By Mary Whelan

AS PHILLIP Island and San Remo grapple with rising populations of residents and visitors, our transport system is at a crossroads.

While VicRoads is proposing some very big engineering projects to improve traffic flow on the island, there is a concern that road and intersection upgrades will dominate the major funding for transport for the next several years.

Meanwhile, low-tech solutions are being overlooked, the community’s emphasis on safety seems to be forgotten, and there are no current plans to improve public transport services.

These are the solutions recommended by our community and adopted by the council in the Phillip Island Integrated Traffic Study (PIITS) in 2014.

How much do we build on the island to ease congestion? The community broadly accepts VicRoads plans for roundabouts at the Woolamai and Back Beach Road intersections with the main road. However, there is much less support for a proposal to widen the roundabout and road at Newhaven, and duplicate the Phillip Island Rd in the adjacent farmland along the Surf Beach, extending to the new roundabout planned for Back Beach Rd.

The council has adopted three different plans that express the community’s desire for alternatives to private car use on the island. These include improved public transport, works to encourage active transport (cycling and walking), a reduction in inappropriate speed limits to protect people and wildlife, and limits on visitor numbers at busy periods.

Background
PIITS encapsulated a community vision for integrating transport by:

• providing alternate modes of transport to private car use,
• prioritising safety,
• protecting the characteristics that make the area attractive,
• improving and better utilising existing facilities to address congestion, and
• creating and protecting commercial opportunities.

 
Since then, the council has adopted two plans that have changed the transport landscape.  
The Cowes Activity Centre Plan (adopted in March 2016) has four key priorities:

• Fixing the foreshore;
• Connecting the two ends of town;
• Recreating streets for people;
• Reinvigorating the character of Cowes.

 
The Phillip Island Visitor Economy Strategy 2035 is committed to:

• Sustainable growth
• Limiting visitor numbers to 24,500 visitors a day
• Encouraging investment in land for conservation
• Increasing native revegetation from 7% to 30% of island coverage.

 
Progress
In 2014 a community reference group was set up to advise on priorities for action under PIITS and to inform the community of progress. Back then, our priority was safe access onto Phillip Island Road at the main intersections and through Surf Beach.

The State Government has now funded roundabouts for the Woolamai and Back Beach Road intersections and the authorities have accepted that Phillip Island Road needs upgrading at Surf Beach and San Remo to enable safe access. The ultimate design of these intersections is still the subject of community and council consultation with VicRoads.

The issue of congestion management has become highly charged. VicRoads data showing a traffic pinch point at the Newhaven roundabout led to a proposal to widen the roundabout and road to four lanes requiring an additional roundabout at Forest Avenue,   with a service road in each direction to improve traffic flow. Many Newhaven residents and traders oppose the proposal.  

VicRoads’ Surf Beach & Sunderland Bay Traffic Management Plan, which followed on from PIITS, outlined six options for improving safety and access, and through traffic. The final proposal was a dual carriageway bypass from Surf Beach to the Back Beach Road roundabout.

For many people this is an excessive amount of infrastructure given the community priority is safety, and the three relevant strategies place a very high value on the environment of Phillip Island.

The community has been told that it’s necessary to finalise the road design before starting other projects. But residents want to see progress on pathways, public transport and demand management. 

The Pipeline Projects in the council’s capital works master list tell us that 32 pathways across the shire area have been authorised and have some funding allocated in this budget. Seventeen are on Phillip Island and San Remo.

The current budget allocated $827,500 across the shire for pathways. The total cost is estimated at $14,190,910. There is no time frame allocated to any of the projects listed.

Bass Coast’s Aspirational Network Pathways Plan, which was finalised in 2016, identified 53 aspirational paths that have not been built and were not on any work plans at that time.

Priorities
The priorities for 2019-20 should be to encourage active transport, as recommended in the Cowes Activity Centre Plan:

Cycle paths
The current bike path in Cowes is situated behind the existing angle parking bays, meaning vehicles back into cycle traffic. Moving the cycle path between the kerb and new parallel parking bays will improve cyclist safety.
Parallel parking bays make room for improved landscaping and greater pedestrian activity. Cyclists will be directed to turn right on Thompson at Chapel to link up with the new bikeway and footpath on Steele Street to head to the Esplanade.
Better bike paths and connections on Settlement Road will improve safety for school children.

