The Austin Hospital
The Austin Hospital is one of Victoria's largest public hospitals, and is situated in Heidelberg in Melbourne's north-eastern suburbs. However, the regional Olivia Newton-John Cancer Centre at the Austin Hospital can’t give you access to the newest surgical techniques using robots, because it doesn’t have a robot.
Professor Bolton says the Austin’s patients want to know why they can’t have robot-assisted surgery when it’s available at many private hospitals. “I have that conversation every week,” he says. “It’s hard enough to tell someone what to expect when they’ve been diagnosed with cancer, but to have to tell them that their neighbour is going to have this more efficient, less painful surgery at a smaller hospital is very difficult. And it’s all because their neighbour can afford insurance and they can’t.”
Associate professor Nathan Lawrentschuk says the lack of a robot at the Austin leaves him feeling “empty”. “Having trained on a robot 10 years ago at a comparable hospital in Toronto, it makes me feel hollow,” he says. “Every place in the world that can justify calling itself a cancer centre has a robot - except for the Olivia Newton-John Cancer Centre. Even Toowoomba and Tamworth have robots.”
Not only would a robot at the Austin make good on the equity principle that is supposed to govern our health system, it would build the skill and knowledge base of our surgeons. The physical demands of performing conventional open surgery in tight spaces takes its toll on the necks and shoulders of surgeons. Many retire at 55 because they can’t go on. A robot can extend the working life of surgeons from 55 to well into their 60s.
Surgeon Renu Eapen says a robot “would mean that I could do what I was trained to do”. “I could give people the whole range of treatments,” she says. “It would mean that I don’t have to segregate public and privately-insured patients.” What happens now is that because public hospitals such as the Austin do not have a robot, many of its most promising surgeons must leave, heading overseas to learn how to carry out robot-assisted surgery.
Not only is there a brain drain, but as robotics inevitably becomes more vital to a whole suite of surgical techniques, the more likely it is that Australian doctors and public patients will be left behind. They’ll be missing out on the best and it will get further away from them. As Dr Joseph Ischia says, “The future is clearly in robotics. We’ve only just started with the robot. The sky is the limit.”
Professor Bolton can tolerate the inequity no more. He is spearheading a group of Victorians from a wide range of professional fields – including communications, education, and entertainment – who are redoubling the effort to persuade the government to give the people who rely on the Olivia Newton-John Cancer Centre and the Austin access to robot surgery.
In addition to the above, there are further reasons that make the Austin a logical choice for such a robot to be based. The hospital has a large urology department undertaking surgery for more cases of urogenital cancer than any other public hospital in Victoria, with patients drawn from the extensive case-load of a leading cancer centre with a particular interest in this cancer field (Olivia Newton-John Cancer, Research and Wellness Centre = 120 major cases/year).
In addition, the hospital has many fully robot trained surgical and nursing staff with extensive experience in robotic surgery. The provision of a surgical robot at the Olivia Newton-John Cancer Wellness and Research Centre would provide both the Austin Hospital and the co-located Mercy Hospital for Women with facilities for best practice minimally invasive surgery, where currently there exists no on-site facility for public hospital treatment of gynaecologic cancers for in Victoria. Due to recent refurbishments of the Austin Hospital this could be undertaken without reconfiguration of the current facilities for surgical services, and with no requirement for additional operating theatre renovation or further capital spend on sterilisation equipment.