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Sunday, April 10, 2011

In Australia: Moms fork out for 'five-star' hospital

In Australia: Moms fork out for 'five-star' hospital

The founders of The Cradle say it offers superior safety for mothers and babies – a claim other private hospitals say is outrageous.
The founders of The Cradle say it offers superior safety for mothers and babies – a claim other private hospitals say is outrageous. Photo: iSTOCK IMAGES
THERE may not be a doorman or a porter to take your luggage, but everything else about The Cradle in Hawthorn, which claims to be Australia’s first five-star maternity hospital, feels like a luxury hotel.
There are marble foyers and polished floorboards. The private suites have double beds, flat-screen TVs, lavish ensuites — and 24-hour room service.
And forget hospital food; women and their partners who stay at The Cradle, which opens next month, will be offered  fine dining and an impressive wine list. George Calombaris’s eatery The Press Club and Richmond’s Pearl restaurant are among the tenderers for the food contract.
Kate Murrowood inspects a room at The Cradle, where she will deliver her first child next month.
Kate Murrowood inspects a room at The Cradle, where she will deliver her first child next month. Photo: Simon O'Dwyer
But it’s not just five-star comfort that the directors are spruiking.
Controversially, The Cradle also claims its 30-bed facility on Burwood Road will offer better care than other hospitals by having a ‘‘rested’’ obstetrician, pediatrician, anaesthetist and theatre staff in-house 24 hours a day.
At Melbourne’s dozen or so other private maternity hospitals, most of these staff are on call after hours.
In some cases they may have one specialist on duty around the clock, but not all of the specialists. At big public hospitals such as the Royal Women’s, a full team of doctors is on duty all the time, but after hours they are senior registrars yet to complete specialist training.
The Cradle claims it will be the only private maternity hospital that  will have all of those specialists on duty 24 hours a day.
The founders of The Cradle, including Associate Professor Peter Lutjen, say the model of having specialists on call can   lead to delays in providing appropriate care and put mothers and babies at unnecessary risk.
‘‘If someone has a problem in labour, there is no delay in whatever treatment is needed ... because all of those specialists are there ready to go. And this doesn’t happen in any other private facility,’’ he says.
‘‘In other private obstetric hospitals, the obstetrician could be 10 minutes away or up to an hour away. And if a woman wants an epidural or there’s a need to do an urgent intervention like a caesarean section the anaesthetist can often be an hour away.
‘‘In obstetrics, most of the time everything goes fine but when things go wrong they can go horribly wrong,’’ says Professor Lutjen. ‘‘And they can go horribly wrong very quickly and it’s those time delays that can result in major problems, lifelong problems.’’
The Cradle can’t, however, guarantee that a woman’s  own obstetrician will deliver her  baby — a key reason why women choose to go private. If the birth occurs after hours the baby is likely to be delivered by the rostered obstetrician.
The Cradle’s sales pitch has rankled other maternity facilities. Clare McGinness, nurse director, specialty services, at Malvern’s Cabrini Hospital, says there is nothing wrong with obstetrics care in Australia and The Cradle’s claim  of providing ‘‘a greater level of care’’ is a ploy to worry women into paying more for unnecessary services.
It is understood that the ‘‘out-of-pocket’’ cost to have a baby at The Cradle, including all obstetric and other fees, for a woman with private health insurance that covers hospital stay, is about $6300. This compares with an average cost of between $2000 and $3000 for a woman with the same level of cover to have a baby at most other private hospitals. Having a baby at a public hospital usually involves no out-of-pocket costs.
‘‘I don’t think using a tactic of fear is a going to do them any favours because women are intelligent and they have a choice and they will choose a model of care that is right for them,'' Ms McGinness says.
''There is a lot more involved in delivering a high quality of care to women than having these specialists at a hospital 24/7. It's really about having the right people at the right time with the right skills. It's about having competent midwives who can assess a woman and know when to call an obstetrician, who can be here within half an hour … This is the model we've worked with very successfully for 60 years.''
Damian Armour, executive director at Epworth Freemasons Hospital, says The Cradle's claim of a safer environment for mothers and babies ''has the potential to make women feel a bit anxious about their choices''.
Freemasons has two anaesthetists on call 24 hours a day, who can be on-site within 30 minutes. The hospital is considering introducing an overnight on-site obstetrician.
Kate Murrowood, who is due to give birth to her first baby at The Cradle in early May, says she chose it primarily because of its safety claims. Ms Murrowood, who is 34 weeks pregnant, has placenta praevia - a condition in which the placenta lies unusually low in the uterus. She will deliver her baby by caesarean section.
''It's quite nerve-racking having your first child and because I have a high-risk pregnancy I just felt like this was the best option for me,'' she says.
''And also it's such a nice place to have a baby. It feels more like a hotel than a hospital and that makes me feel more relaxed too. It will hopefully make the whole experience more enjoyable.''
The Cradle isn't the only obstetrics hospital to boast a hotel-like feel. Ms McGinness says Cabrini's Malvern facility offers a ''hotel-style'' service.
Mothers and babies at the private maternity hospitals at Epworth Freemasons, St Vincent's and Mercy Private and Frances Perry House (the private wing of the Royal Women's Hospital) who meet clinical criteria also have the option of staying at five-star hotels after birth.
Dr Andrew Pesce, the Australian Medical Association's federal president and an obstetrician, says there is nothing wrong with obstetrics care in Australia, but he welcomes any model that aims to provide the highest standards of care for patients.
''I don't believe there is a crying-out need for this type of facility,'' he says. ''I think standards in existing obstetrics services in both the public and private sector are at the very high end of world best practice. But if people have a choice of even better care then that is a good thing. In saying that, I don't think it's driven by any huge failure of services in our existing system.''

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