Prioritising pedestrians
Replacing roundabouts with signalled intersections at the two major intersections on Thompson Road will improve safety for pedestrians and cyclists, especially school children. It also gets people out of cars and spending more money, which boosts the local economy.

Expanding public transport
We need more services from Cowes to Melbourne on weekends and more services across the Island. We also need better timetable information to include connections with local bus operators.

PIITS recommended:

• Improving coverage of the existing network, so residents in townships are never further than 400 metres from a bus stop.
• Providing services at least half hourly.
• Running services from 6am-9pm on weekdays, 8am-9pm on Saturdays and 9am-9pm on Sundays.
• Developing facilities and routes that enable the highest number of people to use public transport services.
• Promoting development of Cowes- Anderson link and Phillip Island loop services.

 
As the first step in improving services, the community reference group asked the council to approach Transport for Victoria (TfV) to review our public transport. TfV declined. So there are currently no tangible actions in progress to make public transport a viable alternative to car travel.

Reducing speed limits
The Cowes Activity Centre Plan recommended reducing the speed limit to 40km/h in inner Cowes.
PIITS recommended:

• an 80 km/h limit on arterial and rural roads, which means reducing the 100 km/h limit on Rhyll-Newhaven Road, Back Beach Road after the race track, Ventnor Road to Grossard Point Road and Berrys Beach Road,
• 60 km/h on major and collector roads in urban areas;
• 40 km/h on residential and high pedestrian areas, including Surf Beach and Sunset Strip. It is pleasing to see action has been taken this year on the San Remo Access Strategy recommendation to reduce the speed in Marine parade to 40 km/h, improving safety for pedestrians.

 
VicRoads has acknowledged that the speed limit also needs to be reduced to 80 km/h on Phillip Island Road on the Melbourne side of the Silverwater Estate and Potters Hill Road, where there is poor visibility. No time frame has been set yet for this to occur.

Protecting wildlife
Our local wildlife carers have highlighted how many animals are injured and killed every week on Phillip Island’s roads. Two passionate, committed women who run a wildlife rescue service on Phillip Island keep statistics of wildlife kill hot spots where wildlife need extra protection. Phillip Island Nature Parks is also gathering data in order to recommend actions.

Road authorities need to change the ‘business as usual’ mindset of ensuring drivers get to their destination as fast as possible. They must lower official speed limits and install dynamic signage to further reduce speed limits in ‘hot spots’ at dawn and dusk.

In the current planning process for the Phillip Island Road Corridor, the PIITS community reference group, Landcare and PINP have all highlighted the need to consider wildlife and the major corridors of natural vegetation across the Island.

Reducing speed limits, overpasses and underpasses, escape routes, reducing roadside grass and water and public education to encourage fauna-friendly driving practices all need to be evaluated. Solutions should be based on local evidence and what is effective in other places of high environmental value.

Demand management
VicRoads rejected extended use of the Blue Line due to the work needed to widen and strengthen the road shoulders of Phillip Island Road.

Real time information
Early identification of likely high (non-event) demand is essential, with appropriate traffic management responses in place, including dynamic signage at Bass.
A local resident has developed a Facebook page which enables people to change their travel plans when traffic is at a standstill. 

Mary Whelan is spokesperson for the community reference group advising on the implementation of the Phillip Island Integrated Traffic Study. This is an edited version of the group’s update to the community report for 2018.

By Mary Whelan
 
AT THE opening of Phillip Island’s new health hub on April 21, a quietly spoken elder of Phillip Island was the focus of much attention.
 
Gwen McRae was in turn nurse, manager and board member of Warley Hospital for 54 years. In the story of the hospital her dedication and work over many decades won the admiration of all who knew her.
 
She started as a nurse in 1954 and later managed the hospital. Even then, she continued to work as a theatre nurse. “I loved the theatre work with the surgeons – all the things they could do to make people better.”
 
After Gwen retired from her role as nurse and hospital manager in 1993 she joined the board and was there until Warley closed in early 2008. Gwen, like the rest of the Phillip Island community, felt a great sense of loss.
 
