Obstetrics cut from Millicent Hospital
by S Lowe for 5THE FM’s newsonline WattleRangeNow
CHSA announced late yesterday that all obstetrics will cease in Millicent. This comes hard on the heels of Jayne Downs, Health Services Director, statement to Wattle Range Council on June 11th that –
‘no services will be watered down at Millicent and there are no plans to let services diminish in the future.’
Local GP Dr Stephan VanEeden, from the Millicent Medical Clinic addressed the Wattle Range Council meeting, July 9th and began with this quote by Jayne Downs, saying he found it hard to believe, especially in light of the following services that have been lost to Millicent.
- Dialysis has been closed some time ago
- Chemo services stopped and doctors not allowed to administer chemo, moved to Mt Gambier
- After hour’s theatre closed and this is a particular problem with obstetrics
- Mid Wives reduced – some days there are no mid wives on duty at all
- Nurses hours at the hospital have been cut
- Mental Health funding has been cut – Community Health
- Gastroenterology closed –Dr Peter Wilson stopped coming and not been replaced
- Physio funding has been stopped
- Obstetrics are half closed and soon to be closed. ( press release late yesterday stated that it has been closed)
Dr VanEeden said it is hard to believe that statement (by Jayne Downs) when all this has happened.
Negotiations between the Millicent Medical Clinic GPs and Country Health SA have been long and drawn out, with CHSA demanding the local GP’s cover more days on the accident and emergency roster at the Millicent Hospital, than they believe they can do safely. To do this they risk their own health and it would result in longer appointment waiting times at the Clinic. If they don’t sign, they are threatened with not being allowed to give secondary care to their patients in hospital and they don’t want to do this. They shared their concerns that they feel powerless to stop the removal of these services and still maintain a first class health care to their patients.
Ms Downs also said at the June meeting, ‘ that CHSA was trying to set up a safe and sustainable hospital with solutions that work in the long run.’
“How can that be,”said Dr Van Eeden, ‘”when they lock junior doctors out of the hospital, how does that fit in the long term plan. They remove the 2nd on call doctor from the roster and this doctor could help in an emergency. They do this and then use the situation to bargain with us to sign their contract. How does removing a 2nd on call doctor provide a safe and sustainable health care system? “ he said.
“CHSA are only going to provide only the very basic of health care in Millicent,” he said.
He explained to the meeting that there is a shortage of doctors across the state and Millicent is no different. He also said that it is difficult to encourage local youth to consider going into medicine in the current situation. Local people who do go into medicine are more likely to return where family and friends are - to stay. This helps grow a medical service.
A place like Millicent has a great deal of professional satisfaction for a doctor because they can give primary care at the clinic and then follow through with secondary care at the hospital, but under the present circumstances, this advantage in recruiting and retaining has turned into a disadvantage, because of the way that the hospital operates, he told the council.
The GP’s are required (by CHSA) to make the hospital work dominate their time, resulting in longer delays for appointments at the clinic and very unhappy patients, and ” rightly so,” he said. If the doctors don’t agree they risk being thrown out of the hospital, pay cuts and the clinic’s young doctors being refused hospital experience.
Another downside to hospital work is the risk. Since funding has been cut for a 2nd on call doctor, the one doctor on call must deal with all emergencies.
He said that all the doctors can hope for is that their health holds up and their family’s don’t become too resentful for their continued absence from home.
There are up to 4 doctors to address an emergency in Mt Gambier but in Millicent one doctor is expected to do it alone.
Dr Bushell said it means that if he is delivering a baby and an emergency arises, he cannot call another doctor to assist and he can’t do both. If there are multiple emergencies how can the one doctor be expected to do it all?
He explained that in the past, there has been 2 doctors on call. They may have been on call for different reasons, not necessarily accident and emergency but, they at least were available should the need arise. This worked in the past while there was no contract with CHSA but now that they are demanding a formal contract, the on-call funding has been cut.
Dr VanEeden proposed the establishment of a Health Care Action Committee to support first class health care in the region. He asked Council to assist this group which he feels will be able to stand alone in the long term. He suggested that it be an independent committee with no connection to the clinic or hospital, except as a patient, no one connected to the Health department and no one who can be gagged because of their involvement in any organisation or department.
A number of people from the community interested in supporting such a committee, attended the meeting and will meet next week to formalize it.
Dr Wachtel said that even though the doctors have been under great pressure, they have not reduced any services, but she feels that CHSA would have the community believe that they ( the doctors) had.
Dr Bushel told the meeting that a former clinic doctor, Dr Jun Koh, is training in anesthetics in Mt Gambier, and she is the planning to return to Millicent and join the practice here. This will provide on-call anesthetics, however in the current situation, if she were to be called in an emergency, she would not be paid because that funding has been cut.
He also said that the clinic has doctors coming and they will then be able to cover more days on the hospital accident and emergency roster, but they need time to put that in place . CHSA will not allow that flexibility. He said he is concerned that once services are lost, they will not be returned.
WattleRangeNow recently reported that a new clinic doctor was refused hospital entry to work on her rostered shift, until the clinic sign a contract. Dr Wilson, a qualified GP was refused entry to work in the hospital. In a press release to WattleRangeNow, CHSA said that they will process her application to work in the hospital once the GP’s sign their contract.
Dr VanEeden said that the Clinic is committed to the region’s health care, they have made the commitment and stand ready to support any group or individual who will take a stand, ‘what we need is manpower,’ he said. “We need to stop kidding ourselves that CHSA will provide a first class health care.”
“This group needs to be prepared to ask the hard questions and stand up to anyone who endangers the health of this community.”
Mayor Peter Gandolfi told 5 THE FM today that he would attend the first meeting of the new committee, but he sees it as an independent committee and is happy for it to go ahead and meet next week. The Mayor said he will contact all levels of State Government today, Wednesday, to ensure that the community’s health services will be retained.
In a recent interview Hon Mitch Williams MP, told WattleRangeNow that the worst thing to happened was , we, as a community, lost control of our hospital. “Even I do not know what is going on in the hospitals in my electorate,” he said. This was the sentiment of the meeting last night too. Mr Williams addressed Parliament today about the loss of obstetrics from the Millicent hospital.
After the delegation from the Clinic and members of the public left the meeting, there was discussion in council about press releases that had been circulated during dinner. One from the AMA saying that the GP’s will sign the CHSA contract before the end of the week and another from CHSA saying they expected that the contract would be signed this week. CHSA also advised the media that obstetrics would close in Millicent and be transferred to Mt Gambier. The decision to stop obstetrics in Millicent was made as early as May this year. At the same time CHSA were saying publicly that they would not reduce services. (Sources confirmed)
Last nights meeting was hopeful that there would be a better outcome today, regarding obstetrics, but it has been widely reported that it will definitely close.
Council showed great concern about the loss of services, particularly the most recent in obstetrics. This means that there is no obstetrics in place between Murray Bridge and Mt Gambier. When CHSA say that moving services to Mt Gambier is just 30 minutes down the road from Millicent, this is not so for a woman in labour at Kingston or anywhere along the 331K road between those two services. This point was discussed by councilors at some length and serious concern was expressed by many of the councilors.
The meeting also discussed the health care of the whole Wattle Range Region, including the difficulties facing Penola.
Shadow Minister Rob Lucas office told 5 THE FM/ Wattle Range Now today that -
“The Liberal Party is deeply concerned by the slashing of health services in our regions.”
The loss of medical services in Millicent was discussed at length in Parliament today.
5 THE FM/WattleRangeNow can advise that the Millicent GP’s have not signed the CHSA contract at this time.