February 1 - 28, 2025: Issue 639

 

tragic Death of 2-year-old Joe Massa at Northern Beaches Hospital ED Prompts Renewed Calls for Hospital to be Returned to Public Hospital model immediately

Photo of NB Hospital by Cabrils.

Balgowlah parents Elouise and Danny Massa have spoken out this week about the tragic loss of their little boy at Northern Beaches Hospital ED, demanding a comprehensive review of Northern Beaches Hospital after the death of their two-year-old son, Joe.

Elouise and Danny Massa took two-year-old Joe to the emergency department at Northern Beaches Hospital on the morning of September 14 2024 after he had spent the night vomiting.

The toddler had hypovolemia, a condition that occurs when the body loses too much fluid.

Despite his mother’s pleas to attend to her son as his condition deteriorated, she was ignored.

Joe suffered a fatal heart attack at 10.47am - more than three and a half hours after he first presented to the hospital. 

"We will not stop on this fight to get justice for Joe and awareness in our community and reform at its highest level because we won't let one more life be lost," Mrs Massa said.

Mr Massa said the standard of care must be higher in Australia.

"It's 2025 [in] Sydney, we should not have a hospital system that is run like this, he's not here because of their care... they stole memories," he said.

In a statement, Joe’s parents said Joe's heart rate was at 183 beats per minute when they arrived at the hospital's emergency department, yet he was misclassified as a low priority, category three patient, instead of red zone, category two.

The Northern Beaches Hospital missed critical warning signs, including when Joe lost consciousness, and his mother's requests for an IV drip were denied, the statement said. 

A Serious Adverse Event Review was conducted by the hospital after Joe's death.

The SAER, submitted to the NSW Health Ministry on December 20, identified several serious failures in Joe’s case including “failure to recognise and respond to a heart rate in the red zone particularly in the absence of fever”, “failure to respond to parental concern” and “failure to respond to clinician concern as per internal escalation processes”.

It also recommended reviewing the hospital’s patient IT systems that currently do not automatically flag and escalate dangerous vital signs.

“During the SAER investigation, it was identified that two clinicians’ professional practice was not to the expected standard and have referred this to the hospital’s executive unit for further management,” the report said.

“The SAER team acknowledge they cannot say definitively that the child’s death was preventable, however, they do acknowledge that there was a delay/failure to recognise deterioration. The SAER team accept that an earlier recognition of the deteriorating child may have provided an opportunity for early escalation and resuscitation with potential prevention of the cardiac arrest event.”

Healthscope, which operates the hospital, said in a statement: "Northern Beaches Hospital offers its deepest condolences to the Massa family for the loss of their son, Joe. We recognise Joe's death has caused unimaginable heartache and grief for the family.

"We have met with the family to apologise and hear directly about their tragic experience and to discuss the findings of the Serious Adverse Event Review.

"We will continue to support the family in any way that we can as we implement the improvements identified in the review, including improvements around triaging processes and internal escalation processes."

Joe's mother said no parents should have to go through what she and her husband had.

"Joe was the most beautiful boy, loved by his sister and brother," she said.

"He loved dinosaurs. He had the most infectious smile. He was just two months off turning two years old. 

"He was, and is still, the light of our world. The system at Northern Beaches Hospital, the emergency department, entirely failed us at every possible level."

NSW Health Minister Ryan Park has stated the family was "let down" by the hospital.

"This is an absolute tragedy and the commitment I will say very clearly is, we will do better... we are prepared to have a look at this in more detail, including with the chief paediatrician," Mr. Park said.

"It seems to be that from the moment little Joe came into the Northern Beaches ED, we had escalating problems.

"Mum was ignored, and her concerns were ignored and that's a big problem in a hospital when that occurs... the triaging of the serious nature of Joe was not done properly.

"The system let down this family in the absolute worst way possible."

Premier Chris Minns said the situation was "every parent's worst nightmare".

"I can only imagine what they're going through," Mr. Minns said.

"We won't rule anything out, including further inquiries.

"We take this incredibly seriously and I'm profoundly, profoundly sorry this has happened.

"It's absolutely heart-breaking."  

The family have called for an independent public review into “serious malpractice and operations at NBH emergency department”, as well as “statewide enforcement of the REACH protocol informing every parent or carer upon admission of their right to escalate concerns when their child is deteriorating, including a text message notification” and “urgent IT system upgrades” to ensure immediate alerts for at-risk patients when human error occurs.

