Adapting to a world with COVID-19 has been a challenge for everyone, and private hospitals have been no exception.
Changing the way staff work, dealing with differing advice from governments, and working with the public system have all presented hurdles for the private sector.
For some staff, it has meant going back to the frontlines of medicine.
Dr Bronwyn Webster is an anaesthetist with Epworth HealthCare, who volunteered to help in any way possible during the pandemic.
For the past month, she has been working as a doctor on a COVID-19 ward, primarily responsible for coronavirus-positive patients from residential aged care facilities.
“Epworth sent around a survey asking what we’d be happy to do and I just ticked every box because I was happy to muck in wherever I was required,” she said.
“It’s been 20 years since I worked on the medical ward as a junior doctor. This is week four of work on the ward and it feels like I have been here forever now.”
Dr Webster said her big transition was "terrifying".
“When you are a specialist, you are used to doing your own thing perfectly and being the boss, so having to step into a role where I’m not a specialist in this area, and I am used to being the boss, it involves being humble and being told what to do.”
Dr Webster has enjoyed helping people as one of Epworth's dedicated Resident Liaison Officers. Family members can call a mobile number and have direct access to information about their hospitalised relatives.
“I like talking and communicating, which is not something I do as much as an anaesthetist, because our patients are generally asleep,” she said.
“It’s something I really like about this job because I have built up a relationship with a lot of families who I speak with every day.
“Sometimes I don’t have a lot to tell them. It might be that your mum is well and she’s not requiring extra oxygen and she doesn’t have a fever. They just like to hear that and they like to hear it from a doctor who they know has seen their loved one every day.”
Dealing with COVID uncertainty
At an organisational level, COVID-19 has meant a lot of changes in the way private hospitals carry out their work.
For Alan Morrison, CEO of Adelaide-based healthcare group sportsmed, one of the biggest challenges was the initial uncertainty.
“At the beginning of COVID, there were constantly changing rules and expectations,” he said.
“That was followed by the ban on elective surgery, and then when it was brought back, managing it within the rules.”
Anne Crouch, chief operating officer of Cura Day Hospitals Group, echoed Mr Morrison’s concerns.
“One of the biggest challenges has been the mixed messages and making sure the messages we get to our staff and our doctors are correct,” she said.
“And in the beginning we did struggle a bit with Personal Protective Equipment (PPE). We had some samples in, but found they were not of the best quality, so dealing with that was time consuming.
“But it’s something we worked out and we got through it.”
For hospitals in Victoria, hit hard by a resurgence of COVID-19 cases, the challenges have been much greater.
Epworth Group chief executive Dr Lachlan Henderson said the second wave of infections had been almost overwhelming.
“The rapid spread of COVID-19 into residential aged care facilities has been a big challenge for us.
“After a call from the Department of Health and Human Services, our chief medical officer, Dr Luis Prado, led a team of Epworth staff into St Basil’s Aged Care home in Melbourne’s north.
“Our staff were rapidly mobilised in an unfamiliar environment, caring for the most vulnerable in our community and they’ve done an outstanding job under pressure,” he said.
'The dedication of caring professionals'
Everyone agreed their staff had been superstars in these unprecedented times.
“The resilience from our staff and their flexibility towards change was amazing,” Mr Morrison said.
“They really embraced different ways of working, using telehealth or working from home. From a culture point of view, staff really came together and supported each other.”
Ms Crouch said Cura was blessed with “a great team”.
“We have 25 hospitals and all our staff, our doctors, our committee, everyone has been amazing. It’s been great to see everyone working together.”
Dr Henderson is “immensely proud” of his staff, with Melbourne locked down under a night-time curfew during stage-four restrictions.
“I am impressed by their resilience. We are supporting our staff who are doing a great job, with many of them also juggling the demands of a second round of remote learning for their children.”
Australian Private Hospitals Association (APHA) CEO Michael Roff said it had been a difficult and stressful time.
“Issues like dealing with uncertainty around elective surgery restrictions being imposed and then eased, and trying to source supplies of PPE, when national governments around the world were all competing with each other, have taken everyone out of their comfort zone,” he said.
“I am particularly concerned for private hospital staff in Victoria at the moment, tasked with caring for COVID-infected aged care residents, not just in their own hospitals but in some cases actually staffing the nursing homes.
“It can’t be easy, but it highlights the dedication of these caring professionals.”
Building new understandings
For the first time across Australia, the private and public health sectors worked together to combat the COVID-19 pandemic.
A private hospital viability deal was struck with the Commonwealth Government in just five days, then individual deals had to be made with each state to implement the viability payment.
“I think a plus in this situation has been that we have built strong relationships with the public sector,” Mr Morrison said.
“I think we have a better understanding of how the public sector works and they have a better understanding of how the private sector works as well.
“Pre-COVID, we had been trying to build a closer relationship with the public sector and we have now formed a COVID advisory committee with South Australian Health.
“It’s really unprecedented and now that things are a bit more controlled, we have other committees that have spun off that with private representation.”
Ms Crouch said Cura was thankful for the opportunity to work with the public system.
“We haven’t had to outsource our staff, but certainly we have been in touch with the public system, they have kept in contact with us, particularly in Queensland.
“The AMA organised a series of webinars, which we were a part of, and it was amazing to see everyone working together,” she said.
Of course, it has not been all smooth sailing.
“COVID has highlighted the vastly different approaches to the private sector by different state health departments,” Mr Roff said.
“Let’s just say that some are easier to work with than others! I am hopeful that one outcome of this situation is that State Governments will have a better understanding of the role and capabilities of the private hospital sector, which will hopefully lead to better collaboration in the future.”
For Ramsay Health Care’s Victorian hospitals, helping the public sector has been part and parcel of their response to the pandemic.
The global group's Australian CEO Danny Sims said Ramsay was “willing and able” to work with the state healthcare workforce.
“The size, capacity and locations of our facilities in Victoria are significant and will assist the public hospital system to curb the virus.
“All our staff have undergone thorough training and all our facilities have implemented pandemic response plans, to ensure the workforce is ready to assist people who are at greatest risk during the pandemic,” he said.
APHA's key role in COVID-19 response
While the pandemic continues around the world, Mr Roff said he was happy with the response of APHA and its members.
“Thankfully the leaders in the industry all pulled together in a time of crisis,” he said.
“I’m grateful that the APHA Board and a range of our task forces were all willing to meet much more regularly than normal, sometimes on a daily basis, as things were moving so rapidly.
“Given our national membership, we were quickly able to exchange information about what was happening in each state and work together for the benefit of the sector.”
Mr Morrison, who is also on APHA's national board, said negotiating state agreements was an “enormous” amount of work, but the structure of the organisation had been a huge help.
“With the structure of the APHA at a state and national level, having that in place and working with state governments and the federal government, it was really seamless.
“In South Australia we had about 60 day surgeries and hospitals we had to make deals with, and being able to do that with one organisation and a centralised approach, that all happened way quicker than it would have otherwise,” he said.
Mr Roff said he was pleased APHA had played such an integral part in Australia’s ongoing response to COVID-19.
“We didn’t really have time to think about how we had to change the way we did things – everyone just got on with the job and pitched in together to get the best outcome possible for our membership,” he said.
“The viability deal means that all private hospital staff have remained employed and are available to provide care for our own patients, in addition to assisting state governments with pandemic-related care, particularly in Victoria.”