Dunedin Hospital is the main public hospital in Dunedin, New Zealand. It serves as the major base hospital for the Otago and Southland regions with a potential catchment radius of roughly 300 kilometres, and a population of around 300,000.
Operations
Dunedin Hospital is New Zealand's largest hospital south of Christchurch.[1] Patients are transferred or sent to this tertiary level care hospital from smaller secondary care hospitals across Otago and Southland including Dunstan Hospital in Clyde, Lakes District Hospital in Queenstown and Oamaru, Gore and Invercargill hospitals. Dunedin Hospital is the major trauma centre for the Otago region and the tertiary major trauma centre for the Otago and Southland regions.[2]
Dunedin Hospital is operated by the Southern District Health Board, formed by the amalgamation of the Otago District Health Board and Southland District Health Board. It is located in the central business district of Dunedin close to the University of Otago, occupying the city block bounded by Great King Street, Hanover Street, Cumberland Street and Frederick Street. It is an approximately 400-bed tertiary hospital and is affiliated with the University of Otago. It has approximately 3,000 staff members.[3]
Queen Mary Maternity Centre
Dunedin Hospital includes the Queen Mary Maternity Centre. The maternity unit directly replaced the nearby Queen Mary Hospital, which opened in 1937. Queen Mary in turn directly replaced the Batchelor Hospital, originally known as Forth Street Maternity Hospital.[4]
The Ward Block building has a helipad on the roof of the northeast corner (ICAO: NZDH).[5] The building was designed with consideration for a helipad, and, after substantial fundraising, one was built on the roof in c. 2000. The hospital helipad improves patient care, reducing the need for ambulance transfers between a remote helipad and the hospital. Due to CAA safety requirements, only "Performance Class One" (twin-engined) helicopters are allowed to land on the hospital.[5]
History
The original hospital was built at The Octagon in 1851, and moved to the site of the present hospital in 1865.[6]
The original buildings were gradually replaced and new structures extended the site, most notably in the late 1930s. Many o these buildings were demolished in the mid to late 1970s, with a new central ward and administrative block built in 1980.[7]
2007 Norovirus outbreak
In March 2007 two wards of the hospital were closed due to a suspected outbreak of norovirus, thought to have been brought in by a patient.[8] On 16 August 2008 the hospital was put in lockdown for one week due to a norovirus outbreak affecting 73 patients and nearly 100 staff, blocking most visitors for the duration, and postponing 2,300 procedures.[9][10][11]
COVID-19 pandemic
In early June 2022, the Dunedin Hospital was closed to visitors following an outbreak of COVID-19 within its wards.[12]
Parts of the hospital are significantly dated, especially the Clinical Services Block (erected 1965) which was constructed with asbestos, as was standard construction practice at the time. The Clinical Services Block has also had significant maintenance issues, such as asbestos and leaks in the roof which allowed rain water to seep into the main operating theatres during a storm.[14] As a result of these and other issues, a significant rebuild project is underway for the reconstruction of the entire hospital, headed by Pete Hodgson, at an estimated cost of $1.2 to 1.6 billion. It is estimated to be completed by 2028.[15]
On 4 May 2018, Health MinisterDavid Clark announced that the Government would be building a new public hospital on the site of the former Cadbury factory site and a neighbouring block that included the building occupied by Work and Income. The construction project is estimated to cost NZ$1.4 billion, would involve around a thousand workers, and is expected to finish by 2026. Clark confirmed that the Government had purchased the former Cadbury factory site from Mondelez for an undisclosed sum. While the Government has ruled out private-public partnership, Clark has told Stuff that the Government has not ruled out Iwi investment.[16][14]
In September 2022, the Otago Daily Times reported that the budgetary concerns had led the Ministry of Health to consider reducing the new hospital's capacity including reducing the number and size of beds, operating theatres, and wards. The hospital's budget had increased from NZ$1.2 billion to NZ$1.47 billion due to inflation and the rising costs of building materials. In response, National List MP Michael Woodhouse expressed outrage that the Government was considering reducing the number of beds and services.[17] In late October 2022, a report by Te Whatu Ora Southern expressed concern that efforts to trim NZ$100 million from the hospital rebuilding budget could pose a "reputational, operational and clinical risk" to the public hospital.[18]
