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GP lock-out suspends obstetric services at Naracoorte Hospital

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Kincraig Medical Clinic Doctors Front: Dr Michaela Malek (registrar) Dr Jeff Taylor (practice partner) Back: Dr Tony Cohen (practice partner) Dr Nicholas Lye (registrar) Dr Ron Wallingford      (registrar) Dr Pulak Sarker (practice partner)

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Medical Services at Naracoorte Hospital will be provided by locum doctors at the cost of approximately $4000-00 per day, following the break down of contract negotiations with Country Health SA and Kincraig Medical Clinic.  GP’s from the Clinic said  CHSA has enforced a lock-out at the Naracoorte Hospital which prohibits them from working at the hospital.  The GP’s said they were and are still willing to continue to work under the former contract until new contract conditions can be agreed upon, but as it stands now, with out a contract they can no longer work at the hospital in obstetric, anaesthetic and emergency services.

Both parties provided us with statements yesterday and we take a look at these as well as comments from the Member of McKillop Mitch Williams.

A statement from the Kincraig Medical Clinic said – “Country Health SA has enforced a lock-out at the Naracoorte Hospital which is prohibiting local GPs from working at the hospital.  A long-standing contract with doctors from the Kincraig Medical Clinic (KMC) to provide essential medical services at the Naracoorte Hospital has not been renewed by Country Health SA, meaning clinical privileges have been withdrawn and GPs have been forced out the door.  There has been no meaningful attempt to negotiate for over 14 months by Country Health SA, bringing about the shut-out which came into effect on Monday afternoon and puts the wellbeing of residents in the South East at unacceptably heightened risk. ”

“We are taking a stand on behalf of our community and in the interests of retaining health services for the residents of Naracoorte and the surrounding rural population,” the KMC GPs said. “Country Health SA has a scandalous track-record of eroding the skills and services available to regional communities through its forceful mishandling of contract negotiations. This has typically increased costs for all parties, threatened to destroy country towns and, far too often, had tragic results for country families.”

The GPs cited the loss of services at regional hospitals at Keith, Bordertown, Penola, Mount Gambier, Millicent and Victor Harbor as examples of the damage done on Country Health SA’s watch.

Obstetric Service disrupted :- ‘The stand-off is also seriously disrupting the normal provision of Naracoorte’s busy obstetric services, being the only facility between Mount Gambier and Murray Bridge which offers a high level of obstetric care and women’s health services.’
“This means unfortunately there are uncertain times ahead for our obstetric patients. We currently have five patients due to have their babies in Naracoorte, but given the current situation we expect they will now have to travel to Mount Gambier to give birth,” the GPs said.

It is a distance of 364k between the two remaining obstetric services available to regional south east South Australia.

Huge Cost of the Deadlock – ‘The contractual deadlock in Naracoorte is not only seriously jeopardising local health services, but comes at a huge cost to Country Health SA and the South Australian Government, which is now footing a $4000 daily bill for a solitary stand-in locum to be on-call at the Naracoorte Hospital. The on-call service provided by KMC with three or four GPs available providing a 24-hour, seven days-a-week obstetric, anaesthetic and emergency services is currently $540 a day in total, which is less than 15 per cent of the cost being incurred for the current drive-in, drive-out locum service, which is only covering inpatients and emergency outpatients. There has been no provision for obstetric and anaesthetic emergency services.’

Locum shift 72 hours – The current stand-in locum at the Naracoorte Hospital is expected to work a 72 hour shift, which will very likely create further risks for the provision of health services at the hospital.

The clinic would usually have three GP’s on call 365 days of the year at the Naracoorte Hospital.

“Our long-standing contract with Country Health SA has helped us attract and retain skilled rural procedural doctors, to enable them to use and develop their skills for the benefit of patients from Naracoorte and across much of the South East,” the GPs said. “Attracting and retaining doctors in rural areas is a huge challenge. KMC is proud to be a teaching practice and we have used our hospital access to develop our trainees’ procedural interests, which is a “win-win” for all concerned, including the Naracoorte Health Service, our practice, the trainees and our local community.”

KMC GPs, led by Dr Brian Norcock who was recently awarded the Order of Australia Medal in recognition of championing the region’s health services, have worked tirelessly to ensure Naracoorte continues to provide a high level of obstetric, anaesthetic and emergency services to a wide rural area. The doctors’ efforts have also been instrumental in attracting more than 20 specialists to work regularly in Naracoorte and in the development of close working relationships to tertiary hospitals in Adelaide.
The partners of KMC has invested into the community with a new purpose-built medical clinic immediately adjacent to the Naracoorte Hospital, believing it had the security of a long-term contract to provide medical services to the community at the hospital.

