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Rural doctors given ultimatum to sign standard contract


Medical Clinic Millicent


by S Lowe 5THE FM newsonline wattlerangenow

Medical Clinic Millicent GP’s, are among many rural GP’s around SA forced to sign the Country Health SA (CHSA) standard contract to provide medical services in country hospitals, or face being locked out.
CHSA released a statement after the deadline last week saying that 97% of doctors had signed, guaranteeing continuation of service in rural hospitals. CHSA did not confirm how many doctors signed for the full three years when 5THEFM/wattlerangenow contacted them saying only that ‘the standard rural agreement extends to 30 November 2017.’
The deadline was recently extended to allow further negotiation between the Australian Medical Association (AMA) and Rural Doctors Association SA (RDASA) and CHSA.
Acting CHSA CEO Rebecca Graham said, “This is an excellent outcome for everyone and provides certainty for the GP’s and their communities for the next 3 years.”
“The Standard Rural GP agreement is key to ensuring high-quality health care in the 64 country hospitals located across our state,” Rebecca Graham said.
Dr Scott Lewis President of the Rural Doctors Association SA (RDASA) spoke with 5THE FM this morning on 107.7 and he said that while 97% was probably an accurate figure it in no way indicated it has been signed happily. Many doctors had advised him they had only signed for one year, not the full three years. Dr Lewis said this was one of the suggestions they made to doctors to keep CHSA bureaucracy accountable to deliver on promises made over the past 12 months. Dr Lewis said that on information fed back to them by doctors around the state, about 20 – 30 % of doctors had signed for 1 year only.
Dr Scott said that the contract negotiations with CHSA had been particularly difficult this time and much of the goodwill between CHSA and RDASA had been lost; requiring a lot of work to regain that relationship over the next 12 months. In February this year RDASA released a statement saying that rural hospitals were facing chaos due to changes imposed by CHSA and rural doctors concerns unable to be resolved. At that time 108 junior doctors were advised that they would not be able to work in rural hospitals if GP’s did not sign.
Vice President of RDASA said in February this year that a formal response from the Minister of Health Jack Snelling had been sought, saying that the RDASA was not able to endorse the proposed contract in its current form. Following this meeting CHSA CEO Maree Geraghty was instructed to take responsibility for the negotiations with RDASA so that the deadlock regarding key issues could be resolved. The loss of 108 junior doctors and many GP’s from hospitals would severely negatively impact patient care and this concern had been raised by over 20 rural locations including 10 maternity hospitals.
In answer to the question if our doctors were being bullied by CHSA, Dr Scott Lewis said today that doctors around the state are committed to providing quality care of their patients and this would be at the forefront of their minds when they signed the contract despite being unhappy with the conditions and certainly an ultimatum had been given by CHSA making it very very clear that if contracts were not signed by May 25th the doctors would not be allowed into hospitals.
Millicent GP’s have worked a 7 days on – 7 days off roster on the in-patient, accident and emergency roster at the Millicent Hospital since the last contact negotiations with the alternate weeks covered by Locums. CHSA have continually cited the lack of available Millicent doctors as the reason for the loss of services from the hospital. When the Millicent GP’s offered to increase their days on the hospital roster as part of the current contract negotiations, their offer was rejected by CHSA and the new contract will include the 7 days on and off as it did before. In a recent statement to 5THE FM/wattlerangenow, Millicent GP’s said they wanted to extend their hospital roster to every week day, with locums used only on weekends and public holidays.
“Originally the CHSA contracts were structured to allow scope to introduce site specific factors for sites that had specific needs and the best way of providing these needs; but despite numerous requests RDASA have had no information back from CHSA about this or what sites need this,” Dr Scott said today. He also said that this particular condition will be part of their discussion with CHSA over the next 12 months.
Medical Clinic Millicent partner Dr Stephan Van Eeden spoke to 5THE FM/wattlerangenow saying, “Doctors are fearful to speak to the media for fear that they will not get a contract at all; and they may face the same outcome as GP’s at the Victor Harbour Hospital, which is now staffed by locums entirely.”
“If we don’t get a contract at all we lose contact with our patients in the hospital and we don’t want that to happen,” he said.
“Another of our concerns is that we want our Anaethetist to be included on the Millicent Hospital theatre lists,” Dr Van Eeden said. Anaethetist, Dr Caitlin Kerrigan joined the Millicent Clinic in January this year, but has not been included on the theatre lists to date.
Another of the Millicent GP’s concerns is their Registrars contracts are usually for a 6 – 12 month period which makes workforce numbers hard to guarantee over the three year period of the contract. With an expected change to legislation later this year there may be changes to the training providers Sturt Fleurieu and Southern GP Training. The Providers are not contracted so they are not forced to provide Registrars.
“We have no guarantee of staffing levels and yet we are expected to sign a 3 year contract,” Dr VanEeden said.
Dr Van Eeden said the Clinic is committed to providing the best possible care for the community and with that at the forefront of their minds will be in the same position as many others around the state who have signed to provide continuity of care for their patients.
Millicent GP’s must also have a current contract for their 5 Registrars to continue hospital work.
Ms Graham said , “The agreement will ensure doctors are adequately remunerated for patients not covered under Medicare by implementing fee collection methods for non-Medicare eligible overseas and motor vehicle accident patients.”
She said, “The community can be assured all public hospital services across country South Australia will operate as normal and anyone who requires emergency or inpatient care can continue to attend their local hospital.
Dr Lewis said the Millicent GP’s were welcome to discuss their particular concerns with them and the RDASA would certainly support the local GP’s.
“Doctors around the state are relatively unhappy, it is a statewide issue.” he said.



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