Repatriation General Hospital Concord

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Concord Hospital was erected in 1941–1942 by the Department of the Army and was known as the '113th Australian General Hospital'. It was designed to cater for the treatment of members of the armed forces and received its first patient in March 1941. The administration of the Hospital was handed over to the Repatriation Commission in 1947. The Hospital, which is operated by the Commonwealth Government through the Department of Veterans Affairs, at present has a patient capacity of 731; a total of 2,356 full-time and 193 part-time staff are employed.

The role of the Hospital is to provide in-patient treatment for veterans and eligible dependants requiring the facilities of an acute general hospital. The policy is for the Hospital to be maintained at a high clinical standard to enable it to provide a wide range of treatment for repatriation beneficiaries. To maintain this standard, the Hospital is associated as a teaching hospital with the University of Sydney. It has an emergency accident centre and community patients are treated in order to ensure a varied clinical caseload.

Concord Hospital first entered the field of undergraduate teaching in 1948 to meet the needs of the University during the period of high post-war enrolments. These arrangements were suspended in 1951 but recommenced in 1963 when the Hospital was affiliated with the University of Sydney as a teaching hospital for medical undergraduates. There are at present 137 students at the hospital in the final three years of the University medical course.

Two Professors, one each in Medicine and Surgery, and an Associate Professor in Psychiatry, oversee medical undergraduate training with the participation of other University staff, full-time departmental specialists and some visiting specialists. The Hospital is also accredited as a postgraduate training institution in a number of specialties including medicine, surgery, ophthalmology, anaesthetics, psychiatry, pathology, radiology and rehabilitation. In conjunction with other teaching hospitals, Concord participates in postgraduate exchange and rotation programmes.

The completion of the clinical sciences building in 1973 has greatly facilitated both undergraduate and postgraduate training, together with the overall administration of the clinical school. The building comprises offices, examination rooms, tutorial rooms, demonstration rooms, a lecture theatre, Professorial Units and research laboratories. The opening of the emergency accident centre in 1976 broadened the range of clinical material at both the undergraduate and postgraduate levels.

In 1980, extensions to the clinical sciences building were completed; these have enabled wider use of the latest teaching aids, such as audio-visual equipment and a computer terminal which allows student self-assessment. Included in the new extensions are lecture theatres, lounge and television rooms for students, tutorial rooms and several offices for research fellows.

A Professorial Sub-Unit of Surgery commenced in 1966, the Professorial Sub-Unit of Medicine commenced in 1969, and the Sub-Unit of Psychiatry in 1971. The present full-time University appointees to the clinical school are: Professors R. Lusby (Surgery) and J. R. Lawrence (Medicine); Associate Professor C. Tennant (Psychiatry); L. Bokey, Senior Lecturer (Surgery); J. Payne, Senior Lecturer (Surgery); and R. Walls, Senior Lecturer (Medicine). Professor M. T. Pheils, the first Professor of Surgery, retired at the end of 1982.

As a major teaching hospital, Concord is conscious of the need to provide medical care of an exceptionally high quality. It plays a role in educating practitioners, nurses and allied health professionals and actively contributes to the advance of medical knowledge. Medical research is the means whereby advance is achieved and as such it is encouraged at the Hospital. The spirit and practice of research have grown within the Hospital, and over recent years a number of services have been developed to cater for the needs of investigators. Computer facilities have been used to develop a generalized data analysis programme to facilitate retrieval of records for retrospective research. The Hospital’s medical record librarians are deeply involved in the research programmes, and the well-equipped medical library provides research workers with ready access to reference material.

The Department of Veterans’ Affairs recognizes two areas of responsibility in relation to medical research carried out in the Hospital: firstly, a need to encourage and support medical research as an integral part of the process of patient care and secondly, a need to ensure high technical and ethical standards in research. Within the framework of a two-tiered advisory committee structure, a large number of research projects is carried out in the hospital; these range from basic biomedical investigations to research into health services.

The Professorial Surgical Unit has, over the past eight years, specialized in the investigation of disorders of the large bowel. Clinical, pathological and immunological studies have been performed on patients suffering from colo-rectal cancer. In 1978 the Professorial Unit, in conjunction with two Visiting Surgeons, formed the colo-rectal clinic to investigate and treat disorders of the colon and rectum. The members of the Unit have performed an increasing number of colonoscopies. The Unit has treated many new cases of rectal cancer by an operation which conserves the patients’ normal anatomy, made possible by the development of an automatic stapling device called the E.E.A. gun. The clinical and pathological pro forma created for storing data by computer has been widely acclaimed and is probably unique in the study of diseases of the colon and rectum. Laboratory studies have continued into immunological and other tests to monitor and perhaps make an earlier diagnosis of the disease with the hope of improving survival rates.

Much progress has also been achieved in the transplantation of Islets of Langerhans in the treatment of diabetes.

From 1977, the Professorial Medical Unit began to share with the hospital clinical responsibilities for general medical, immunological and renal patients. The various research projects undertaken by the Unit include a study of seasonal allergy in rural N.S.W.; immunological aspects of glomerulonephritis; clinical aspects of systemic lupus erythematosis; the effects of prolonged immunotherapy; research into Huntingdon’s disease, electrolyte metabolism and hypertension.

The Professorial Psychiatry Unit has had an active interest in the area of stress and psychopathology. Research has continued into the association between psychological factors, heart disease and gastrointestinal disease, in collaboration with physicians and surgeons in the Hospital.

The undergraduate teaching programme has continued in recent years with a dedicated and enthusiastic group of students. Outstanding results have been obtained by the students in the three-year clinical phase of their tuition. The Medical, Surgical and Psychiatric Units have all had a very successful association with the Hospital, actively participating in the Hospital’s educational programmes such as the weekly physicians’ workshop. Certainly the University will continue to make a valuable contribution to Concord Hospital in the future. The Hospital provides a high standard of patient care to entitled veterans and to members of the community, and this achievement is largely due to the abilities and performance of the health care professionals associated with the University of Sydney.

Source: J. W. Mold, "Repatriation General Hospital Concord" in Young J, Sefton A and Webb N, Centenary Book of the University of Sydney Faculty of Medicine. Sydney University Press, Sydney