmNl. Jlfaiawnamoe Workahop ia also ad.er corurtruotion and 111 targeted

fer completion iri March, 1979.

!be Ma.in W4U"d. Jlock911 111truot\lftl. o011pl11t'tion data is June, 1979 but telephone iutallaUou will contimls to the nd of Allgr.ust, 1979. Other buildinp

haft lMn ooapletad. and have

Ne

pat i.Dto senicea theae inolude the Serf'ioea

Blliltliac,

~ and 80IW

atatt

acocrmiodation vith ^& cape.oit;r tor 225 naidnt~.

To 4at. the mamber

et

reaidenh h.u 'been reatri.otad. because dinJ.n6 1'00lll f'acilit-

1•• wen

aot an..Uable and 11011t of the aocOllllilOd.Ation is not. selt o o n ~ . Jo'tveea J ~ an4 Oeto'ber 197, the Village Complex vill be progresainl.7 OOl!QleW. It will provide 196 bed sitter units for

au.rt.

WI!( OF HOSPITAL RESOURCES 11 DAR\ill

fllere han been lower than expeoted population growth rates tor Darvin and

~ lllorthem hffi tor., in geural. The pndioUou for the period to 1985 haft alao lKta lowered. VariaUona betw.n the Parliaaentar., Wo:dca Coaaittff nid.eaN1 l>a:Nin. lleoomstnoUon 001Ri11eicm ^and the Depart:aw.nt ot the llorlhern hffitu,' an ::nfieoW as follon far the Gnater Darvin Area I

WC

1,12 1980 ' ' 777

1,es 157 ,16

me

1975

Dft 1977 62 200

58

000 51 ~40 86 000 62 890

Darwia Rural Artli&

1 - l ~

Bovard Sprillgs/McMinns Laeoon

XOolpiny-ab/llumpt,y Doo le:n.'J' Spriap ^Area 1 imu.a ii ver Area.

2

297

22, 11}

149

kluoe

ot

Rural

iaclmu,g

Jtu.rd.ng Diatricts 11 , 112, lf3 and. :tU.grator,. Popula:Uon

45 262

2 782

7 320

55 :,64

I

9 3

of

7

11

The Commonwealth coat sharing agreement requires that receipts such as inpatient fees be deducted from gross operating costs be.tore oa.loula.ting the 50}6Commonwealth share. In

1977/78

^the

receipts totalled $1 028 892. Thus the Commonweal th¹ s contribut- ion would be i

$17 465 385

Less receipts 1 028 892 2)$16

436 493

$ 8 218

296

For ea.oh add.i tional 36 ^{bed ward} opened at Casuarina Hospital, the

average overall cost would be $1 618 013. This figure contains an element for the whole of the hospital's responsibilities i.e. not just the staff to treat the patients and olea.n the floors but all the Bupport services such as cleaners of residential accommodation which houses_ the staff who treat the patients.

(2) Darwin Hospital's operating costs will increase as the alack is taken up at Casuarina. and planned functional units begin to operate or existing uni ta ex:pa.nd.,

The following figures are exclusive of the Northern Region Admin- istration Base operational expenses except for cleaning, repairs and maintenance etc. This is because they are eeeentially

Community Health functions and are not part of the hospital cost sharing agreement between the Commonwealth a.nd Northern Territory Governments. Prices a.re in 1977/78 dollars.

(a) Sta.ff Acoommodation, Pilot Rehabilitation Unit

001

and Psyohiatrio Services only $3 050 050

(b) ^The above {a) plus 30 bed non-acute geriatrios etc $3

595 341

(o) The above (a) plua (b) and full outpatients services

34

380

775

(d) :ruJ.l implementation of plan Future Role, Danrin

Hospital 1980-1985 as updated in this document

$7 655

220 (3) Summary of estimated costs using 1 and options (c) or (d).

FULL YEAR OF OPERATION .