For long-term residents there was also anger that this once great community asset – which they had donated to, volunteered in and truly valued – was gone.
 
Legal battle
In the midst of the community sadness and anger over closure, there was heated argument over what should happen to Warley’s residual funds.
 
When the hospital closed, the board owed $1.9 million plus about $400,000 in staff entitlements. Warley’s 13 bed licences were sold, and the bank sworn valuation of the property was $3.3 million, leaving a balance of $1.4 million.
 
At Warley’s AGM on September 30, 2008, the president of the board, David Luscombe, reported: “The Board hopes to sell off some of the assets to service the debt, leaving some land and buildings with which to investigate the provision of health services to the community.”
 
But that’s where it got complicated. The 1923 deed of trust to establish Warley stated that if a hospital ceased to exist the trust proceeds were to go to the Central Council of the Victorian Bush Nursing Association (VBNA). However the Central Council had ceased to exist in 1998.
 
A dispute then arose between the Warley board and Aged and Community Care Victoria (ACCV), the successor organisation to the Central Council of the VBNA, about the proceeds of the sale ($1.4 million).
 
After some acrimonious debate a consent order in 2011 determined that ACCV would become the trustee of the remaining funds from Warley Hospital, adding disbelief and anger to the community’s widespread grief at losing their hospital.
 
Health hub
Since the closure of Warley there has been a vocal and persistent call for Phillip Island to have its own hospital again.
 
Many found it hard to accept the complex reasons why a small hospital like Warley could no longer offer a financially viable model of care, in particular the changing landscape of healthcare and the fact that most Phillip Islanders had not chosen to use the hospital in the last decade of its existence.
 
However, now the legacy of Warley Hospital will live on as funds from the Warley Trust have been dedicated to building Phillip Island’s new Health and Medical Hub, which was formally opened on April 21.
 
The $5.8 million project, funded jointly by the Federal Government ($2.5 million), the Victorian Government ($2.2 million) and the Warley Trust ($1.1 million) is constructed on land provided by Bass Coast Shire Council, truly a collaborative effort.
 
It will house the existing community services, which were previously provided by Bass Coast Health from a building in Warley Avenue. These include physiotherapy, counselling, speech pathology, dietetics, alcohol and other drug services, clinical nurse consulting, health promotion, health independence programs, social work and counselling and child, youth and family services. 

The Hub will make healthcare accessible for all Island people: those who are disadvantaged; those with complex and chronic health conditions; families and individuals with social needs; and those who are referred for care from local health care providers. Services will be complimentary to other private services. A number of medical consulting suites will be available for use by an increasing range of medical specialists, now consulting, and operating at the Wonthaggi Hospital. An oncologist will be on site one or two days a week.
 
The Hub has been constructed to allow for further expansion as the population grows and funding becomes available for additional services.
 
Warley legacy lives on
There will be no babies born and kept warm by an old agar stove in the Hub, but the legacy of Warley will not be forgotten: from the Thompson family who donated the land and building for the cottage hospital to the many families who donated money for the new hospital and aged care annexe, the hundreds of people who served on committees, the auxiliaries,  the volunteer ambulance drivers, the dedicated nurses and GPs, the visiting surgeons and obstetricians and the kitchen, cleaning and maintenance staff.
 
My thanks to the many people who have shared their experiences and memories. I realise this is not the full story of Warley and there will be many others who can add to or modify the words here. I invite all contributions and would particularly enjoy hearing lasting memories of Warley. 

This is the second and final part of Mary Whelan's article about health care on Phillip Island. 
Part 1: In sickness and in health

By Mary Whelan
​
IN 1798, when George Bass first saw Phillip Island, it was already inhabited by a few sealers. Much later came  graziers, farmers, chicory growers and shopkeepers. Guest houses and schools were built, but there was no resident doctor and no hospital.

Most illnesses were treated at home with home remedies passed down from mothers to daughters. In the case of serious illness or accident, patients were transported on basic stretchers to Cowes Pier to go by ship across to Hastings Hospital or to Melbourne, which was a very rough five-hour journey away. In 1910 residents tried to organise a link with the Bush Nursing Association and former nurses living on Phillip Island but the attempt failed.

