Longtime Nowra resident Bill Hancock can never been accused of not thinking outside the box.
In response to South Coast MP Shelley Hancock’s survey into the Future of Shoalhaven District Hospital Mr Hancock, who lives adjacent to the ever growing facility, has come up with a radical plan.
In a 20-page document prepared in response to the MP’s survey, Mr Hancock believes a totally new facility should be built on a greenfield site south of Nowra, closer to the city’s major growth and older population areas.
And the bold idea won’t cost as much as expected - the state government has recently announcement of a new Tweed Hospital on a ‘greenfield’ site costing $500 million.
“When you combine the $10 million pledged for the new multi-level car park at the Nowra site and the more recent $434 million pledge for a major upgrade of the existing hospital we are not far off that figure,” Mr Hancock said.
Mr Hancock is proposing a greenfield site on the corner of the Princes Highway/Forest and BTU roads south of Nowra.
“It makes more sense to have a more centralised hospital and to have health facilities closer to where the city’s population is exploding,” he said.
“Geographical data does not support the current location for a hospital - the site is stranded between the river and the immediate residential area and is not sufficiently flexible for a modern state-of-the-art hospital supported by 24/7 helicopter air ambulance operations which overfly a large portion of the densely populated Nowra urban area at any hour.
“Demographically, the site is no longer central to the population spread in northern Shoalhaven which raises the spectre of unacceptable periods of time from medical emergency to hospital admittance which could lead to avoidable deaths.
“In earlier years the hospital site might have been adequate to the requirements of a limited capacity ‘cottage hospital’ but times have drastically changed with the site no longer able to sustain its geographic locational capacity to serve the growing demands of a hospital deemed fit for the 21st century.
“High speed emergency access is not possible as ambulances need to slow down in order to negotiate narrow urban and often times congested CBD/residential streets while taking due care to negotiate traffic lights, roundabouts, pedestrian crossings and school zones, adding critical minutes to the transfer times.“
As the hospital undoubtedly undergoes further necessary development in the present location, further multi level structures atop the river escarpment will create visual and environment problems, Mr Hancock said, destroying the visual enjoyment of the natural beauty of the picturesque river.
Mr Hancock believes retaining the current site could in fact result in costing people’s lives, saying research recommends a total of 80 per cent of population should live within a 20-minute drive or a 20 kilometre radius of a hospital.
A graph from the Emergency Medicine Journal shows that mortality rates for people living less than 10km away from a hospital is decidedly lower than those between 10-20km and further than 20km.
For chest pain the mortality rate for someone living within 10km is 5.5 per cent, respiratory problems 10 per cent and injury through poisoning, asphyxiation or haemorrhage is around two per cent. Other reasons for death was about seven per cent.
In comparison those in a 10-20km radius of hospital for the same problems, chest pain percentage is about 5.5 per cent, respiratory problems is around 13 per cent while injury through poisoning, asphyxiation or haemorrhage was around two per cent. Other reasons for death was about 11 per cent.
For those further than 20km chest pain increased to about seven per cent, respiratory problems jumped to 20 per cent while injury through poisoning, asphyxiation or haemorrhage was around 3.5 per cent. Other reasons for death was also 11 per cent.
“The research says any increase in distance could be directly associated with an increased risk of death to conveyed patients,” Mr Hancock said.
“In-hospital survival is the main outcome parameter, which is critically dependent on admission in the shortest possible time.
“Thus, the relationship between time/distance to hospital and patient mortality is a life or death equation and to minimise the time spent in the relatively uncontrolled out-of-hospital transport environment aiming for a direct and early admission is an absolute imperative.”
A 20km radius around the current hospital does not take in the growing areas of Vincentia and the Bay and Basin and only parts of Huskisson.
“The residents of Bewong, Wandandian, Basin View, St Georges Basin, Sanctuary Point, Erowal and Old Erowal Bay, Hyams Beach, Vincentia and Huskisson are all taxpayers; the tyranny of distance imposed on these folk in times of required medical treatments and emergencies demands they are included in the 20 minutes/ 20 kilometre radius,” he said.
