 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
|
|||||||
|
St
Andrew's Hospital |
||||||
|
|
|
|
||||
|
St Andrew's Private Hospital, Adelaide, was opened in 1936 - the initiative of Ms. Janet Hay, the owner and Director of Nursing ('Matron'). The original building, which had accommodation for 19 patients, no longer exists. There have been many changes since those early years, to the large modern medical facility we have today.
In 1947 the privately owned hospital and the land on which the present hospital stands, were bought by the Presbyterian Church of South Australia and renamed St Andrew's Presbyterian Hospital. A Board of Governors was appointed by the General Assembly of the Presbyterian Church and charged with the responsibility of running the hospital, which was established as a body corporate. It is worth noting that membership of the Board was not then, and has never since been, restricted to Presbyterians. Governors have always been selected primarily because of the contribution they could make to the Board's deliberations as a result of their experience in various fields and a significant proportion of the governors have been non-Presbyterian.
Until 1977 the "... supreme control and government ..." of St Andrew's was vested in the General Assembly of the Presbyterian Church in South Australia, which appointed the Board of Governors and to which the Board was responsible. However, the General Assembly, in all cases, made appointments on the recommendation of the Board of Governors. Seal holders were also appointed by the Board of Governors and held their appointment, which included membership of the Board, for life or until resignation or removal by the Board. Similarly, the Title Deeds of the property were held in the name of St Andrew's Hospital. With the inauguration of the Uniting Church in 1977 the hospital's constitution was changed and the "... supreme control and government ..." of the affairs of St Andrew's was vested in the Board of Governors instead of the church authority. Governors are now appointed by the South Australian Synod of the Uniting Church but the Synod can appoint only persons nominated by the Board. Subsequently the hospital's name was changed by deletion of the word "Presbyterian". St Andrew's Hospital is a non-profit organisation which means that all its funds must be used for the purposes set out in its Rules and that no funds may be used for private profit or gain. None of the hospital's income or assets can be distributed or transferred either directly or indirectly by way of dividend or bonus or in any other way. From 1947 the hospital gradually bought additional premises and land as they became available and it now owns the whole of the block bounded by South Terrace, St. John's Lane, Gilles Street and Vincent Street with the exception of four cottages on the east side of Vincent Street. All this property was acquired for the future development of St Andrew's. Between 1947 and 1959 the Board devoted much time and effort to the task of raising funds to build a modern hospital dedicated to the health service of the community at large, regardless of religion. There was a generous response to public appeals and fund raising activities conducted through Presbyterian Church congregations throughout the state and after lengthy negotiations, the State Government recognised the value of the project to the community and agreed to subsidise on a 1:1 basis the capital cost of building the new St Andrew's. With the help of this subsidy, and with substantial borrowings, the Board was able to start building the new hospital in 1959. The new building, which was designed for 140 patients was finished and occupied in August 1961. Unfortunately, however, the Board had insufficient funds to build staff quarters so the top floor of the hospital had to be used to accommodate resident nursing staff and, because of this, only 104 beds were available for patients. Although the new hospital was well supported from the outset and all available beds were quickly filled, it was clear by mid-1962 that, if St Andrew's were to survive financially and be able to repay the money that had been borrowed, it was essential to provide extra staff accommodation so that the fourth floor could be used for patients. To this end, the house on 348 South Terrace was leased late in 1962 (it was bought several years later) and adapted for use as staff quarters. This made it possible to move some staff out of the fourth floor and an additional 17 beds thus became available for patients at the beginning of 1963. At the same time an additional loan of $50,000 was negotiated and with this money, together with a Government $1 for $1 subsidy and funds raised by a further public appeal, the new Nurses Home was built in 1963 and by the end of that year the whole of the fourth floor was available for patients and all the extra beds were occupied as they became available. Financially, 1963 was the turning point and it became clear that the hospital would be economically viable when operating at full designed patient capacity, despite the heavy burden of mortgages. From 1963 onwards the demand for beds in St Andrew's grew steadily and an increasing number of patients had to be refused. In 1966, therefore, it was decided to enlarge the hospital and the Women's Auxiliary Wing was added in 1968 at a cost of approximately $25,000. This brought the total bed capacity to 174. No major work was undertaken during the next few years, partly because all available funds had to be used to pay off the loans. Negotiations continued to obtain City