In December 2022, the Otago Daily Times and Radio New Zealand confirmed that Te Whatu Ora would be reducing the number of beds and operating theatres as part of a "value management exercise" to manage a NZ$200 million budget increase in the Dunedin hospital rebuild. While the Government had earlier invested an additional NZ$110 million in the Dunedin hospital rebuild, there was still a shortfall of NZ$90 million. In order to cover the shortfall, the number of beds would be reduced from 421 to 398 beds, the number of operating theatres would be reduced from 28 to 26, the number of MRI scanners would be reduced from three to two, and the PET-CT scanner would be delayed. In response, National Party MP Michael Woodhouse criticised the Government for delaying the hospital rebuild project and abandoning its promise not to reduce the hospital's capacity.[13][19][20]
Though Mayor of DunedinJules Radich initially supported the proposed cutbacks to the Hospital and described the redesign as a "reasonable compromise," he revised his position in the face of opposition to the proposed cutbacks from the Dunedin public and fellow Dunedin councillors including David Benson-Pope, who announced plans to submit a motion calling on the Dunedin City Council (DCC) to campaign for the Hospital to be rebuilt according to its original specifications.[19][21]
On 18 January 2023, the Otago Daily Times reported that a pavilion building dedicated to providing staff workspaces and other staff facilities had been eliminated from the final design of the new hospital Te Whatu Ora had also confirmed that it would cut more than 450 non-clinical spaces. In response, the Association of Salaried Medical Specialists southern representative Kris Smith expressed concern about the proposed loss of individual workspaces on the morale and well-being of medical professionals including having to wear facemasks and working from home for non-clinical duties.[22] In response to criticism from Mayor Radich, Health Minister Little denied that the Government's revised hospital plans would involve cuts. He also stated that the new hospital would have a larger capacity than the present hospital including 26 surgical theatres rather than the current 16 theatres.[23] In addition, the New Zealand Nurses Organisation organised a petition opposing the cutbacks and urging the Government to build the inpatient buulding as outlined in the original business case.[24]
In opposition to the proposed cuts, Benson-Pope filed a notice of motion urging the DCC to contribute NZ$130,400 for a public campaign to support the hospital rebuild project as it was outlined in the final business case. Benson-Pope's motion was seconded by Mayor Radich.[25] On 31 January, the DCC voted unanimously to support Benson-Pope's motion to fight changes to the Dunedin Hospital's design.[26] On 1 February, incoming Health Minister Ayesha Verrall confirmed that she would meet with Dunedin City councillors to discuss their concerns about the hospital rebuild changes. Dunedin electorate MP and former Health Minister Clark also rejected criticism by Councillor Carmen Houlahan that local Labour electorate MPs were not doing enough to advocate for the Dunedin hospital.[27]
In early March 2023, the Otago Daily Times reported that staff vacancies and a large number of patients had forced the Hospital to postpone some "planned care." A Te Whatu Ora spokesperson reported that other hospitals nationwide were facing similar staffing and service problems.[28] On 25 March, the DCC rejected Te Whatu Ora's and the Government's proposed cutbacks fo the hospital rebuild and launched a campaign urging public opposition against the cutbacks.[29] On 27 March, the Council heard submissions from several health professionals opposed to the proposed cutbacks including senior surgical trainee Dr Janet Rhodes and former Southern District Health Board member Dr Jonathan Chambers.[30][31]
On 14 April, Verrall confirmed that the Government had reversed NZ$10 million in hospital cuts and announced the return of the hospital scanner and a collaborative space for clinicians to work. In addition, the Government allocated NZ$97 million to the hospital's data and digital infrastructure. However, Verrall ruled out further substantial "redesigns" and confirmed that the hospital rebuild would proceed along the revised hospital plans.[32] The Government's announcement was welcome by Radich, who confirmed that construction of the new hospital had begun.[33]
On 16 June 2023, Te Whatu Ora along with the University of Otago and Otago Polytechnic abandoned plans to establish an Interprofessional Learning Centre at the new Dunedin Hospital site due to escalating costs. The building would have served as an educational facility for Otago University and Polytechnic students at the new hospital. Instead, the three organisations would focus on developing interdisciplinary training for future healthcare professionals.[34]
During the 2023 New Zealand general election, the National Party campaigned on reversing some of the Government's cuts to the Dunedin Hospital if elected into Government. In early July 2023, Luxon announced that National would invest NZ$30 million in restoring cut beds, theatres, and a PET scanner at the new Dunedin Hospital.[35] On 12 September, the Government announced that it would reverse two proposed cuts, namely a separate pathology laboratory and 24 beds for elderly mental health patients.[36]
