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Business case put forward for Adelaide’s first public eye hospital

Two prominent South Australian ophthalmologists are lobbying their state government to consider an $8 million proposal to develop Adelaide’s first dedicated public eye hospital.

The new outpatient facility would be based in the CBD and replace ophthalmology departments that currently exist within larger general hospitals in Adelaide. It would also become the state’s epicentre for ophthalmology training, clinical trials and a new interdisciplinary vision and eye research centre.

Robert Casson.

The project is being spearheaded by Professor Robert Casson, a consultant ophthalmologist at the Royal Adelaide Hospital and head of the discipline of ophthalmology and visual science at Adelaide University. He is being supported by Australian of the Year and ophthalmologist Dr James Muecke.

Casson told Insight he first proposed the project in 2015, but state government and bureaucratic inertia has limited progress. He recently presented a detailed business case to the government, highlighting the efficiencies that could be generated from a public eye hospital.

“Adelaide doesn’t have a dedicated public ophthalmic hospital like some of the other states in Australia and many other cities around the world,” he said.

“All public ophthalmic services are delivered inside large general hospitals. The cost of cataract surgery in general theatres at the Royal Adelaide Hospital, for example, is significantly greater than what it would cost in a day surgery. We are trying to point out the state government isn’t getting value for money with the current system – they are paying way too much for a service that could be provided at a much lower cost and more efficiently in a dedicated facility.”

Casson said ophthalmology departments that had been “shoehorned” into general public hospitals were not adequately equipped for the high volume and throughput of ophthalmology where a large proportion of procedural work is performed in the outpatient setting.

If adopted, the new eye hospital would become the city’s teaching hospital for registrars and junior doctors and would replace ophthalmology departments with the Royal Adelaide Hospital, The Queen Elizabeth Hospital in the city’s northeast and possibly Modbury Hospital in the northwest. They would, in turn, amalgamate into the proposed eye hospital.

James Muecke.

“We’ve identified an excellent site in the CBD in a pre-existing building that is architecturally suitable for day surgery – and our costings suggest that the fit-out for three theatres and the outpatient facilities would be about $8 million,” Casson said.

“We aren’t envisaging inpatients here, they would remain at the Royal Adelaide, but we are planning on optometrists working alongside ophthalmologists. We are also planning multi-disciplinary clinics, so the aim is to be optimising the patient care in an efficient way with multi-disciplinary teams to reduce waiting times.”

New research centre 

Casson said the eye hospital would also become the epicentre for clinical eye research and trials in the state.

Another unique component is a yet-to-be established Centre for Interdisciplinary Vision and Eye Research (CIVER), which would bring together a number of research areas in South Australia that could help improve eye healthcare.

“Examples of that are laser technology, the new Australian Institute for Machine Learning (University of Adelaide), which ophthalmology and optometry lend itself to beautifully with our imaged based data,” Casson said.

“In South Australia, we also have the Centre for Nanoscale BioPhotonics, which does some really interesting work. We have already collaborated with them for potentially new imaging technologies to obtain real-time information about retinal metabolism, as an example. Genetics research at Flinders University would also be part of it.”

Casson said the proposal was now with the state government which wants to conduct its own costings.

“Overall, it’s an exciting project and the research component is particularly interesting. If we can achieve this it would be something really great for South Australia,” he said.

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