Chris Oldfield, Naracoorte Community News
The SA Government is using taxpayer funds to pay fly-in locum doctors up to $3000 per 12-hour shift at country hospitals.
And it is claimed it pays our local Naracoorte GPs as little as $285 per 24-hour shift to cover accident and emergency.
Seven SA country hospitals including Millicent and Mount Gambier are now reliant on taxpayer funded fly-in locums – when they are available.
This trend is growing due to an alleged failure by the government’s Country Health SA – re-badged Rural Support Services (RSS) – to attract, retain and engage local rural workforces through sustainable contracts.
Government contracts with rural doctors around the state expired a year ago, including Naracoorte, throwing rural health into turmoil and exacerbating rural GP shortages.
It is claimed that the Government will have no accident and emergency doctors at the Naracoorte hospital for five days during December, including Christmas Day, Boxing Day and the day after.
Last March rural doctors put forward a possible solution for the SA Health Minister Stephen Wade and his department to consider.
During a September visit to Naracoorte, which excluded local GPs, Mr Wade revealed he had not seen the proposal.
COVID pandemic issues are exacerbating the problems confronting the State’s rural doctor crisis, especially for border communities such as Naracoorte.
Kincraig Medical Clinic’s Brian Norcock is the regional representative for the Australian Medical Association (AMA) and SA Rural Doctors Association (RDASA).
He and other local doctors recently met in Mount Gambier with AMA President Dr Michelle Atkinson, Vice-President John Williams and AMA CEO Samantha Mead.
Dr Norcock said issues discussed included attracting and retaining rural generalist GPs as well as COVID-19 responses and the opening of borders.
As a guest of Member for MacKillop Nick McBride, Dr Norcock also attended Parliament House, Adelaide.
“I was fortunate enough to have 10 minutes one-to-one with the Minister for Health, Mr Stephen Wade, and discussed mutual goals, challenges and keenness for this to be resolved,” Dr Norcock said.
“Mediation commenced on Friday, October 7, between the AMA and the RDASA and RSS (formerly Country Health SA), with mutual goals of securing long-term sustainable contracts for rural GPs to provide accident and emergency services to rural hospitals – without the escalating costs of the service being provided by locums.”
As reported in Statewide media, SA Health has declined to release the cost to taxpayers of its expenditure on locums, at this stage.
Naracoorte’s diminishing number of full-time doctors have been struggling to fill accident and emergency rosters and cannot compete with locums at a cost of $2500 day per shift
“Kincraig Medical Centre recently employed three locums in the one week largely at its own expense, which was a hefty financial loss and unsustainable,” Dr Norcock said.
“Locums are not involved with training, nor do they invest or spend their time and money in local communities.
“Increasingly most doctors – including registrars and trainees – do not want to work in country areas.
“They return to the city with no on-call work, similar remuneration, less stress and less exposure to litigation, or join the inviting locum circuit, or retire prematurely.”
Dr Norcock said several times Kincraig Medical Centre had proposed cost-effective solutions to the Local Health Network (LHN).
“However, at the instruction of the RSS such solutions were not accepted or allowed to be trialled,” he said.
“That resulted in the hospital having no duty doctor for two to five days per month in the last 12 months due to critical workforce shortages and /or lack of availability of locums.
“Kincraig Medical Clinic looks forward to being able to work with the Local Health Network to achieve the best outcomes for our community and secure a sustainable cost-effective workforce going into the future,” Dr Norcock said.
Health Minister Stephen Wade said the current government was the only party committed to regional health.
“We have a $20 million commitment to develop SA’s rural health workforce and to ensure high quality health care is delivered in regional SA,” Mr Wade said.
“Whilst I am not involved in the rural doctors contract negotiations, I look forward to a positive resolution and a strengthening partnership with rural doctors.”
Shadow Health Minister Chris Picton visited Mount Gambier, Naracoorte and Bordertown last week.
“Communities like Naracoorte are left uncertain about the future of their health services, as remaining doctors do the best they possibly can with dwindling support and increasing workload pressures,” Mr Picton said.
“There have been shocking examples this year where this crisis has now left the Naracoorte Hospital with no medical coverage for the hospital.
“The AMA’s Dr Chris Moy …described the relationship between rural doctors and SA Health as ‘toxic’.
“Talks about country doctor funding agreements continue to stall, with Steven Marshall refusing to step up and take responsibility to fix it.”
Mr Picton said while in the South East “no-one I met was clear on what the COVID plan is when borders open or how services would cope with (the) struggling workforce.
“The impact of this extreme country doctor shortage will be further under stress on November 23, especially in the South East, when SA opens up to interstate travel.
“If Naracoorte is struggling to manage current demand, how is the community meant to manage if a positive COVID case enters a health service and forces doctors into quarantine?”
SA Health’s Rural Support Service (RSS) chief clinical advisor Hendrika Meyer said as part of negotiations with the AMA and RDASA, “we have made increases to the payments for GPs in our offer, with an overall increase of roughly 10 per cent across the whole agreement.”
“Our regional Local Health Networks work collaboratively with local GP practices and locum providers to ensure that healthcare services can be maintained while also responding to community needs for COVID-19 testing and vaccinations,” Ms Meyer said.
This article appeared in Naracoorte Community News, 10 November 2021.
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