A group of Canberra cardiologists has said there has been an "unacceptable and dangerous deterioration" in cardiac care at Canberra Hospital over the past year.
They have claimed patient care has been "undeniably worse" since multiple senior cardiologists were stood down from the hospital last April.
The cardiologists, who are in private practice and are not affiliated with Canberra Hospital, have written to Health Minister Rachel Stephen-Smith outlining a series of concerns and urging urgent action.
"The quality and quantity of services provided to public patients requiring cardiac care at the Canberra Hospital has been declining for many years, however, there has been a marked deterioration in the last 12 months," the letter said.
"The reason for this communication is that we feel it is imperative that you are made aware of just how deficient the delivery of cardiac care in the public sector has become."
Ms Stephen-Smith and health authorities have invited the group to meet at the "earliest date possible".
The letter, seen by The Canberra Times, showed the group had concerns about a "disparity of care" for those affected by poor socioeconomic conditions.
"Such patients should be able to access fully-funded outpatient cardiac investigations through the cardiology department, but at present have no option other than pay for such services in the private sector," the letter said.
"If inpatient care is required, the situation is significantly worse, as all patients without private health insurance are completely dependent on the Canberra Hospital, regardless of their socioeconomic status."
The letter was sent from Libby Anderson, Darryl McGill, Chris Hii, Ben Jacobson and Siang Soh.
The group also aired concerns about delays to referrals for inpatient procedures, the local availability of specific procedures, long wait lists for outpatient cardiac investigations and training for advanced physician trainees.
The cardiology department at Canberra Hospital has faced a series of issues in recent years.
A group of senior cardiologists were stood down over allegations of bullying and misconduct following an investigation into the department last year.
The group of private cardiologists said following their suspension there was no "ready-to-run" operational plan to ensure cardiology could continue to run at the hospital.
"Effective risk-management planning prior to the suspension of staff should not only have designed strategies to handle the clinical burden expected with the sudden departure of four cardiologists," the letter said.
They said locum cardiologists had been employed to replace the roles as three of the four positions are still technically filled due to ongoing investigations.
But the letter said they did not believe another investigation was needed.
"We do not believe another lengthy investigation (such as that which immediately preceded the current problems) into the function of the cardiology department is required," the letter said.
"From a patient-care perspective, service delivery by the cardiology department has been undeniably worse since that investigation was completed and its recommendations implemented."
The group also took aim at senior managers with "inadequate clinical understanding" and these decisions were being "poorly implemented, communicated and overseen by clinical administrators".
"There has been an unacceptable and dangerous deterioration in the last 12 months in the cardiac services provided by the cardiology department at the Canberra Hospital," the letter said.
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Canberra Health Services clinical director of medicine Ashwin Swaminathan said the department was performing solidly despite challenges.
"I can assure you we are providing our Canberra community with a safe and high quality service. We closely follow the performance of our cardiology department in terms of how many procedures are performed, the length of our outpatient waitlists and clinical outcomes for patients," he said.
Dr Swaminathan also said Canberra Health Services had taken a firm stance against inappropriate workplace behaviour and while it was hard it was "the right thing to do". He said they were able to cover disruptions related to essential care, including the ability to manage heart attacks.
"We were able to plan to cover the disruptions to our acute cardiology services after the cardiologist suspensions and we were very keen to ensure that there would be no disruption," he said.
Dr Swaminathan also said the organisation wanted to partner with the private cardiology practices so processes could be improved.
"We'd like to partner with our community cardiology colleagues but also our general practitioner colleagues and we want to know how we can improve the processes," he said.
Ms Stephen-Smith has said she will meet with the group. She said some of their claims were concerning but she also wanted to speak with them about changes that were being implemented.
"The ACT government has an absolute commitment to delivering appropriate and safe health care for all Canberrans. It is clear this group of cardiologists share the same commitment and I thank them for writing with their concerns and ideas," she said.
"The cardiology department has undergone a lot of change in recent years as Canberra Health Services has been working to improve both the culture and operating model for cardiology services, in response to recommendations from independent reviews.
"This includes setting a very clear standard for workplace behaviour, more training opportunities for staff and improving connections between the cardiology department, emergency department and the intensive care unit."
Opposition leader Elizabeth Lee was also sent a copy of the letter. She said the Health Minister needed to address these concerns.
"The Health Minister is lurching from one crisis to another at the moment and it appears as though there is a breakdown in communication between the minister, directorate and frontline health workers," Ms Lee said.
"[Ms Stephen-Smith] must come out and address these concerns raised by the cardiologists and explain what she is doing to address this serious issue."
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