Despite opening six extra over-census beds and taking six beds from the theatre recovery area, the 12 extra beds have done nothing to alleviate the bed shortage. The new standard of two recovery beds per operating theatre means we are five beds short (we have five theatres and five recovery beds). 

We now have to wake patients up in theatre instead of the specialised recovery area. This delays theatre activity and impacts on our ability to service the lists, causing further cancellations. This has been further impacted by the decision of the many orthopaedic surgeons in Wollongong hospital not to look after fracture and trauma patients from the Shoalhaven. 

There had been a longstanding arrangement that when our two surgeons at Shoalhaven hospital were not on call, Wollongong hospital would look after these patients. Ten days ago the Wollongong surgeons announced this arrangement would end on March 1. This was without any discussion with our surgeons or me as Head of Surgery.  

The administration of the ILSHD was asked for clarification and their response was that we had to absorb into our already overrun hospital all the fracture care and trauma. This means we will have to deal with something of the numbers of 2000 episodes of care in the last seven months that was dealt with by the much better equipped service in Wollongong. 

The action of the administration in Wollongong  was to provide us with one more junior doctor and allow us to use two senior orthopaedic surgeons to be on a roster with our two surgeons to be on call each weekend and try and cover each weekday as well. This does not come with any extra theatre time , nurses, anaesthetists, wards staff, beds or radiographers. This new requirement will impact on our core business and further add to the cancellations and waiting lists. 

I have for years had to add services to the theatre using a cost neutral technique. That is I have had to take time from one surgical group to add another, so as to provide increased services. We currently have no more funded theatre time or skilled theatre nurses let alone hospital beds or ward staff.

A colleague said to me on Thursday the “ hospital is broken”.

We will all rally to look after all our patients, however the increase in numbers at the South Coast Correctional Centre, the two navy bases (they now have no hospitals on base) and the tsunami of economic refugees heading from Sydney and Wollongong have put our hospital system under terminal stress.

State MPs Ward and Hancock promise long-overdue transport improvements for Nowra but drivers caught in the daily traffic jams while crossing the Shoalhaven are frustrated in knowing they will wait 10 more years for a wider bridge. And during construction congestion will be even worse. Meanwhile the big trucks continue to crawl through this suffering city, polluting its air with diesel fumes and noise.

An obvious solution is to build a bypass around Nowra and Bomaderry but Mr Ward only begrudgingly acknowledges this – despite knowing his government has constructed bypasses around every town on the Hume Highway and is working to finalise bypasses up the Pacific Highway. Nineteenth century politicians were determined to progress Nowra and the South Coast when they built the railway from Sydney for freight and passengers.

They expected future governments would take efficient rail transport south of Bomaderry – but the quality of politicians appears to have diminished.