NSW Health Minister Jillian Skinner has endorsed the closure of Bulli Hospital's emergency department.Describing the emergency department (ED) as dilapidated, Mrs Skinner told the Mercury she strongly supported plans to convert it into a clinic for common and minor illnesses.Her comments are likely to anger northern suburbs residents concerned about travelling to busy Wollongong Hospital for emergency treatment.

MERCURY SAYS: Bulli reflects a system in poor health

But the comments have been welcomed by the Illawarra Shoalhaven Local Health District, which recommended the urgent care centre and its positioning as an aged-care hub.Mrs Skinner said the hospital must evolve to meet the changing needs of the region."This is consistent with my observation of the hospital during visits as shadow health minister - wonderful staff mostly providing care for older patients, but in a dilapidated building, half of which was boarded up because it was in such bad repair," she said."Despite the emergency shingle hanging outside, the department [is] mostly used as a GP-type clinic, with complicated cases and ambulances diverted to Wollongong Hospital."Peter Garling, QC, recommended the closure of Bulli Hospital's ED during his 2008 inquiry into the public health system, declaring it unsafe.The ED is regularly closed, does not receive ambulances and lacks the equipment necessary to deal with complex emergencies.There are concerns its emergency signage deceives people into believing the hospital has an adequately staffed, fully equipped casualty unit.Illawarra Shoalhaven Local Health District board chairman Dr Denis King said the consolidation of Bulli Hospital would also boost the performance of Wollongong Hospital."Bulli will remain open and while its role will change, it will finally be clearly defined," he said."We have to show we can run services in the Illawarra and Shoalhaven effectively and show we're not wasting them. As soon as we do that, we have a very legitimate argument to get more resources."Consultation on the proposed changes will begin shortly, paving the way for the ED to be replaced by the urgent care centre next year.Bulli Hospital's ED treated 7865 people last financial year, the vast majority minor cases that could still be treated at the urgent care centre. Urgent care centres treat patients with minor and common illnesses like sprains, lacerations and chest infections.Australasian College for Emergency Medicine president Dr Sally McCarthy said the jury was still out on their effectiveness. But she said the closure of Bulli Hospital was a sensible move, provided more resources were diverted to Wollongong Hospital."There is a very good argument for reviewing the services provided at smaller hospitals because some would argue they are trying to be all things to all people," she said."While a community often says 'we don't want to lose our services', we know that providing medical care in acute hospitals is pretty expensive and complex these days and it's a better use of taxpayer dollars and resources to focus the high-end care at the bigger sites."