MBBS, MD, BA, FRACP, FCICM
Dr Raper is the Head of the Intensive Care Unit (ICU) at Royal North Shore Hospital (RNSH).
Dr Raper graduated with a Bachelor of Medicine and Surgery from the University Sydney in 1977. He completed his resident years at RNSH and trained in the RNSH Intensive Care Unit from 1982-1983, before being admitted to the Fellowship of the Royal Australasian College of Physicians (RACP) in 1983.
He completed further training in Intensive Care Units overseas before returning to Australia in 1986 to work full-time as a staff specialist in the RNSH Intensive Care Unit. In 2003 he became Head of the RNSH ICU department – a position he still holds.
Dr Raper furthered his studies, graduating with a BA (major in Philosophy) from Macquarie University in 1994. He was also awarded a Sydney University MD in 1996, for his research thesis related to Cardiovascular function in critical illness.
Dr Raper has been recognised as a Foundation Fellow of the Joint Faculty of Intensive Care Medicine (JFICM, 2002), and of the College of Intensive Care Medicine (CICM, 2010). He has also held many positions throughout his career including Coordinator of Advanced Training (Intensive Care Medicine) RACP and JFICM from 1993 to 2004; Board Member of JFICM from 2001 to 2004; NSW regional Chairman of the Australian and New Zealand Intensive Care Society (ANZICS) from 1993 to 1995; and NSW regional Chairman of the JFICM and of the CICM from 2006 to 2010.
Dr Raper’s thoughts on the NSW Government’s redevelopment plan for RNSH
Along with several of my colleagues, I have had extensive involvement in planning every little detail of the new, state-of-the-art Intensive Care Unit (ICU) at RNSH. We have visited and researched ICU facilities nationally and world-wide to ensure the best possible set-up and resources will be available at the RNSH ICU after the redevelopment. The planned ICU will be a wonderful facility for RNSH patients and staff and will be able to serve the needs of critically ill patients in NSW for many years to come.
However, many aspects of the redevelopment plan for the rest of the hospital and its facilities have fallen far short of our aspirations. The major pitfall at present is the shortage of beds and the lack of single bed rooms. The ICU is a very expensive resource, and its efficiency is limited by the shortage of acute medical and surgical beds in hospital wards outside the ICU. This inadequacy results in prolonged ICU stays for patients recovering from critical illness, and therefore restricts the capacity of the ICU to admit more patients who need life-saving or preserving treatment. This is further exacerbated by the relative shortage of single bed rooms in the general wards, forcing patients who require isolation to remain, and take up valuable bed space, in the ICU.
In tacit recognition of the gross inadequacy of the planned bed numbers, there have been suggestions that one of the ICU pods might be used for non-ICU acute patients. This would result in closure of the cardiac surgical ICU that has been functioning on the campus for over 30 years. This can only be detrimental to the department and the critical cardiac services that it provides.
Another problem with the redevelopment involves Rotary Lodge – a motel-like facility for the families and carers of critically-ill RNSH patients. This ‘port-in-a-storm’ building has already been demolished, but only after an assurance and as a condition of the DA approval, that the facility would be re-built. It now appears that this will merely be a caveat on the land divestment. This is a repudiation of the earlier undertaking and unless reversed, will be a disastrous outcome for the families and carers of our patients.
These inadequacies contribute to an extremely short-sighted plan and will add to the expense of acute services for years to come.