In 1923 Mr and Mrs Thompson agreed to buy a building in Cowes, known as “Buena Vista”, for a hospital if the residents would undertake to furnish and equip it as a hospital. The house was then renamed Warley after Mr Thompson’s family home in England.

The Victorian Bush Nursing Association (VBNA), which was founded at about this time, was overseeing a number of small bush nursing cottages which, as time went by, were converted to small hospitals. According to the association’s printed handbook of 1926: “Bush nursing hospitals are private hospitals, owned and controlled by the Centres, available to all who need them, at fixed fees. They enable many cases of illness to be dealt with.”

The inaugural Warley hospital committee sought donations to equip the new hospital and applied to the VBNA for affiliation and help with maintenance funds. June Cutter’s Sixty Years of Caring – The story of Warley Cowes Bush Nursing Hospital records that affiliation was granted with the agreement that “if at any time the project was abandoned by the residents, the hospital should become the property of the Central Council of the Association”.

Warley officially opened on December 8, 1923 with beds for six patients and an operating theatre with modern appliances, including a 600-candle power lamp.

Island families donated goods from very early on. The first Warley patient, Mr Harmon West, was admitted with a septic arm. During his stay he learned the hospital had to buy milk so he offered the use of one of his cows. This was gratefully received, as were preserves for the kitchen pantry and wood for the fires. The Alfred hospital and Red Cross Hospital donated beds and equipment. Children from the local school gathered eggs for the hospital. Local guesthouse owners and other businesses sponsored fund-raising events such as the hospital ball, garden parties, fetes, car raffles and tennis tournaments, all of which were well supported by residents.

Annual subscriptions from residents helped Warley to remain financially viable for many decades. About 60 per cent of residents held private health insurance (at a time when the state average was 50 per cent), which mostly covered the hospital fees.

The Warley model of care became woven into the fabric of the lives of locals. Annual memberships entitled them to a lower fee for hospital stays; fund raising involved a willing whole community; costs were contained and volunteers did anything that was needed, including being volunteer ambulance drivers.

Over time the hospital committee guided the extension of Warley so more patients could be cared for, then the construction of the new Warley building (opened in 1962), and the addition of a nursing home in 1980. The original cottage was relocated by Mr O’Donoghue to nearby Genista St.

Warley was a “not for profit” private hospital serving its community. Pensioners were given a discounted rate for hospitalisation, and at times bed occupancy by pensioners was 38 per cent.

Warley was able to care for people at every stage of their life: from birth through illness and surgery, during convalescence and finally at the end of their life. An emergency department was staffed by nurses 24 hours a day with local GPs on call if needed; there was an outpatients service for patients who didn’t require hospitalisation and a visiting outpatients service for patients discharged from hospital.

All these were made possible by constant fund-raising, careful management over five decades and only small increases in population.

In 1921 the population of Phillip Island was 858 people. By 1976 the population was 2340, an increase of 1482 in 55 years. Over the next decade the population almost doubled to 4350 people.

Numbers game
Suddenly, the community service model of care was fraught with problems. There was more use of the 24-hour service as well as the extra patients who presented in summer holidays. There was no funding for this or for the outpatients or visiting outpatients work carried out by the nursing staff.

​In the early 1990s, a fee was introduced for patients attending the emergency department: $10 for members and $20 for non-members. Accounts were sent to the patient after their visit. The problem was that a number of patients didn't ever pay their bills, particularly visitors using the after hours service in the peak tourist period.

The doctors did not charge the same level of fees they would have at a standard private hospital as Warley provided a community service for patients and some didn't have a lot of money to pay higher fees.

When the GPs were being called in a lot or had to be on call, they requested they be paid an 'on call' fee as paid by public health services. The Warley Board could not pay this. The doctors and the Warley Board requested assistance from the government but this 'on call' fee was never paid. 

With increasing use of the 24-hour service at Warley, busy local doctors were no longer able to be on call at night and over the weekend so new doctors were needed to fill this gap.

Medicare was introduced in 1984, adding the cost of the levy to those who also paid for private health insurance. As premiums rose, many chose to drop their private insurance and use public hospital services.

Nationwide the cost of medical professional indemnity insurance rose sharply, particularly for GPs delivering babies and visiting obstetricians. Fewer doctors were willing to provide this service, particularly in small rural hospitals. Dr Ian Wilson, a GP obstetrician at Warley, observed “The government realised there would be a major problem and provided a subsidy for rural doctors which allowed them to continue this work.”

