Community pressure persists for CT scanner in new hospital

Mayor Rhonda Hoban with Dr Danny Ryan in June last year
Mayor Rhonda Hoban with Dr Danny Ryan in June last year

The new Macksville Hospital build is inching closer to completion, but community pressure is still being applied to the powers-that-be in order to secure a CT scanner at the site.

At the January 30 Nambucca Valley Council meeting, it was resolved that Council would forward a 2,507 signature-strong petition "requesting a commitment to provide for" the scanner to our State and Federal Members and Ministers for Health, and to the Board Chair of the Mid North Coast Local Health District (MNCLHD).

What does a CT scanner do?

A Computerised Tomography (CT) scanner is a radiology tool which uses X-rays to take images in very fine slices through the body - much like a loaf of bread. Combining the many different slices and 3D reconstructions creates a very detailed picture of the structures making up a person's body, which helps with diagnosis.

Doctors order CT scans for a long list of reasons including the detection of bone and joint problems, internal injuries, tumours, blood clots, excess fluid or infection.

A CT scanner can also help detect changes in patients with cancer, heart disease, emphysema, or liver masses. And they are used to monitor the progress of treatments like radiation therapy and chemotherapy.

The debate so far

In an initial letter penned to MNCLHD Board Chair Warren Grimshaw "on behalf of all the doctors and nurses at Macksville", local GP Dr Danny Ryan said there was a "unanimous" and "strongly-held view" that "a CT scanner is both necessary and would pay for itself within a few years".

The push for the scanner, led by Dr Ryan, has been ongoing for a while now. However when Guardian News broached the subject with the MNCLHD mid-last year they explained then that the need for one had not been raised by anyone during the hospital planning phase.

"When clinical services planning was undertaken following the announcement of the Macksville Hospital Development in 2015, a CT scanner was not identified as a clinical priority. This consultation process involved input from a range of stakeholders including hospital staff, local doctors, hospital volunteers and representatives from local government and community groups," a spokesperson for MNCLHD said.

"The clinical priorities identified for the new Macksville Hospital included Emergency Department services, general inpatient services, Community Health, Perioperative services, Mental Health and Drug & Alcohol Services, Palliative Care services, support services (radiology, pharmacy, allied health), Maternity Services, and Oncology/haematology ambulatory care services."

They said they were looking into "the feasibility of locating a CT facility within the new hospital" but that [as of June 2019] "on average fewer than two patients a day are transported to Coffs Harbour for a CT scan".

"A significant number of the patients transported to Coffs Harbour for CT scans would be transferred for clinical reasons regardless of the availability of a CT scanner at Macksville," the spokeperson continued.

But Dr Ryan said the cost-benefit would come not just from reduced patient transport costs, earlier diagnosis, and shorter admissions, but also from "outpatient referrals of CT scans billed to Medicare".

He noted that Macksville's Star Street practice had ordered 165 CT scans in a three-month period.

"Other practices in the Nambucca Valley have also expressed a preference to refer to a CT service at the public hospital if given the choice," he said.

"In addition, Emergency Department patients who are mobile usually have their scans done privately. Hence a CT scanner at Macksville Hospital would receive conservatively at least seven referrals per day. These numbers are likely to increase not decrease.

"Speak to any of the doctors associated with Macksville Hospital. None can believe that a new hospital is being built without a CT scanner. They say what is the point of having a nice building without the equipment to meet basic clinical needs."

After further enquiries today by Guardian News MNCLHD Chief Executive Stewart Dowrick has said: "As part of the new hospital development, the Mid North Coast Local Health District is preparing a dedicated space for a future CT scanner and will continually look at demand for CT services while balancing the health needs of the District".

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