All such localities would be within the 20 minute/20km radius at his new proposed south Nowra location.
It would however mean the majority of Berry fell just outside the zone.
“The age group forecast to have the largest proportional increase in the Shoalhaven is the 70-74 year olds, and expected to increase by 51.5 per cent to 7,188 persons who are most likely to suffer respiratory and heart problems,” he said.
Mr Hancock believes the problem of the proposed area not being zoned for such facility could be easily overcome, with the state government “simply” rezoning the land.
“The site is closer to the northern Shoalhaven’s centre of population, ideally somewhere served by multiple roads for high speed ambulance access north, south, east and west,” he said.
“The site is accessible by a number of all-weather alternative routes, it is well placed to service long-term growth (eg) Comberton Grange, HMAS Albatross, South Coast Correctional Centre, proposed West Nowra by-pass and to develop a broader health and education campus over time in association with the university.”
The site could provide ample space to include co-location of public and private hospital facilities.
“Public and private co-location increases efficiency and mutual cost-saving dependency of both by sharing the cost of treating patients and infrastructure costs such as pathology, radiology, laundry, parking and joint catering aspects.
Parking would be ‘fit for task’ being expansive, well laid-out and convenient.
“Co-location increases the ability to recruit and retain staff,” he said.
“Co-location contributes to quality of patient care, increases the ability of teaching services, and allows installation of better technologies.
“Co-location would increase the attractiveness of the Wollongong University’s Shoalhaven Campus School of Medicine to both Australian and overseas students, thereby increasing job opportunities to this area.”
He said with the proposal being next to HMAS Albatross, movements by lifesaving air ambulance helicopters would not be as much of an issue as they are in Nowra.
“The demand for air ambulance helicopter services is inexorably on the rise, a trend is expected to continue,” he said.
“The actual size of helicopters has increased as most are now twin engine aircraft.
“The Oil and Gas industry in the United Kingdom (OGUK) warns the downdraft created by helicopters of this size, combined with prevailing wind speeds can generate winds equivalent to a category one hurricane.
“Similarly, there is concern over increased noise levels that such aerial services impose on the immediate highly populated residential areas.
“The proposed multi level car-park construction will severely impact the flight paths in and out of the helipad.
“This is in defiance of the Shoalhaven City Council’s development application for the 24 hour helicopter landing site.
“It will cause further noise pollution to such facilities as a pre-school, a primary school and St Michael’s Parish Church, as will unwelcome noise levels adversely affect the nearby Nowra retail centre.”
He said residents requested an up to date report to be provided regarding most likely helicopter types, recommended flight paths, noise, vibration, frequency and downdraft levels residents can expect, also a ‘Flying Neighbourly Agreement’ and ‘Prior Permission’ protocol as set out by CASA to be implemented.
Mr Hancock said continued development on the present site contradicts the NSW Government’s Illawarra-Shoalhaven regional plan November 2015 Action 1.3.1 ‘To better integrate recreational uses around the Shoalhaven River’.
He also believes the Aboriginal heritage and links to the current site are being overlooked, as was the original proposed use of the site when it was surveyed in 1851 as “public recreation”.
“If a greenfield site was developed for a new hospital elsewhere, a new opportunity would arise to responsibly develop the Scenic Drive site in any number of creative ways,” he said.
“The vacant infrastructure should be modified in removing some buildings, open up public access back onto the recreation area and reconnect it to the Nowra Showground and Paringa Park.
“Special attention could be made to restoring Ben’s Walk and other connective cycle/pathways. The area could be reconfigured into a botanic gardens of sort.
“Some of the suitable low level buildings on the present site could be retained and renovated with the various Community Health facilities currently scattered in various buildings throughout the Nowra CBD could be consolidated into the one location.
“A new Community Health Precinct could be created offering ample space for future and would provide an opportunity to open up the Nowra CBD for further development.”
Mr Hancock previously came up with a traffic flow solution for the Nowra CBD and more recently a parking solution instead of building a proposed $15 million million multi level car park in the CBD.