Four weeks ago, I received a call from my friend and colleague Steph Cooke who was attending the Emergency Department (ED) in Moree. She is the Cootamundra MP and as Shadow Water Minister, was visiting for work. She had been taken to the ED in an ambulance and was waiting to be assessed by the doctor.
I called in and discovered no doctor was rostered on. In fact, there hadn't been a doctor physically present in the Moree ED for several days. I immediately made enquiries with the Minister's office and the Hunter New England Local Health District (HNEHD) only to be told the ED had "full access to a doctor". The doctor they were talking about was a laptop on a trolley, a so-called "virtual doctor."
A laptop on a trolley is not good enough in a busy emergency department. It is absolutely and utterly hopeless and a huge failure of policy.
I understand we have a significant shortage of doctors in the bush however we cannot accept the future of our health care, especially emergency health care, is a laptop on a trolley.
Both state and federal government need to admit health care in regional NSW is at breaking point, and we need urgent action.
I believe the best way to get change is to offer solutions as opposed to sledging from the sidelines so if the Government is against splitting up HNEH then here are some other ideas to address the regional healthcare crisis.
1. Pressure the Federal Government to train more doctors.
2. Pressure the Federal Government to completely wipe student debt for bush service. Let's be honest, money talks. We need real HECS forgiveness - not token bonuses - for doctors, RNs and allied health professionals who commit to five or more years in rural or remote Australia. Other countries do this with enormous success and so should Australia.
3. Call on the Federal Government to fix Medicare's deep-rooted bias against the bush. A GP in Coogee gets the same rebate as a GP in Glen Innes, even though running a rural clinic is tougher, more expensive, and often 24/7. Rebates for rural GPs need to be lifted otherwise, there is no real incentive to practice in the bush.
4. Start fixing the system locally.
5. Recognise proper overseas training such as South Africa.
6. And finally - bring back proper Government investment into Regional NSW.
Australia doesn't have a shortage of people who want to study medicine. We have a shortage of doctors where they're needed most – in the bush. The Commonwealth Government funds thousands of medical school and specialist training spots in the cities. Training places should be drastically increased to regional campuses such as UNE (for the full duration of the course) and the Federal Government should guarantee rural internships and specialist posts. If we train doctors in the bush, they're more likely to stay.
Doctors are wary of the bush because of the workload, the lack of support and the fact they can make more money for less work in Sydney. A young doctor does not want to be the only GP in town, working 24/7 with no backup. The NSW Government needs to urgently train and fund more nurse practitioners, more allied health workers, and fund rural specific locum pools to share the load. We also need professionally trained full-time security guards at our hospitals to look after the staff we have.
Overseas-trained doctors already prop up much of our regional workforce, yet doctors from countries like South Africa are forced through a maze of bureaucracy to have their qualifications recognised. The State and Federal Governments should fast track the accreditation process and visas and give these doctors the support they need to settle in rural communities.
Like all of us, doctors, RNs, and allied health professionals want good schools, safe communities, good housing, and a community where their partners can work. Investing in rural infrastructure such as housing, roads, transport, childcare, and education is central to attracting health professionals to regional NSW.
Health Care professionals are intelligent, they will not sign up for burnout, less pay, impossible rosters, and broken promises. They will go where they are supported, well remunerated, properly respected, and able to build a life for their families.
If the NSW Government is genuine about addressing regional health care, then it's time to stop treating doctors, RNs and allied health professionals like charity cases and start treating them like the important professionals they are by training them locally, paying them properly, supporting them with strong teams, and giving their families reasons to stay.
Anything less, and a doctor on a laptop in the ED will become the norm.
For those of us in regional NSW, we should not have to accept that.