1980 Oall'WU:.'ina. Hospital with 336 beds authorised

1• Darwin Hospital with : geriatric and long stay patients, eta.ff accommodation,

pilot rehabilitation unit, psychiatric services and

319 513 035

full outpatient services ~ 280 775, 1985 Caeuarina. Hospital with 336 beds authorised

above in 1980 plus 72 beds on the fifth :floor

1985

Darwin Hospital developed to a 160 bed institution with allied functions

12, 893

810

$19 513

035

1 618 013 1 618 013

$22 749 061

7 655

²²⁰

s,o

^{404 281}

DARWIN HOSPITAL - FUTURE ROLE 1980-1985

Index Page

1 The Need for Review 1

2 Important Considerations 2

3 Population Predictions 3

4 Outpatient Services

4

5 ^tr, Central Chest Clinic 5

6 X-ray Facilities 5

7 Pathology Services 6

8 Sterile Supplies 6

9:i r Psychiatric Services 6

" 10 Quarantine and Nutritional Rehabilitation Unit 7

f ' 11 A.H. Humphry Home for Severely Handicapped Children 8

,/f> 12 L Rehabilitation and Longterm Orthopaedics 9

13 General Ward 10

v,14 Geriatrics 10

15 Rehabilitation Workshop and ¥Jaintenance Workshop Extension 11

16 Linen Reception/Distribution Gentre 11

17 Catering 11

18 Medical Library 12

" 19 Operating Theatres 12

20 Aboriginal Health Worker Training 12

ll 21 Nurse Aide Training 13

22 Industrial Staff Changerooms and Amenities 13

23 Incinerator, Mortuary, Boilerbouse 13

24 Hospital Store 13

25

Coveredways, Footpaths and Roads 14

26 Landscaping and Gardening 14

27 Staff Accommodation and Amenities 14

28 Northern Region Administration Base 15

29 Wards 11 and 12 15

30 Wards 14 and 15 1

5

31 Demoli tion/Redti.ndancy/Removal Program 16

Attachments:

A Statistics B Site Plan 1977 C Site Plan 1985 D Bed Summary

In 1

( )

( (

( (6

( 6

for

3 Population Predictions 3 (a) Greater Da...T>Win Area

Year

1971 1976 1976

the Northern :predictions - 1

December 1975 and DNT -

FWC 1972 36 828 62 096

- - - · ·

... .•. ... ··•···• . .. ^{. . .} ... -··· .•••... ,. ..•... ,

1977 1978 1979 1980 1981 1982 1983 1984 1985 (i) (ii) (iii)

1

68 825

76 293

84 580

777

115 310 127 881 141 833 157 316

census figures include the rural area

for referrals from

3 (b) Darwin Hospital Area of 1

30.6.76 Greater

of

Area

F'irmiss including

and

Doo Area Area

2 113

2 782

1

1979

1981 1 1 1

G:rea

62 65 400

4 Outpatient Services

contact or

will be provided at Darwin Friday excluding public visiting specialists clinics

by heads units hours Casualty

13

8am to

4.

these will be

and staffed

personnel. The will be used

Ambulances will take accident victims direct to

CI:IC

It is anticipated that the service will be utilised the to and

workforce and those residents within the older town boundaries {lo utili

---

^...

---· · -

5

5 Central Chest Unit

The Central Chest Unit will transfer from the leased premises in the MLC Building to the Radiology Department building at Darwin Hospital and utilise equipment already installed.

Staff establishment for the Central Chest Unit is:

Medical 2

Nursing 2 + 1 part-time Paramedical 2

Clerical _L

15 + 1 ^{II II}

The number of people X-rayed at the Central Chest Clinic in 1976 was 5 919 with 6 502 exposures.

Consistent with common practice, TB patients in hospital will be treated at Darwin Hospital.

6 X-ray Facilities

The existing Darwin Hospital Radiology Department will be used as the Central Chest Clinic. Non-specialist radiological investigations will be conducted during outpatient hours by the Chest Clinic

radiographic staff with Casuarina Hospital support~

By 1980 it is estimated that radiological services will be provided to 8 200 outpatients with 24 700 exposures. To this must be added

- 0 91.lfl/11

the Chest Clinic attendances. Inpatient demands are.expected to be low.

These levels of activity will generate the need for medical records storage and the staff to operate the service.

All specialist radiological examinations and those involving contrast media or special patient preparation will be conducted at Casuarina.

7

Pathology- Services

Until a permanent (see 19) at Da._""Win facilities the the collection of Casuarina Laboratories The temporary demountable the site.

8 Sterile

6

is established in the use will be

of basic for services

will

The Central Sterili to

the

but instead will serve as the for

sterilised material at the

9

Casuarina Darwin

Services - Patients and Alcoholic

1 and 2)

sessions , the service will be

1

Two wards will be provided:

Ward 1- with restraint facilities and inpatient beds Ward 2 - with day care beds, group therapy amenities and

psychiatric day centre facilities.