Council approval for further development of the hospital in an area zoned under the City of Adelaide Plan as "residential". The town planning problems were finally overcome in 1976 and during the next three years the hospital was improved by alterations and additions to the ground floor; modernisation of the kitchen and the patient meal service; landscaping and the construction of car parks; and the upgrading of fire protection services, including the installation of an automatic fire alarm system to bring the hospital into line with the modern standards applicable to new buildings. With increasing work pressure it became obvious that additional space was required for administrative offices and an eastward extension was built at ground level, providing offices for General and Nursing Administration; a Board Room which provided accommodation for a number of other functions and a practical doubling of cafeteria capacity. By 1979 it was apparent that additional operating theatre capacity was needed to cope with the greatly increased amount of surgery being performed at the hospital and after consideration of various ways of updating and expanding the original surgical suite, it was decided that the most efficient and economical solution would be to build an entirely new wing comprising six operating theatres with support facilities. That was done in 1980 and when the project was completed the old surgical suite was altered to provide a new ten bed ward for short-stay patients (bringing the hospital's total bed capacity to 184) and improved facilities for the X-ray Department. One of the old operating theatres was retained for use in special diagnostic examinations and can still be used as an emergency theatre in case of need. Computerised Axial Tomography was introduced in November 1982 by a consortium of radiologists. In February 1985 further space was provided to the Radiological Practice to establish a modern angiography suite. The provision, upgrading and extension of a High Dependency Unit on the first floor and installation of ducted air conditioning system in the main hospital block was completed in early 1984. During 1984 an old house owned by the hospital at 352 South Terrace was extensively renovated to enable the establishment of the privately operated Adelaide Radiotherapy Centre which commenced in early 1985. In May 1985 the former Abergeldie Private Hospital (64 beds) at 548 Portrush Road, Glen Osmond, was acquired thus bringing the hospital's total bed complement to 248. With the transfer of Ophthalmology services to Abergeldie this allowed for rationalisation of facilities at South Terrace. Following the acquisition of Abergeldie, the hospital with the help of consultants produced a Master Plan for the long term development of the hospital. Numerous frustrations occurred with the council regarding land use and zoning etc which was compounded by a review of the City of Adelaide Plan. The Master Plan was finally produced and adopted by the Board of Governors in April 1987. In the latter half of 1987 a link was constructed between the Nurses Home and the Theatre Block to enable a modern Endoscopy/ Colonoscopy area to be established. This incorporated the most modern endoscopy equipment available in Australia at that time. Also new facilities were made available in the Theatre Undercroft area for Stores and Maintenance. During 1987 approval was given by the Adelaide City Council for the establishment of Medical Consulting Facilities in the Cottage at 344 South Terrace. Similar negotiations were not successful with the Council regarding the Cottage at 341 South Terrace. It was not until December 1993 that the Council finally approved 341 for use as medical consultant facilities. During 1987 work commenced on renovating the old coach house at the rear of Waverley House for use as a Chapel. This work was possible with funds from a very generous bequest from the estate of Edith Louise Tucker. The new Chapel was dedicated at a service conducted by the Moderator, Mrs. Elizabeth Finnegan, on 12th February 1989. Also during 1988 approximately $400,000 was expended on the ground floor of the acute block to provide new and expanded facilities for CSSD and Pharmacy. A new Portico/Main Entrance was completed during 1989 along with the demolition of the 'old hospital' to provide additional car parking spaces. Thus all preliminary tidying up work was completed prior to a full scale attempt to commence the Central Wing Project. During 1988 and 1989 the hospital staff worked closely with Arthur Andersen Consultants to conduct an Operational Review of the hospital. This proved to be a pivotal decision, as the adoption of many of the findings and recommendations of the review resulted in significant financial savings to the hospital. A new management structure was introduced and many efficiencies effected. A day Surgery Suite concept was developed and implemented on the first floor adjacent to the General Ward. This facility was well received by Doctors and Patients alike and proved to be extremely valuable in the years ahead. A significant development occurred in 1989 with the introduction of Magnetic Resonance Imaging (MRI) and Nuclear Medicine (NM) by our resident Radiologists, Dr. Jones and Partners. This equipment was installed in the old house at 349 South Terrace and necessitated the complete refurbishment of this building. The Board room which had been transferred from the acute block to this building in 1987 was again relocated to the first floor of the renovated nurses home. Senior staff were also relocated at this time, reflecting