MUSWELLBROOK Hospital is archaic and inadequate and its emergency department "grossly undersized" because of an asbestos problem so severe that even minor refurbishments are out of the question.
The Upper Hunter pours billions of dollars in royalties into NSW coffers, but critical improvements have been frozen for years because at least $64 million is needed to refurbish the hospital and deal with the asbestos problem.
"There are significant issues associated with asbestos contamination on site," an internal Hunter New England Health report completed in March this year found.
"This impacts on general maintenance ability and prevents significant refurbishment being carried out anywhere in the building.
"The current scenario is that even minor building works to address clinical needs can't proceed."
The Department of Planning approved the Mount Arthur coalmine in 2010 despite accepting existing health services were "under strain" and the mine would increase the problem, but on the basis that royalties would flow back to the shire to improve the service.
But only $4 million has been allocated to the hospital since then, and a planned emergency department upgrade using that $4 million has struck problems because of asbestos.
The masterplan catalogued the hospital's woes including:
● An emergency department on the first floor with "problematic" access where even urgent ambulance cases are required to wait for a lift. It is "grossly undersized" at 88 square metres, when it should be nearly 500 square metres.
● An "isolated" maternity building where staff are forced to take pregnant women on a "long tortuous" route to theatres in case of complications during labour. Building layout is "dysfunctional" and "bathrooms are dilapidated".
● General ward space is less than half what it should be, with "minimal options for isolation of infectious patients".
● Non-complying theatre space is less than half what it should be, with a lack of recovery space for day stay patients despite a doubling of day stay patients in less than a decade.
● A pathology department is in "cramped facilities without space to accommodate the services provided".
● An inadequate "1970s vintage" power supply has "archaic and superseded" distribution boards and an emergency power supply that "provides only the minimum amount to meet demand".
● An air-conditioning system so affected by interior wall asbestos that vents have been sealed and areas cannot be reached for maintenance.
"Some of the areas (in the hospital) are identified as having grossly insufficient space to operate under existing conditions," the Hunter New England Health masterplan found.
The lack of space magnified the asbestos problem because existing services could not be relocated within the hospital to allow remediation work to be carried out.
The masterplan concluded it would take at least 15 years to implement all proposed works to refurbish and upgrade the hospital, at a minimum cost of $64 million.
"This is a significant investment for both Hunter New England Health and NSW Health to consider," the masterplan said.
A total new building option involving construction of a new hospital and demolition of the existing building after its completion, was costed at almost $88 million.
Hunter New England Health is negotiating to remove an 18-bed aged care unit from the ground floor to a new facility off the hospital site, which is several years from completion.
Hunter New England Health chief executive Michael DiRienzo said the organisation was focused on providing the Muswellbrook community with the highest possible quality of health service.
A new emergency department was among the priority recommendations of the masterplan. He said the government had committed $4 million for the emergency department and the health service would pursue opportunities for additional funding for the overall project.