The eventual demolition of the old and surplus buildings in the vicinity of Ward 2 and facing Lambell Terrace will enable land- scaping development and a street-front approach to the psychiatric centre. A consultative and counselling service will be established staffed by specialist psychiatrists, psychologists, social workers and support staff.

Psychiatric bed occupancy for

1976/77

averaged 15. This figure will be increased with the return of about 10 patients presently accom-

modated in Adelaide and will be further increased with the introduction ~

of new regimes such as inpatient assessment of drug dependent patients.

10 Quarantine and Nutritional Rehabilitation Unit (Ward 4)

The Department will be required to vacate the premises and surrender the site of the existing Quarantine Station in due course to make way for the construction of a power station. Because of the diminishing demand for accommodation of persons under surveillance and isolation for quarantinable disease it is considered impracticable to proceed with building a new quarantine station which is seldom used.

The need exists however for the provision of a ward unit offering high security for the care of infectious disease, and accordingly Ward 4 will be utilised for this purpose. The ward will normally be used for nutritional rehabilitation but will be made available

immediately when required for quarantine purposes.

Precise statistics are not available of children admitted for

nutritional rehabilitation since often they are admitted to hospit~

for other reasons. However for avitiminoses and other nutritional

8

7

j.s rr111.cr1 rnorr:~

mothers.

11 Severely Children - A.H. Home

It is planned to develop this unit on the Casuarina in due course for children who carmot be maintained in the community.

The three categories those bedridden and

those partially mobile but those mobile but who are

it is

are:

intensive

ie handicapped children will be admitted to enable care

care for them to be a brief or to go 'On Most severely handicapped children

transferred to southern states, mainly

negotiations between the South Australian and

5)

their families

care are recent resulted in an agreement that this would cease 1

9

The Australian Hospitals and Health Services Commission recommended the provision of 0.5 beds/1000 population for severely handicapped children. On this basis a Darwin and rural population of 63 000 (see 3(c)) will need 32 beds. With referrals from the remainder of the NT (except Alice Springs which has a 15 bed unit), a unit of 40 beds will be required after 1980.

Sufficient accommodation including group therapy, playgrounds, assessment and dining facilities is available in Ward 5 and these interim arrangements will apply.

12-- Rehabilitation a."1.d Longterm Orthopaedics (Wards 6 and 7)

A rehabilitation service is to be provided which contains traditional inpatient accommodation for medical and surgical cases and support from the paramedical disciplines including occupational therapy,

<

social work, psychology and physiotherapy. The service is planned to provide office accommodation for the staff from the Department of Social Security and linking mechanisms with other government agencies and voluntary organisations such as the Handicapped Persons Association and their sheltered workshops.

The acute rehabilitation process will commence with the admission of They will be transferred to Darwin patients

Y?

Casuarina Hospital.

----!- \

liospi tal ~-~ and when the clinicians consider this desirable. Psychiatric rehabilitation will be undertaken mainly in the psychiatric ward but there will be a sharing of general patient amenities facilities, occupational therapy etc.

Additionally, facilities are required for the accommodation of long- term orthopaedics. The estimated number of orthopaedic patients by 1985 is 25. Of these a percentage, say

40%,

could.be classified as long-term ie whose hospitalisation would be expected to exceed 21 days.

Thus Wards 6 (including the area presently used for Intensive Care)

and 7, providing 30 beds (10 long-term orthopaedic and 20 rehabilitation) and support services including offices, group therapy and exercise

areas will satisfy these needs.

1

In

1

(

lci.me:n.i ties

• l . ; / •

lI12-Cl011l-,l f:'.:

1 5 Ret~abi1.i tatior:t

vicini of tl1e

The kitchen will all

exception of diets and order meals to consumption by patients a.~d staff.

The present maL~ kitchen is scheduled for demolition.

with the kitchen for

pati

19

:fu:r1ctio11;1

is

20 :Pb .. i

Jfacili ties are education of

to enable effeci;ive

the

progTams

be retaineCL for

21 Nurse Aide

is that wi:'iilst the of staff will ta~e

This will

and to

Adequate facilities at Darwin

rooms on a share basis for nurse Heal th Worker :programs,

22 Industrial

These will be

23

Incinerator, These units be

24 Hospital Store The existing

Instead the

(to be used as the Linen converted for use as the

in

is the Store,

demolition, the Linen

) , will

1

site of

II

in

2b Northern Administration of

With the

Northern Health Commission an administration base for

distinguished from the Divisional Health Commission, its secretariat, Lambell House is under consideration

of Casuarina The foyer and

but will be available ferences and discussion groups.