15 year history of workable contracts with CHSA
The current contract was negotiated in 1999 and has, with minor modifications, been rolled-over four times since then. Last year KMC partners accepted, in good faith, a reduction of 10 per cent in income from NHS to ensure contractual arrangements continued and services at the hospital would not be compromised.
“Country Health SA representatives have previously spoken to us of their commitment to maintain existing services at Naracoorte, but their actions tell the real story,” the GPs said.
“We call on Health Minister Jack Snelling to bring the agency back to the table to negotiate a fair and reasonable outcome for Naracoorte.”

In response to Country Health SA’s statement of 1/09/2015:

‘Rather than discuss this matter with the Kincraig Medical Clinic, Country Health SA has chosen to release a media statement this afternoon, which contained misleading and inflammatory statement which do not reflect the true manner in which KMC has sought to negotiate with Country Health SA over the past 14 months.’
“KMC remains prepared to execute the generic form of contract with site-specific variations which are most relevant, unique and appropriate with this region, particularly in view of the area serviced by the Naracoorte Hospital,” the GPs said.
“Country Health SA has not negotiated, simply demanded that we sign a generic contract without regard to issues relevant to the region.”

Country Health SA  said yesterday afternoon:-

Medical services at Naracoorte Hospital will continue to be provided by locum doctors following a decision by Kincraig Medical Clinic to reject a new service contract with Country Health SA.  Chief Medical Advisor Dr Peter Chapman said Country Health SA had put forward a fair and reasonable offer to Kincraig Medical Clinic.
“We are disappointed that Kincraig Medical Clinic has decided not to accept a new standard GP contract, with almost 100 per cent of rural doctors across the state having committed to this approach,” Dr Chapman said.
“Kincraig Medical Clinic has made a number of unique demands regarding payment for hospital services, which we do not find acceptable.
“This includes a request for additional premium payments, which means the clinic would receive over half a million dollars per year more than other rural GP clinics who provide a similar service and volume of hospital work.
“We believe agreeing to this would be unfair to other GP practices and to the public who must be confident that health funding is spent appropriately.”
The decision by Kincraig Medical Clinic to reject the standard agreement will not impact regular GP services provided by the clinic and Kincraig doctors will also continue to treat private patients at Naracoorte Hospital as normal.
However, public inpatient and emergency services at Naracoorte Hospital will now be provided by locum doctors until an agreement can be reached or a new service arrangement put in place.
Dr Chapman said obstetric services will be transferred to Mount Gambier Hospital in the short-term due to a lack of necessary on call anaesthetic and obstetrics cover while these temporary measures are in place.
“Antenatal and post natal care will continue as normal and we will work closely with all women impacted to ensure they are supported throughout their pregnancy and can return to Naracoorte as soon as possible,” he said.
“We are also doing everything we can to ensure elective surgery continues as normal at Naracoorte Hospital, however there is a possibility that some non-urgent surgeries may be postponed.
“Country Health SA has negotiated in good faith with Kincraig Medical Clinic up to the contract deadline of 31 August and will continue to do so in an effort to reach a mutually acceptable agreement.
“We will be communicating regularly with patients, staff and residents about how we continue to provide all current Naracoorte Hospital services into the future and address any concerns they may have.”

Member for MacKillop Mitch Williams told the ABC this morning, he doubted CHSA motives in this situation; he said he believes  the workable contract that was in place could have been rolled over until an agreement was reached but similarly in the case of his home town Millicent, obstetric services were removed 2 years ago with CHSA saying  Millicent did not have the required obstetric and anaesthetic doctors to continue the service but currently there is an anaethetist, recruited by the Medical Clinic Millicent, who CHSA will not allow to practice at the Millicent hospital.







One thought on “GP lock-out suspends obstetric services at Naracoorte Hospital

  1. CHSA have plans to close the hospitals in Millicent, Narrcourt, Penola, Kingston and Meningie within the next few years. It’s time these hospitals were removed from the clutches of CHSA and placed back in the hands of local community boards who care about the communities.
    I for one am disgusted with the outcomes provided by CHSA. No one elected for this beauracracy to slash and burn our services. CHSA have fostered a culture of deceit amongst key staff in efforts to manipulate admittance statistics at the outlying hospitals in order to provide statistical justification for closing them down on various levels. It’s way beyond the joke and everybody knows it but for some reason nothing is being done to counter the blatant manipulation occurring. The health workers are to afraid of loosing their jobs. It’s blackmail, corrupt and should not be condoned.
    Where is the opposition Minister for healths stance on all this?