Concern for HIV patient care ahead of infection unit move
Patients living with HIV say their care could be compromised, after South Australia's Employment Tribunal dismissed an appeal to stop a specialist unit from being moved out of the Royal Adelaide Hospital.
The ruling means SA's infectious diseases unit will be relocated from the Royal Adelaide Hospital (RAH) to a building across the road within weeks.
"We feel like we're being shoved across the road out of sight into a dingy building that's not really fit for purpose yet," said Katherine Leane, who lives with HIV and has been a patient of the infectious diseases unit for 38 years.
"What they're doing is actually going to make it harder for people to access care."
The move has been prompted by a lack of space for public health services within the $2.3 billion RAH.
The state government previously subleased a space within the hospital that had been rented to a private health consortium, but in 2023, it decided to end that sublease and instead started to rent a space at 21 North Terrace.
In March, the Central Adelaide Local Health Network (CALHN) said that cost was the "main driver" behind the leasing decision, with taxpayers estimated to save $2.25 million over five years.
After months of consultation, the network decided that the infectious diseases unit — which cares for patients who have been diagnosed or are at risk of contracting illnesses such as hepatitis and HIV — would be the most appropriate service to move.
But the SA doctors' union tried to appeal that decision in the SA Employment Tribunal, arguing it could result in compromised clinical care.
"Many of these patients have got mobility issues, they are an ageing group and they're really concerned,' SA Salaried Medical Officers' Association chief industrial officer, Bernadette Mulholland said.
"There's also, in our view, not the workforce to sustain a model where a service is across two sites."
In a judgement handed down last week, Deputy President Judge Miles Crawley wrote that 21 North Terrace was "not as aesthetically pleasing as the present outpatient unit", and was also "significantly smaller".
However, he wrote the new building was "adequate in size" and provided "all the required facilities".
"Although a number of vulnerable patients will be unhappy with the relocation and adversely affected by the move, many will continue to have ongoing involvement with other services at 1 Port Road [the main RAH building], so as not to feel excluded," he wrote.
"Other concerns I consider will be adequately met, as they will be continuing to attend the same staff in premises adequate for the purpose."
Judge Crawley wrote that the move would create "additional work for the nursing staff", but he was "satisfied the provision of additional nursing resources as and where required, together with some changes to existing work practices … will alleviate this issue".
"Although the … proposal is not ideal, I cannot say that is not within the bounds of reasonableness to the extent that I should interfere with the decision of the respondent to implement it," he wrote.
But Ms Leane, who gave evidence to the tribunal as a patient and president of Positive Life SA, said she was concerned some patients might stop attending appointments once the infectious diseases unit moved.
She said patients who would be required to attend clinics inside the hospital, as well as at the infectious diseases unit at 21 North Terrace, would find it challenging to cross between the two sites.
"One of our community members recently lost his leg," she said.
"If he needs to go there [to the infectious diseases unit] to see a doctor, then go back to the RAH to get a blood test, then go and get prescriptions, it's going to make it really difficult.
"You can't get an ambulance on that side of the road."
Ms Leane added that people living with HIV felt like they were being "pushed out of sight".
"It just adds to that self-stigma that you think it's just because I've got HIV, they don't want to be in the same room as me".
In a statement, CALHN CEO Dr Emma McCahon said the safety and wellbeing of staff and patients was the network's "number one priority".
She said the network welcomed the Employment Tribunal's decision, and thanked those who contributed to the case.
"We are now focused on ensuring the process of moving outpatients services will occur with minimal disruptions," she said.
"The move is expected to be completed over the next few weeks.
"The infectious diseases unit will continue to be supported to deliver high quality outpatient care for the community from the Royal Adelaide Hospital until their outpatient clinics relocate across the road to 21 North Terrace.
"High quality care will continue to be delivered to all patients from the new location."
Dr McCahon said CALHN would "work with staff and consumer groups to ensure patients are informed of the move".
CALHN program director Jane de Bruyn previously told the Employment Tribunal that the network "in no way" wanted to make a decision that deteriorated "the patient and staff experience".
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