the hospital's desire of providing patient accommodation and services as its first priority. From an administrative point of view 1989 saw the introduction of Preferred Provider Agreements with the major Health Insurance Funds. Physical development slowed during 1990. However, much of the year was spent in planning the Central Wing Development and the proposed third bunker in the Radiotherapy expansion. Planning problems with the Adelaide City Council were extremely difficult to overcome, however, persistence in this area continued and at the end of 1990 all the necessary approvals were in place. During 1991 the design development phase of the Central Wing project was tackled with great enthusiasm by the staff and the Building and Development Committee. The degree of detail undertaken during this time was to prove vital as the later stages progressed. Many plans were developed and discarded as more workable options were discovered. For example the final decision to locate the new passenger lift outside the existing acute block proved to be architecturally and financially a worthwhile decision. Whilst a great deal of attention had been given to the Central Wing project the Board resolved to continue with its plans to develop Waverley House. This was to prove successful when in August 1991 the Council advised it would view favourably the use of Waverley House for Medical Consulting suites. After further planning and discussion it was determined that the western half of the ground floor and the whole of the first floor of Waverley would be converted for use as consulting suites. The eastern ground floor section (the old Ball Room) would be renovated for use as the Board Room and meeting functions. This development would proceed at the completion of the Central Wing Project which was estimated then to be in September 1993. During construction of the Central Wing the Ball Room in Waverley was utilised to enable a mock-up patient room to be built. This proved a valuable decision which enabled many design changes to ensure smooth running during the construction stage. In late 1991 after vigorous discussion at Board and Committee level it was agreed the Central Wing should be built using a Construction Management Contract system. The hospital was pleased when in December 1993 it was agreed to appoint Hansen Yuncken (SA) Pty Ltd as Construction Manager. This was a decision which proved to be one the hospital would not regret. Planning and documentation proceeded unabated but it was not until Easter 1992 when the first sod was turned on the building site. Despite inclement weather during the early stages the Building programme remained substantially on budget and on time. On 17th September 1993 the ground floor was handed back to the hospital with the 1st, 2nd, 3rd and 4th floors progressively handed back over a six week period. It was with some pride and satisfaction that on 30th November 1993, St. Andrew's Day, that the Central Wing was officially opened. During construction two significant additions were made to the contract viz. the central vacuum cleaning system and the Co-generation Plant, both proving to be financially economic and environmentally friendly. On a clinical basis the decision was made in 1990 to acquire a lithotripter but the implementation of this decision was deferred as the South Australian Health Commission was reluctant to give approval for this. Finally the SAHC dropped its opposition and the unit was purchased and made operational in December 1992. Following a consultative review with the Uniting Church SA Synod the Board agreed to provide additional resources to the hospital's Chaplaincy Service and in 1991 a Co-ordinating Chaplain was appointed. Also in 1992 we saw the opening of our Stomal Therapy Clinic to provide a support service to ostomate patients from both the public and private sector. Following a feasibility study conducted in January - March 1993, the Board resolved to upgrade the existing HDU unit and create an ICU unit on the first floor of the existing acute block. This development, whilst originally planned for 1994 did not actually commence until January 1995. During the refurbishment HDU patients were located in the first floor Eastern extension. This necessitated the 8 two bed wards (16 beds in total) being serviced to cater for HDU patients. After a long period of investigation and financial analysis a decision was made in 1994 to sell Abergeldie and consolidate all Surgery on the one South Terrace site. In January 1995 all Plastic Surgery was transferred to South Terrace. The transfer of Ophthalmic patients from Abergeldie was delayed until later in the year due to the fact that they were to be nursed in the 16 bed Short Stay Ward. As mentioned above this area was not to become free until the ICU/HDU development was completed in July/August 1995. Careful planning came to fruition in September 1995 when the Ophthalmic patients were transferred to South Terrace and Abergeldie was divested on 3rd October 1995. The sale of Abergeldie was to be another challenge to management. Expressions of interest were called in late 1994, however it wasn't until March 1995 when successful negotiations were concluded with a group of Adelaide doctors for its sale. Such negotiations successfully incorporated a delayed settlement to October 1995 allowing sufficient time for the ICU/HDU development. Over the long weekend in October 1995 all equipment required at South Terrace were transferred and a smooth handover occurred on Tuesday 3rd October 1995. Concurrent with the Abergeldie negotiations the