29

Wards 11 and 12

The are to deteriorate

will be up the centre of the

landscaping and recreational areas for for children accommodated in the creche.

30 Wards 14 and 15

T'nese will be closed but in 1

of

of

establish

, con-

of

site

16

31

Demolition/Redundancy/Removal Program Refer Attachment B

Building No

6, 86, 87 11

46 -57

82

38

21 27

28

29

32-33 3 9

7

65/66 43

4 3

30/31 34 / 35

2./o

/

*eee t epGi:t

Pres.ent use Program

Hospital Store

1978/79

Gardeners Store "

Mindil Accommodation Units

1979/so

Cylinder Store Residence

Psychiatric Day Centre Ward

11

Plant Room Ward 12 POQ 2 Library Workshop

Myill~ Cres. Laboratory Pathology Laboratory Creche

Kitchen

Kitchen Store

~Ward 14

~ " 15

W~q

II

II

1980/81

II

II

II

II

II

II

II 7

II

II

II

II

II

jl

ATTACEMENT A HOSPITALS IN DARWIN

The total beds estimated to be needed for Darwin at occupancy are:

ACUTE CHRONIC

1977

^{360 81}

1978

369 83

1 86

1980 391 89

93

1982 417

1983 433

99

1984 445 104

1985 462 108

Casuarina Hospital was planned as follows:

<

Second Floor = ² wings of 36 = 72 Third ^II = ^{2 II II II} = 72 Fourth ^II = 1 wing ^It 36)

1 ^{II fl} 35) ⁼ 71

Fifth ^II

=

^{2 wings =}

Sixth ^II

=

^{2 II =}

Seventh ^!I ₌

II ti

= .J..5.

Total beds/cots/bassinets

=

Less ICU beds

Less exempt bassinets for babies born in hospital although the number initially required in

1 "

383 500

beds

!l

II

II

II

I!

II

!I

TOTAL 441

452 480 499 513 532 549 570

General Wards

II II

"

^{& ., ~ bed CCU}

28 -bassinets Obstetric

II II

20 ^II Paediatrics ICU

117 ^II

AT'l1ACllMEM.' A 2

The two following tables demonstrate that C;-1 suarina Hospital could handle all inpatient demands to

1 982

at 80"/o occupancy. The first table is based on current demand and the second on perceived inadequacies due to restrictive admitting practices. Accordingly, extra beds have been allowed in the second tmle for tuberculosis, geriatrics and handicapped children.

Table I

Estimated bed requirement by discipline based on bed occupancy at Darwin Hospital for the

12

month period ended

3 0

April

1977

including an allowance made for backlog of surgery:

% 1 980 1981 1 9B2 1983 1984 19 85

Medical

20 . 62 69 72 75

77

8·1 83

&u.rgical

3 9 . 66 132 13 7 142 148 154 160

r rthopaedic)

t 32 ) ~ 2; ~ ? 2 )

n i (24 ~ p i n i

ENT) o.66~

2)

Ophthalmic)

· 1. 26 ~

^{4) '}

~ 4) ~ ~ )

Gynaecologica,l)

(4-.25 ) 15 ~ --,. 15) ( 15 ( 16) 1 7l

(Other)

( 27. 17) (90 . (9 4) ( 97) ( 101 ) ( 105 ( 1 09 )

Obstetric

14.26 48

49

5 1 5 3 55 58

?nte-natal^Post-natal) )

~ 4 9. -7 52 4) ) ( 1 (32) 6) (1 (33 6~

^{( 17( 34) ) ( rn}

(35 )

⁾

g; ~ (1 (39 9~

Paediatric

15. 33 51

53 55

57

59

62

Psychiatric

5.82 2 0 2 0 21 22 23

24

'.Pu bercul o sis

0.50 2 2

2

2

2

3

Geriatric

1. 49

5 5 5 5 5

6

Intensive Care

0 .95 3 3

4

4

4

4

Boarder :Mother

1. 37 4

5

5

5 5

5 .

1 00.00 334 346 360 373

³⁸⁸

405

for

DARWI. HOSPITAL

'

LOCALITY PLAN 1977

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