Kids come first at new hospital

By FRANCESCA MOLD

Sick children may find themselves sleeping in their hospital room with Mum or Dad. There will be private washing and toilet facilities right there.

And the place they sleep in will be "safe" - away from the area they might associate with some unpleasant treatment such as an injection or a wound dressing.

These are just some of the things South Auckland Health believes the area's children deserve.

And they will be there in Kidz First, as the healthcare provider is calling its new children's hospital at Middlemore, and the associated community health services aimed at stopping youngsters getting sick so often.

The building, now receiving its finishing touches, is due to open in July, just as the worst of winter sets in.

Much of South Auckland Health's focus for its $60 million modernisation project - which also includes a new academic and research centre, adult in-patient facility and emergency department - was on greatly improving the treatment for children.

And the new hospital was first on its list of priorities.

It is an 82-bed, three-storeyed building built in a crucifix shape. It will provide all medical and surgical in-patient services for South Auckland children and a specialist paediatric burns and plastic surgery unit.

At the moment, Middlemore has beds for about 72 children.

The need for a hospital dedicated to the care of youngsters was considered vital, given South Auckland's growing population, which in the 1996 census was 341,730.

South Auckland Health's chief executive officer, David Clarke, says the number of children being admitted with acute illnesses has been rising about 10 per cent a year.

"That means it doubles every five years. We do everything we can to get children treated quickly and get them in and out of hospital safely, but we have just got to build more beds."

There are about 95,000 children under the age of 15 living in the Manukau-Counties region.

South Auckland has the largest concentration of urban poor of any hospital and health service in the country.

Diseases such as whooping cough, measles, rheumatic fever and meningococcal meningitis occur at rates two to three times higher than the national average.

Only 53 per cent of South Auckland children are immunised, leaving more than 40,000 who are not.

Mr Clarke says facilities for children at Middlemore Hospital have been "fundamentally substandard," with shabby furnishings, no insulation and no provision for privacy and the control of infectious diseases.

The clinical director of child and youth services, Dr Wendy Walker, describes Middlemore's present facilities as grossly inadequate and says they provide an unacceptable environment for children, considering the hospital must cope with up to a 40 per cent increase in paediatric admissions every winter.

She is excited about moving into the new hospital, which she and other staff helped to design.

The layout and structure of the new building are unique and will make the treatment of children a much more pleasant experience for staff and patients.

The ground floor and entry will be taken up with administration and a short-stay treatment area.

The floor above is set aside for medical care, with three wings of the crucifix divided into individual pods each with mostly single and some double-bedded rooms.

This design allows pods to be shut down or opened easily, depending on the demand for beds.

The single-bedded rooms are also considered vital to cope with the large number of children admitted with infectious diseases who need to be segregated from others.

Each room will have an ensuite and a built-in bed for parents, who will be able to stay with their child. Cooking facilities and family lounges will also be provided.

"A large proportion of our admissions are Maori and Polynesian, who have a very strong family focus when it comes to healthcare. We need to reflect and allow for that," says Mr Clarke.

He says ensuites will also give children more dignity and privacy.

"They should not have to go and try to find a toilet in the middle of the night.

"I just don't think the largest acute hospital in the country should have to put up with that."

Small substations for nurses will be located within each wing of the crucifix so children needing fulltime monitoring have help close at hand.

Treatment areas for the children will be kept separate from the pods where they sleep and play.

The second floor will cater for children waiting for or recovering from surgery.

The hospital has also been designed so that another level can be added to the building as the need for beds grows.

A specialist unit for children with burns or needing plastic surgery will also be set up.

Several treatment rooms will have observation mirrors, where staff and family can watch a child having a burn or wound dressed without the youngster being aware there are extra people watching.

This has been designed so the child is less stressed or overwhelmed by people during treatment.

A central core, which runs up through the middle of all three storeys, will provide a large circular administration area for the nurses' station and staff offices on each floor.

Rooms will also be set aside for school and play areas.

In addition to the new hospital, an "acute hub" is being constructed nearby to handle Middlemore's accident and emergency cases.

It will be very different from the present overworked facilities.

The main differences will be more space and, more importantly, that children and adults will be treated separately.

"The separate areas will mean kids don't have to sit around with drunk, violent or aggressive patients who can be found in any emergency department at night," says Mr Clarke.

South Auckland's population growth and health problems have long been threatening to overwhelm its health facilities.

The new state-of-the-art children's hospital is here now because South Auckland Health did not waste time waiting for Government money when it decided to build.

Instead, the hospital and health service did something almost unheard of in the public health sector - it went private.

It took out bank loans and began a massive fundraising and sponsorship drive to gather the $60 million needed for the three-year project to modernise and expand the outdated facilities.

"We could have run to the Government and waited and waited for funding," says Mr Clarke.

"Instead we decided to get off our hands and do something about it ourselves."

But although construction is nearly complete, there is still a great sum of money needed to finish the project and buy vital new equipment.

Funds will be found from South Auckland Health's budget to pay off the bank loans over time.

But the organisation has also set up a charitable trust, known as the Foundation and Friends of Kidz First, in the hope of raising an extra $5 million.

Chairman John Maasland says the foundation will actively market the hospital by approaching corporate groups for sponsorship, as well as leading community fundraising projects.

A significant amount of money has been "promised" so far, but more is needed.

Mr Maasland says South Auckland and Greater Auckland have been very supportive of the modernisation project and are committed to helping the fundraising effort.