physical reconstruction of the old HDU continued at South Terrace. Thus in August 1995 we made the appointment of an Intensivist, Dr Michael Buist, under a service agreement from the Royal Adelaide Hospital. The first ICU patient was admitted in September 1995. The unit was officially opened on St Andrew's Day, 30th November 1995, by the Minister of Health, Dr Michael Armitage MP. Thus the last quarter of 1995 was one of consolidation as a single campus facility with 202 licensed beds plus 18 "day" beds. Following a Strategic Planning Day held by the Board of Governors in July 1995 the newly formed Business Initiatives Team worked solidly on strategies to develop the business of the hospital. The Davidson Chemotherapy Suite on the 3rd Floor was the first manifestation of these initiatives. The Gilles wing eastern section of the third floor was gutted and refurbished for day chemotherapy patients. The second major initiative was the decision to open an Emergency Department. A project officer, Ms D Lane, was appointed and every member of the project team worked feverishly to ensure the success of this venture. Utilising fast track planning principles it was possible to open the Emergency Department in March 1996. This venture necessitated the recruitment of a Medical Director, Medical and Nursing Staff experienced in Emergency Medicine. This in itself meant management was faced with new challenges including new insurance and indemnity arrangements. Occupancy of the hospital increased substantially with new patients being attracted via the Emergency Department. However, the changed patient profile meant a changed case-mix with pressure on hospital staff to review work processes and flow. In the first year of operation the Emergency Department saw 7,330 patients resulting in 2,425 admissions. The Board's faith in the department was reflected in the decision to refurbish and expand the department early in 1997 at the total cost of nearly $350,000. In mid 1996 the hospital became aware of the possibility of acquiring the old East Terrace private hospital at 252 East Terrace, Adelaide. After a long period of negotiations it was acquired in October 1996 for a cost of $1.3m. It was agreed it be refurbished to establish a Day Patient Oncology Service. Thus freeing up private room accommodation on the third floor of the main acute block. The refurbished ground floor of East Terrace, now renamed St Andrew's Medical Centre, was declared open in March 1997 by Dame Roma Mitchell AC DBE. The remainder of 1997 at the Medical Centre was devoted to refurbishing the top floor for Medical Consulting Suites. In October 1997 the eastern half was occupied, the western half to be tenanted by February 1998. Following an approach by Dr. Jones and Partners, Medical Imaging, for an expansion of its first floor leased area to expand its angiographic procedure room, it was agreed to develop this area. This provided an opportunity to make available to Vascular Surgeons and Cardiologists an angiographic suite. Contemporaneously with the planning for the new angiographic suite, the hospital negotiated with Adelaide Cardiology for the lease of the front portion of 349 South Terrace as consulting suites. This also necessitated the move from 349 South Terrace to 337 South Terrace of Dr. Jones and Partners practice administration. In June 1998 this planning came to fruition when the new angiography suite was opened by the Hon. Dean Brown MP, Minister for Human Services. In October 1997, the hospital acquired 333 South Terrace which was fully tenanted by doctors who primarily admit patients to St Andrew's. Plans for the development of a car park and new acute block had developed over the years to a point when in late 1997 the Adelaide City Council gave its concurrence. An appeal from local residents in the Environment Court held this up until the hospital decided not to proceed with the appeal. It was deemed more prudent to await the promised Adelaide City Plan review in late 1998 to enable more accurate planning to proceed. As of March 1999 the revised plan had yet to be made public for review. The decision to acquire 333 South Terrace and 252 East Terrace thus proved to be well founded. The future development of St Andrew's must depend on the needs of the community and, to a large extent, on Government health care policies. The hospital has sufficient land to accommodate any expansion likely to be justified in the foreseeable future but unfortunately the use of the land is constrained by plot ratio problems. Medical and surgical methods and techniques are subject to progressive development and sophistication, with the result that no hospital can remain a static unit and maintain its efficiency. While every effort is made to provide for future needs and fresh techniques, inevitable constant review of requirements is necessary, all of which have profound major financial implications. The Training School for student nurses was started in 1961. The enrolled nurse training programme was started in 1971 in affiliation with the Gleneden School of Nursing and our own full-time course in this field was started in 1976. To November 1990, 729 student nurses and 260 trainee enrolled nurses graduated from the school. From the outset, the School of Nursing has been a most valuable adjunct to the hospital and it has contributed much to the high standard of patient care provided by St Andrew's. Therefore it was with some regret that in late 1988 (following
a report prepared with the assistance of external consultants),
the Board resolved that the School of Nursing should be closed.
