News

The Director of Cancer Services, Brett Hamilton, has shared an open statement to reassure the community that the transition to a publicly operated model at the Albury Wodonga Regional Cancer Centre will ensure continued access to cancer care for the local community, and that services are equitable, accessible, and sustainable for the future. 

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I have been a medical oncologist in Albury for nearly seven years, and I was appointed as the Clinical Director of Cancer Services for Albury Wodonga Health in December 2024.  Our region has a cancer service to be proud of, and the community has poured much blood, sweat and tears into making it a reality.  We have wonderful facilities, dedicated staff and a high level of research activity, and we boast cancer survival rates that rival metropolitan Melbourne.  Ramsay Health Care have run a terrific service for which we should be grateful, but it has been clear to me for a long time that it is time to hand the service back to the public.

As one would expect with a large change to a valued service, there have been numerous concerns – I hear these from my patients every day. There have been limitations on Albury Wodonga Health’s ability to communicate effectively, but I have been given permission to write honestly from my own perspective to address some of these concerns.

These changes have undergone extensive consultation, despite reports to the contrary.  Cancer services underwent two separate reviews in 2022.  Ramsay Health Care first ran an internal review into the function of the Border Cancer Hospital.  The findings of this review were reported to Albury Wodonga Health which triggered an independent review of the current and future state of the cancer service. I was interviewed and provided a written report and all of my specialist colleagues along with scores of nurses, support staff and key stakeholders were able to share their views.  Both reviews clearly outlined concerns both currently and for the future.  I will not go into the issues identified for confidentiality purposes.  The overarching theme was that despite our excellence now, we were unlikely to be able to sustain this into the future. 

Upon the transition, the day-to-day operations of the inpatient ward and day oncology service will be largely unchanged.  Patients will see the same friendly faces of our existing dedicated staff.  Conjecture that the beds at the cancer centre will be grabbed for non-cancer patients is unfounded.  There is a mandate to keep the cancer centre for cancer patients but with Albury Wodonga Health management we will be able to open it to capacity and bring in a wider range of cancer patients that we are unable to currently accommodate, including those with surgical or higher acuity issues.

Recent reports that Border Medical Oncology have not had their lease renewed are true.  The specialists there have all been assured that they have the opportunity to continue to work and care for their existing patients in the cancer centre as part of our public outpatient unit.  Some may opt to continue in private practice.  Our region is large enough to support both public and private cancer services in our region and AWH is supportive of any clinician or patient who chooses private care.  All patients, regardless of their insurance status will continue to have access to the cancer centre where needed.

Private practices will have to be moved off site to create room for a comprehensive public outpatient clinic, so services into the future may be split location-wise.  Public patients will be treated at the Albury Wodonga Regional Cancer Centre; many private patients will too.  Some private patients may choose to see a private oncologist outside the cancer centre, but it will always be a choice.  This is no different to the current state of the service.  The cancer centre has not been ‘one-stop shop’ for all patients since 2021 when Dr Kay Xu and I had no choice but to move out to West Albury to continue to practice.

Recent reports in the media that the cancer centre will work on a paper-based medical record system are not true.  The current state is a fragmented system of private practice software and Ramsay’s prescribing software, while the day oncology unit and ward run off paper records.  There have long been issues with information sharing. Our specialists are unable to see records from the other practice, while the emergency department, wards, day oncology unit and cancer support nurses can’t see any records from anyone.  This fragmentation of patient information is highly inefficient.  As part of the transition, we are working towards the implementation of Charm Evolution as a complete electronic record for the entirety of cancer services.  All staff across the organisation will then have secure access at all times to the information they need to care for their patients.  I can’t see this as anything other than a vast improvement.

Albury Wodonga Health’s recent admission as an associate member of the Victorian Comprehensive Cancer Centre (VCCC) alliance, and transition to public management will open many doors to improving education and professional development for all staff.  We will also be able to realign junior doctor staffing to improve junior doctor workloads and allow increased focus on education and training.  This increased focus on education will undoubtedly enhance future workforce recruitment and retention by improving workplace culture and job satisfaction.

Finally, the greatest issue for as long as I have worked here has been patient costs.  All outpatient care is delivered by our region’s two private practices – Border Medical Oncology and Albury Wodonga Cancer Care.  The cost of running a practice and poor Medicare rebates has long necessitated out of pocket costs for most patients. The rising cost of living, increasing costs to run a practice and the ongoing abysmal indexation of Medicare rebates would continue to place further financial pressure on patients into the future.   I am relieved that this will soon be a thing of the past. All patients will have the same access to high quality care, free of charge, regardless of their financial situation.

Of course, such an ambitious project carries risk, but I personally believe this is critical for the future sustainability of the cancer service.  I knew this in 2022, and I still know this to be true now.  This is not a knee-jerk reaction by Albury Wodonga Health; this has been years in progress and is being planned right down to the IV cannula.  I would like to call for patience and understanding as we continue to work tirelessly to deliver this important transition and make it as seamless as possible for our patients. I can assure you that all involved have the community’s best interests at heart.  I have full faith we can deliver a public cancer service that the community can continue to be proud of.

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Brett Hamilton

Oncologist and Clinical Director of Cancer Services, Albury Wodonga Health