The regional hospital system serving country New South Wales is reaching breaking point. In many instances that name " hospital " gives a false sense of security. There is the expectation that the arriving patient will get the service of a doctor, but in many cases there is no doctor present and diagnosis - and treatment - is via videolink with a medico located in a distant city.
A parliamentary enquiry is looking into dysfunction which has led to deaths and near misses in care and it is hearing of regional hospitals running out of basic supplies, including antibiotics and incontinence pads. In some cases, doctors treating these patients remotely from afar are reluctant to sign a death certificate for a patient they have never physically seen.
The enquiry is hearing horror stories from relatives of those treated at country regional hospitals. In emotional testimony one woman described how her mother died while being treated by videolink in the emergency department of Gulgong hospital, near Mudgee.
Even worse was the treatment afforded a patient who attended a hospital at Condobolin which lacked a doctor and was so short staffed that that the hospital cook was asked to look after the patient in the car park. That is absolutely third world medicine, and has no place in Australia.
This is not new. There is a serious lack of doctors in many country towns and often when a town has a general practitioner, he or she is expected to serve as the emergency doctor at the local hospital. This imposes an impossible workload and is the reason so many country doctors quit and leave to the city.
We are not short of doctors in Australia. The problem is that most of them are concentrated in the cities where they enjoy a relaxed lifestyle and a big income. There is little incentive to move to a country town with a bigger workload and few backup services.
Medicine and law are the most sought after university studies and the output of doctors and lawyers is governed by the intake permitted. The average doctor gains a position of prestige in the community and gains a better than average renumeration for his or her services.
As part of their training, they are required to work under supervision in a general hospital and perhaps the time has come to also require a stint at a country hospital to give them an even broader experience. It would not be unreasonable to extend the time serving in city hospitals by an extra year in a country hospital to extend their treatment experience.
As things stand, nurses serving in country hospitals are standing in for doctors and by necessity are giving treatment beyond their training regimen. Doctors jealously guard their privileged position in the world of medicine and a little country service would not be a big thing to ask as part of that training routine.
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