This decision was consistent with the nursing profession's desire
to move the training of nurses to a tertiary based educational system.
Thus the intake in January 1989 would be the last intake of students
for training resulting in registration as a General Nurse. Recognising the importance of education (and continuing education) the Board determined that the educational traditions of St. Andrew's should continue. This would be achieved by the establishment of a Staff Development Centre which would phase in as the School of Nursing phased down. The centre would cater for the educational and development needs of all categories of staff, but in particular post basic nursing education. Space had to be made available to accommodate the Staff Development Centre. At this time the previous home of the School of Nursing (Waverley House) was condemned as being a fire and safety risk. Accordingly, the Board authorised the sum of $300,000 to be expended on refurbishing the Nurses Home to enable a more efficient use of the Building. The ground floor would accommodate Senior Administration, 1st floor would be Board Room and ancillary offices whilst the 2nd floor would be Staff Development. The final students in the school graduated in December 1991 and in late March 1992 the school was formally closed at the final graduation ceremony attended by a wide cross section of members of the nursing and medical professions. No history of St Andrew's would be complete without special reference to the splendid support given by the Women's Auxiliary. The Auxiliary was formed soon after the hospital was established in 1947. From the outset its members have worked devotedly in the hospital's interest and over the years they have contributed nearly $82,000 to the Building Fund as a result of their fund raising activities. When the new wing was added to the hospital in 1968 it was named the Women's Auxiliary Wing in recognition of the sterling support given by this relatively small band of women. In recent years there has been an increasing and valuable liaison between the Past Graduates Association, the wives of doctors working at St Andrew's and the Auxiliary. It is hoped that this liaison will develop further and ensure continuation of the work done so well by the Auxiliary in the past. More recently in 1989 the Women's Auxiliary undertook to provide funding for the design, manufacture and installation of stained glass windows for the new Chapel. At a cost of approximately $4,000 this was achieved in November 1990, when, on St Andrew's Day (30th November), a wonderful dedication service was held. August 1997 saw the 50th Anniversary of the establishment of the Women's Auxiliary. This was celebrated with a formal luncheon in Waverley House. Unfortunately in 2002, due to changes in society and the health of many members of the Auxiliary, the St Andrew's Hospital Women's Auxiliary closed on the 29 November 2002. The Board of Governors is extremely grateful for the tireless work performed by the Women's Auxiliary since their inception on the 25 May 1948 at St Andrew's Hospital. During 1993 a decision was made to provide an opportunity for those in the community who desired to volunteer their services to the hospital, to do so. A position of Co-ordinator of Volunteers was created and a recruitment drive was commenced. This has proved to be an outstanding success with over 20 volunteers regularly donating services to the hospital in December 1993. By 1998 this number had grown to 65. Although in theory the hospital is eligible for a State Government subsidy towards the cost of approved capital works, the payment of such subsidies depends on the Government's financial position and policies. As indicated above, the Government did subsidise the development projects but unfortunately no subsidies have been available for any of the major work done since 1976 and the whole cost of those projects, nearly $3 million, has been financed from the hospital's own resources supplemented by borrowed funds. At December 1992 the capital value of land, buildings and equipment exceeded $26,000,000 of which the Government contributed approximately $600,000 in subsidies. Following the sale of Abergeldie the revised capital value of our South Terrace site was estimated to be $29,850,9000 land and buildings, plus plant and equipment of $6,240,000. A full valuation was repeated in 1998 and for the audited accounts for the year ended 31st December, 1998 land and buildings and plant and equipment in total were valued at $36,224,000. The hospital receives no financial assistance towards the cost of recurrent operating expenses and must be self-supporting in this respect. The fees charged to patients must, therefore, be maintained at levels that will cover all running expenses and provide sufficient surplus for the accumulation of reserves to cover the cost of keeping the hospital and its equipment up to date. Although it was established by the Presbyterian Church and is now affiliated with the Uniting Church, St Andrew's exists to serve the community as a whole regardless of religion and the aim of the Board and the staff has always been to provide the highest possible standard of patient care at the lowest possible cost. The demand for beds in the hospital has increased steadily over the years. The above record provides ample evidence that the high standards aimed for have been achieved and maintained and it is confidently expected that they will be maintained in the future. Stephen Walker |
||||||
|
|
|
|
|
|
||
|
|
|
|
|
|||
copyright 1999 (c) email a patient | contact the hospital | credits