They also want greater scrutiny on the Northern Beaches Hospital’s public-private partnership (PPP) model, operated by Healthscope since October 2018, which they suggest prioritises financial interests over patient wellbeing.

Northern Beaches Hospital’s privatised model was announced by the former Liberal government in 2015.

Despite years of pushing back against the loss of the Manly and Mona Vale public Hospitals, peninsula residents were to become subject to the private-public model after data mining and costings opined around 40% of us could afford and already pay for private health care.

The hospital opened on Tuesday October 30th 2018, as scheduled to under the agreement, following the closure of Manly Hospital and the downgrading of Mona Vale Hospital, followed by the demolition of the main Mona Vale Hospital building, which opened in 1964.

The Berejiklian government is stated to have provided $600 million to build the hospital and each successive NSW State Government is expected to provide a further $2.14 billion to the private operators over the life of the contract which is until 2038.

However, a May 2024 report by Michael West, ''Caymans Privatisation: Northern Beaches Hospital limps into financial triage'', states Northern Sydney Local Health District (NSLHD) accounts show an amount of about $600 million is being paid by NSLHD to the NBH for the public patient beds, around 2.5x what is paid for a bed in another hospital - Royal North Shore for example..

The NSW Government planned on investing $400 million in road upgrades around the Northern Beaches Hospital in 2014. Soon after the cost had become $500 million and by the end of all the works done, the cost had grown to $700 million. 

The road upgrades did not include any allocation of funding towards ensuring the Narrabeen end of Wakehurst Parkway would be improved to prevent this closing, and limiting direct access to the new hospital for all those at Narrabeen and north of there during flood closures of that road. 

Private operator Healthscope initially ran the hospital but in early 2019 the company agreed to a $4.4 billion takeover by Canadian investment firm Brookfield.

Brookfield now also owns Aveo, and were just awarded the private contract to manage the new “health precinct” at the old Manly Hospital site, the other former larger scale public hospital on the peninsula that was closed under the previous state government. 

Aveo is an Australian real estate company that develops, owns, and operates retirement villages. 

A similar 'model' for Mona Vale Hospital's site was anticipated as soon as the PPP was announced, followed by annopuncements that MVH would be demolished and the site repurposed.

See: Camden-Campbelltown Hospitals & Carrington Convalescent Hospital: A Mona Vale-Frenchs' Forest Hospitals Comparison With Pittwater History Links - Documents reveal MVH 'will have a rehabilitation, aged care and palliative care focus' - 'The Urgent Care Centre service will be: 24/7 in the first 12 months with a plan to conduct an utilisation review to determine usage/ demand' - 'Patients who access the service will: Not require admission to a hospital'

Brookfield agreed to buy Aveo in August 2019 for $2B including debt and settled in December 2109. Brookfield put Aveo for sale in June 2024. Commentators say the decision to sell its 16 South Australian and Tasmanian villages in April 2024 made Aveo a solely East Coast village operator and potentially more attractive for a sale by Brookfield. 

The sale, if successful, will take eight to twelve months. At present AVEO still touts it is owned by Brookfield Asset Management.

The NBH is the only one of its kind in the state after strong public opposition led the former government to scrap plans to expand the same model to Maitland, Wyong, Goulburn, Shellharbour and Bowral.

In March 2020 a NSW Upper House committee released its report on the Northern Beaches Hospital - 'Operation and management of the Northern Beaches Hospital'.

The report lists 23 Recommendations. Of these 6 relate to Mona Vale Hospital and include a Recommendation that the NSW Government take immediate steps to engage directly with the Manly, Pittwater and Warringah state Members of Parliament, community leaders and other stakeholders to investigate the ways and means to restore a public level 3 emergency department to the Mona Vale Hospital as soon as possible. 

Also listed was that the NSW Government ensure that the land on which the Mona Vale and Manly Hospitals sit always remain in public hands for health and medical related activities, and that 99 year or other similar long term leasing arrangements not be entered into for the sites.

Importantly to those then watching the still young by hospital buildings elsewhere being destroyed, the report recommended that the NSW Government cease demolition of the Mona Vale Hospital main building after asbestos removal is complete and retain this public asset for future use. Further, that NSW Health and the North Sydney Local Health District, on an ongoing basis, positively consider opportunities to expand both the range and availability of medical and health services that are offered at the Mona Vale Hospital. 

