Editorial: Women's hospital has seen its day

National Women's Hospital has been an icon for women's health, not only in Auckland but as widely as its name suggests. Its status has not been quite the same since the disclosure of the "unfortunate experiment" in minimal treatment of cervical abnormalities. But it is telling that one of the authors of that disclosure, Sandra Coney, is now campaigning for its survival.

The hospital's days have been numbered since the authorities decided in 1999 to move most of the operations of National Women's and Green Lane Hospital to Grafton, alongside Auckland Hospital. That decision followed five years of open discussion and planning with doctors and professional groups, public meetings and surveys. Many, including the Herald, questioned the wisdom of concentrating so much activity in an area where traffic and parking already posed problems.

In response, Auckland Healthcare, as the hospital company was known, decided to retain more outpatient and rehabilitation services at Green Lane to relieve congestion at Grafton. Construction of the nine-storey addition to Auckland Hospital is now well advanced. Meanwhile, Green Lane is to be redeveloped as a centre for day surgery, diagnostic clinics, outpatient services and recuperation care.

National Women's in-patient services will be moved to several floors in the new building at Grafton, and outpatient services will go to to Green Lane. As a stand-alone hospital, National Women's will be no more. When the decision was made women's health groups were assured, says Ms Coney, that the obstetric and gynaecological wards at Grafton would retain the identity of National Women's. They would have a separate entrance to the hospital, dedicated lifts and their own "bridge" between buildings so women in maternity care would not have to mingle with sick people.

But the hospital-within-a-hospital appears now to have gone by the board. Not only will services be divided between Grafton and Green Lane, but at Grafton theatres for surgery, delivery suites and nurseries for sick babies will be in a different block from pregnancy assessment and postnatal beds. Several women's organisation have appealed to the district health board and Auckland MPs for a review of the plan. They even call for urgent consideration of a replacement of National Women's on its present site.

It is a bit late for that. Likewise, the medical specialists now worried about moving between Grafton and Green Lane should have made their objections heard years ago.

The more recent split of services to women within the Grafton complex is harder to understand. A lay person would think it more sensible to have delivery suites, neonatal nurseries and recovery wards in the same building, if not on the same floor. Let's hope the separations have been designed because women and their babies can best be cared for in proximity to patients of similar condition.

A letter published on this page yesterday was reassuring on that score. Associate Professor John Windsor, of the Auckland University Medical School, said there was little justification for isolating women's health services. "As one of a number of specialists who provide cover at National Women's Hospital," he wrote, "I am aware of the difficulties risks and costs associated with that hospital ... Many of the aspects of women's health which relate to the normal physiological function are no longer provided on the site."

Hospitals are not monuments to a cause. It is hard to believe that there needs to be a fully equipped modern hospital dedicated only to women's health. And easy to believe that everyone's needs are best provided in a fully equipped general facility.

It is not just a matter of cost, though cost is a perfectly worthy consideration. Every dollar spent on superfluous buildings and equipment is a dollar less for somebody's treatment.

National Women's will be missed. Many Aucklanders were born there, and so were their children. They can only trust that the institution is making way for better care.