Probably the most challenging situation I have been involved in since being elected to Council is the continuing issue of maintaining the medical system that we have become accustomed to. Anyone that has lived in Walcha for a long time will have observed the loss of medical facilities and clinical services that once existed. The birthing unit, operating theatre and blood bank have been the casualty of rationalism and fiscal policy. While we have lost services, other services aimed at preventative health have been gained. The doctor model that Walcha has relied on, probably since settlement, is becoming a thing of the past.
The model of a family doctor working out of a surgery and at a hospital is slowly being replaced as young doctors enter the workforce. We are lucky to have a brilliant MPS through the hard work of many, and this has been ably supported over the years by the Hospital Auxiliary and other community groups.
As with many Government departments health suffers from a lack of financial resources. This causes services to be run by fiscal policy rather than being aimed at health and disease prevention. Remote services such as telehealth, hub and spoke systems, visiting services and telemedicine all rely on adequate funding and medical professionals to provide these.
Where are we?
Rural and remote areas in Australia traditionally have higher health needs and poorer access. This naturally leads to a lower life expectancy and is exacerbated by the ageing of both population and medical staff.
It is well recognised that many doctors opt for the lifestyle and ease of the city over the perceived "deficit" view of rural areas. This perception is often perpetuated by media. The 'bush' or 'outback' does not entice people to make the move. We need to build on the strengths of rural life, not the challenges.
Many doctors, like other professions, opt for the support of larger practices as this gives them much better flexibility in their work and social life. Along with this the wish to work for a salary instead of owning the practice has lead to a rise in corporate models. These are very evident in big cities.
At this stage, the advertisement for a replacement VMO is being run on three websites, and being increased by another three this week. These targeting employment of medical staff in rural areas, and as yet there has not been one enquiry. This problem is duplicated across many other towns in Australia.
There are other options that HNEH have at their disposal to fill the role of VMO at Walcha. There are companies that will contract doctors to practice in towns and has some examples of this in place now. The advantage to the doctor is that they do not have to run a practice, the disadvantage for us is that it is near impossible to step back from. There are models where HNEH can put a registrar or locum into the hospital. Overseas trained doctors are heavily screened and often do not reach Australian medical standards. In a meeting with a Recruitment Doctor from HNEH, he intimated that he could probably place ten doctors in situations like ours in his area.
Successive Federal and State Governments have put in place strategies to try and alleviate this situation. There is a long turn around time, and no great results are evident at this stage. An increase in student doctor numbers takes a long time to flow through, and when it does there needs to be incentives to bring them to rural practices.
There are Rural Clinical Schools, University Departments of Health and RAMUS (Rural Australian Medical Undergraduate Scholarships) offered to bolster trainee doctors interaction with rural practices.
A strong NBN presence will certainly assist Doctors with having access to help and support when required, but what seems to really be needed is a bipartisan and long-term approach by the two tiers of Government. Presently Health Boards are the end of the line in the recruitment process. They have many positions to fill of which ours is just one. To us, it is the most important one, and the best assurance I can give is that Council is trying as hard as we can to assist in recruiting a VMO.
Dr Adrian Allen has given plenty of notice of his intention to resign the VMO position. He has given untiring support to this role and has even extended his VMO retirement to allow us more time. After his retirement as VMO, his practice will continue to operate under its current structure. There is no magic panacea to this problem. There could be an excellent applicant this week, or it may take a while. We can and will keep on trying.
In a talk with Emer O'Callaghan Senior Manager of Recruitment and Retention for NSW Rural Doctors Network (where the ad appears), she spoke of how this situation is evident in many towns. It appears that personally spreading the word to as many people in the medical field is seen as an option that sometimes has good results.
Kris Smith, Manager of the Walcha MPS, is adamant that the MPS will continue to operate as it has done. All facilities and services will remain. This is a situation we would prefer not to be in, but we continue to move towards a resolution and Council will keep everyone informed of the progress.