A report on the condition of The Women's and Children's Hospital, Adelaide in Australia has raised serious questions on the risks both the patients and the staff there are exposed to every day.
Titled The Case for Change, it reveals a litany of problems with ageing facilities in two of the hospital's oldest buildings and it describes infection control as a "critical risk".
It states: "WCH is experiencing immediate facilities, infrastructure and related services issues that are exposing patients, families and staff to high levels of risk and reducing service capability."
The Women's and Children's Hospital is one of the major hospitals in Adelaide and is a teaching hospital of the University of Adelaide, the University of South Australia and Flinders University.
The report, commissioned by the South Australian state authorities, focuses on the Good Friday and Gilbert buildings, which house services including medical in-patient facilities, general medicine and renal medicine.
Titled, The Case for Change report outlines widespread problems, including:
INFECTION control represents a critical risk "as a result of the outdated and poor condition of the current facilities and infrastructure". The risk stems from insufficient isolation rooms, poor sewer and effluent drainage due to aged hydraulic systems, and ailing air-conditioning systems.
ASBESTOS within walls and ceilings represents a high risk to staff, parents and patients.
HIGH risk of electrical failure and loss of power, including in wards and dialysis areas.
HIGH risk of failure of the lifts.
HIGH risk of potential death or injury in the event of fire due to non-compliant systems.
OUTDATED design means nursing stations are "completely dysfunctional".
PATIENT rooms and consulting rooms are "grossly undersized" and wards and consulting spaces have no provision for disabled patients.
The report raises three options for redevelopment but recommends the most expensive - full redevelopment of the two buildings at a cost of $41.7 million.
But Health Minister John Hill responded with a statement, "The WCH is managing the identified risks associated with an ageing infrastructure and all other risks identified in the organisation to provide for maximum patient and staff safety on the WCH site," the statement said.
Despite increasing community acquired infection rates, the number of hospital acquired infections had decreased over the last four years, the statement said.
However, doctors and nurses have said that cross-infection is one of their biggest concerns.
WCH specialist pediatrician Dr David Thomas said it was a particular problem in winter, with extra demand on services.
"Cross-infection is one of the biggest concerns in the current structure; it's very difficult for patients to be isolated in a single room," said Dr Thomas, who is also chairman of the Australian Medical Association's Child and Youth Health Committee.
"Patients are often cohorted together and may or may not have the same infection."
AMA state president Dr Peter Ford described the report as "disturbing".
"If these issues identified are causing measurable effects, we should really move to address these issues immediately," he said.
Hospitals across the state were battling with ageing infrastructure.
"I feel that the budgetary allowances for maintenance do not seem adequate to cope with these various areas of urgent need," Dr Ford said.