And that the Northern Sydney Local Health District monitor over time the effectiveness of both the Northern Beaches Hospital and the Mona Vale Hospital in meeting the health needs of the communities they serve, including for emergency care. 

The demolition of the main MVH building went ahead. Much of the site has been given over to aged care rehabilitation services:


'MVH Hospt. Village Green post 2018' - title and photo courtesy Mark Horton

Residents are again calling for a full Level 3 ED to be reinstated at Mona Vale Public Hospital, along with all the support services that would require.

Not only would that put emergency care within reach when the Wakehurst Parkway closes through flooding and helicopters cannot fly due to weather, it would enable residents to access the level of care they had prior to the advent of the Northern Beaches Hospital without having to make an emergency dash by car to the Royal North Shore Hospital.

Those who have worked at NBH state the problems with stretched staff encountered when the hospital first opened have been ongoing.

‘’The staff are stretched, especially the nurses. I used to work there, for a very short time, in the agency nursing section. All wards, including ED were crying out for staff. Every shift, every day.’’ one nurse stated his week

As one patient who waited almost 12 hours prior to leaving with no care given stated this week;

‘’ This emergency department is ill equipped to deal with a community as big as the Northern Beaches, it is understaffed, the nurses are run off their feet and the junior doctors are very obviously way out of their depth to deal with so many patients.

I will not take my family to this hospital until it’s back in public hand’s. Do yourself a favour and drive right past the NB hospital and take yourself to Royal North Shore.’’

Mackellar MP Dr. Sophie Scamps, who had practised at the ED at Mona Vale Public Hospital prior to representing the community, stated on Friday February 21 ’it is time to take our hospital back’.

After expressing her heartbreak over the devastating loss of little Joe, Scamps launched into the ‘failed experiment’ imposed on the community.

‘’The Northern Beaches Hospital public private partnership is a failed experiment. Public health and private profit-making are fundamentally incompatible.’’ Dr. Scamps said

‘’Northern Beaches Hospital must now be returned to public hands. Northern Beaches Hospital is the only remaining public private hospital in NSW. A 2020 state parliamentary inquiry into the Northern Beaches Hospital recommended an end to all public private hospital partnerships – acknowledging they do not work for patients or staff. Five further proposed public private partnership arrangements for regional hospitals were cancelled off the back of this inquiry.

‘’The community should not be left with this mess. It has to end. Patients’ lives are at risk.

‘’I’ve been calling out operational issues with the Northern Beaches Hospital this entire parliamentary term. I called for the former CEO of the hospital Andrew Newton to resign over the failure to deliver the adolescent mental health beds – he’s gone. I demanded that the state government undertake a performance audit of the hospital – something the former State Liberal Government resisted – that is underway, and due to report in June.

But 2-year-old Joe Massa’s death is a line in the sand. Patient care is being compromised, these are not one-off incidents, they are symptomatic of long term and systemic operational problems.’’ Dr Scamps said

‘’Since I was elected in 2022, I have also met with a stream of nurses and doctors from the hospital who have catalogued the ongoing and serious cuts to staffing that they have had to endure. Northern Beaches Hospital is the only public hospital in the state that will not adhere to safe nurse to patient staffing ratios. Nurses, doctors and allied health workers have been stretched to the limit and placed in chronically unsafe working conditions. They are burning out and leaving in droves.’’

‘’These brave whistleblowers have put their own careers on the line for the safety of their patients, and for the wellbeing of the hospital workforce. The situation must no longer be tolerated.

My community deserves a public hospital it can rely on; a public hospital that is safe. The health staff also deserve a safe working environment.

This mess was created by the Liberal Party, but it is for the State and Federal Labor governments to fix. They must step in urgently to ensure the hospital is put back in public hands. Public hospitals must be publicly run to serve our community, not to make profits for corporations.’’

Dr. Scamps launched a petition on Friday February 21 which calls for the NBH to be returned to public hands. There are already 1500+ signatures. See: https://www.sophiescamps.com.au/time_to_take_our_hospital_back 

Pittwater MP Jacqui Scruby reiterated Dr. Scamps statement, expressing her own deepest condolences to the Massa family.

After praising Joe's mum and dad for speaking up, Ms Scruby pointed out chronic under-resourcing, overworked staff and gaps in emergency care at NBH have left patients vulnerable.

Pittwater's MP is also calling for immediate change.

Previously (a Selection - more past reports are listed in past features page)



Karen Draddy at the MVH picnic protest

Karen being Karen at Macquarie street, photo by Michael Mannington.