Blue Mountains Hospital has been an icon of community service for nearly a century; but the leaking roof, the antiquated facilities, the lack of room and the limited services are all becoming too much for the hard-working staff.
The new chairman of the hospital's Medical Staff Council has stepped up to join the fight.
"It's my mission," said Dr Stavros Prineas. "We need a new hospital. Planning must happen right now."
Dr Prineas, a consultant anaesthetist, was elected last month to head the staff council, which represents the 130 doctors who serve the hospital, and he has hit the ground running.
"A new hospital is at least 30 years overdue. The staff here are wonderful and will continue to provide a fantastic service but they struggle, and will continue to struggle, with the existing conditions.
"My number one item for the next 12 months is to campaign for a new hospital, and I won't rest until we see money down for our community."
He pointed out a new hospital has the support of Nepean Blue Mountains Local Health District CEO, Kay Hyman, and chairman of the health district's board, former NSW Liberal leader Peter Collins, as well as hospital managers and local community groups.
Both sides of politics at all three levels have also supported the idea, with State ALP MP Trish Doyle and State Coalition MLC Shayne Mallard, Federal Macquarie MP Susan Templeman and former Federal Liberal candidate Sarah Richards plus councillors backing the campaign.
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Dr Prineas, who was born in the hospital and returned to the area as a consultant about 20 years ago, cautioned that, even if given the go-ahead now, "it would be years before any ribbon was cut".
In the meantime, Katoomba needed urgent support to sustain services.
It has been estimated that initial planning for a new facility would cost between $10 and $15 million.
"That's to identify what current and future service needs should be met in a new hospital and where a new hospital would be," Dr Prineas said. "We don't need a big bundle of money to get this started. I personally don't see why that couldn't happen tomorrow."
Wouldn't replicate Nepean
Dr Prineas stressed that a new hospital wouldn't try to be another Nepean, performing major surgery or complicated procedures. But it could provide more services than are currently available, which would avoid the inevitable trip "down the road" to Penrith.
As a basic starting point, Dr Prineas said a new hospital should have 24-hour emergency surgery for common conditions such as appendicitis.
It also needed to be able to supply infusion services, such as simple chemotherapy or iron transfusions.
"These are very, very simple therapies that make a big difference to people's lives. When you are unwell the last thing you want is a 100km round trip to have a 30-minute infusion.''
He said an outpatient clinic would be invaluable. Without one, doctors often have to admit people; it also means they can't do appropriate follow-ups, although Dr Prineas acknowledged that finding space even for a demountable building to take outpatients would be difficult on the already packed site.
It also needed a revamped close observation unit, where critically ill patients are monitored around-the-clock.
"We are dealing with patients we should be sending down the road but it's too difficult to send them so we're dealing with them here. We need a workforce upgrade to continue care in this critical care unit, with an upgraded telelink with Nepean Hospital's ICU."
The hospital also needs an augmented medical workforce.
"There's two doctors in the emergency department between 10pm and 8am and they need to cover the whole hospital. Twenty or 30 years ago it may have been alright but not today."
He said the increasing proportion of elderly people living in the Mountains puts greater pressure on health services because they need more care.
"We need to have the human resources to meet increased demand."
Dr Prineas believes that next year's state election presents a golden opportunity.
"We need the community to speak loud and clear, with one voice: we need and we deserve a new Hospital. Good health is a precious gift, and a healthy hospital means better health for ourselves and our loved ones. I call on every citizen of the Mountains to help us get this ball rolling."