​The expectations of maternity clients also changed. You needed private health insurance to have your baby at Warley but there were no hospital fees at Wonthaggi. All these factors contributed to a decline in births at Warley. Dr Wilson delivered the last baby at the hospital.
By 2001, Warley no longer provided obstetric services. This loss was a blow to the community as families now had to leave Island to have their babies. It also meant the loss of a major source of funding and use of inpatient beds.

​From the mid-1980s hospitals and aged care facilities had to be accredited. Warley’s doctors and nurses always provided care of a very high standard; however, seeking accreditation was a significant cost that involved upgrading equipment and administrative processes to meet the standards required.

​In the 1990s a change in patient categories reduced the number of days a nursing home type patient could stay in an acute bed.

Each change made Warley Hospital’s financial position more precarious. A local group collected 1000 signatures calling for the Commonwealth to fund public hospital beds in the hospital, but to no avail. In 1990 a report recommended that five public beds be made available to Warley. This was rejected by both federal and state governments, although some funds were allocated for outpatient services. Two reports recommended that Warley increase the number of aged care beds, as there was Commonwealth funding for these beds, but Warley did not have the funds to expand further.

“In hindsight," says Greg Dean, a Warley Hospital board member, "every effort should have been made to become part of Wonthaggi, but Warley was part of us and us being Phillip island – very insular and parochial.”

On February 1 2005 The Age reported that Warley aged care had not met 22 of the 44 aged care standards. This was remedied in the next few months but prompted a review again in February 2007 where all standards were met. However, an unannounced visit in September found 21 instances of non-compliance. These were mainly due to policy, procedures and processes with no sanctions made against the facility, and all were rectified as required. 

The end of Warley
Later that year, after two unsuccessful attempts to find a partnership for Warley’s aged care facility, the board arranged to relocate the residents to Grossard Court, along with any staff who wished to move.

On January 31, 2008, 85 years after it first opened, the acute hospital closed. At the hospital’s 85th annual general meeting on September 30 that year the president explained the series of events that had led the board to that decision.

With a debt of $1.9 million, the board had approximately $400,000 in staff entitlements to pay. The 13 bed licences were sold, and the bank sworn valuation of the existing properties was $3.3 million. “The board hopes to sell off some of the assets to service the debt, leaving some land and buildings with which to investigate the provision of health services to the community”

Warley was held in such high regard by the Phillip Island community that the loss is felt to this day. These are a few of the comments I heard from former patients and staff in researching this article:

• “It was incredibly sad, it was a facility we took for granted, and lovely to have a baby there, so convenient. Warley Avenue was such a vibrant street with a life of its own. When it closed it was like a ghost town.” Irene (patient)
• “It was a wonderful midwifery team. There was great respect between the doctors and the nurses.  
     “You never knew what might happen on night shift. One evening I had a baby on the breast, a man with chest pain on the monitor and the doorbell rang, and when I opened it there was a man with a spear gun in his guts.” Jill (nurse)
• “I worked at Warley for three months and used to think, when I was standing in the ward looking out at the wonderful view over the water, what a lovely place to be when you are unwell.” Marie (nurse)
• “The nursing staff were a lovely bunch of ladies who were very supportive, well trained, very competent, always gave good quality care.” Bruce (surgeon)
• “My dad had a heart attack and we took him to Warley. He saw Dr Wilson who wanted to send him to Melbourne. Dad said no, he wasn’t going. The doctor said ‘I’ve got a new drug but it might kill you’. ‘I’ll have that then,’ says Dad. It didn’t kill him.”  Howard
• “I remember having my tonsils out in the old hospital and Nell Forrest living there. My grandmother Evelyn Anne Janson was the oldest resident on the Island in 1962 and so had the honour of cutting the cake at the garden party opening of the new hospital. My friend Bill Mitchell was the last patient in Warley.” John Jansson
• “Great working there, the team work of the doctors and nurses made it really good.” Dr Ian Wilson
• “Disappointment - we couldn’t save the joint.”  Greg Dean, Warley Hospital Board member

Next issue: Part II: Life after Warley