Public fears hospital demise

Luis Feliu

A public protest meeting last night attended by more than 100 people, including doctors, nurses and residents, has called for a halt to a planned downgrade of emergency services at Mullumbimby Hospital and any loss of staff.

The meeting at the town’s services club, organised by the local branch of the nurses union, condemned the health authority’s recently announced trial of replacing the hospital’s emergency department overnight doctor with a nurse-operated teleconferencing system connected to doctors at Tweed Hospital.

Nurses and doctors say the new system, to be put in place from 1 July, would not be cost efficient as claimed because the cost of transfers of patients to other hospitals would negate any expected savings from the budget measure.

‘We’re now looking at the downgrade of services; if we do lose the night doctor it’s highly unlikely we’ll get it back, we’ll be unable to maintain 24-hour services,’ Dr Michael Pelmore told the meeting, which included many elderly locals and a church group.

‘There’ll be no guiding force from the hospital to work with the nurses, and if we settle for second best and lose emergency-medicine care from the night shift, I feel the future is a slippery slope for our hospital, leading to its demise.’

Dr Pelmore, who has worked in the community and the hospital for 36 years in various roles including obstetrics and emergency, said he had ‘sadly’ seen the gradual loss of services there over the years, including removal of paediatrics and surgery facilities.

‘Once that was all done, things declined and we were unable to reclaim them,’ he said.

‘It’s important to hold onto these service we’ve got and don’t relinquish any further.’

Dr Pelmore said doctors had to support nursing staff with the existing collaborative model of care, otherwise the hospital would eventually close.

Thousands object

The meeting was told a petition with more than 2,500 signatures, calling on health minister Jillian Skinner to urgently intervene to ensure medical services are provided on site at the hospital 24 hours a day, had been collected in just 14 days since the announcement last month by the local health authority.

They meeting urged locals to take part in a combined protest march and rally planned against regional hospital closures and cutbacks at Bonalbo and Coraki as well as the latest at Mullumbimby. It will be held this Saturday 2 June at 9.45am, starting from the Baptist Church above Lismore Base Hospital; local MPs and mayors are expected to attend.

Mullumbimby Hospital’s NSW Nurses Association branch delegate Shauna Boyle said emergency medicine was a collaborative model of care in which both doctors and nurses had their role to play to ensure patient safety, the ‘paramount concern’ of nurses.

‘The proposed new model leaves nurses working by themselves with only a video link, which is tenuous at the best of times,’ Ms Boyle said.

She said emergency-care cases at the hospital last year were 7,700, yet this year alone there had already been 7,000.

She said that large nearby musical festivals such as Bluesfest would impact on hospital services with overflows and any serious injuries.

Ms Boyle said nurses would welcome the new tele-medicine camera technology ‘tomorrow’ as an adjunct to existing services, but collaborative care with both a doctor and nurse working together was the ‘safest emergency care you can have’ and ‘to introduce a new model of care is ridiculous’.

‘We’re not a supermarket and not supposed to be making money; it’s a service, that’s why it’s called a health service. I don’t see why our medical services should be decreasing; this is a flawed plan.’

One member of the audience told the meeting that if an elderly person suffered a stroke during a holiday period, ‘they wouldn’t make it to Tweed Hospital, it’s too far and too congested’.

Cost of locums

Dr Peter Bowles, a duty doctor at the hospital, explained how on-call local doctors were paid just $11.60 per hour to attend night on-call emergency cases and yet half the caseload was done by locums, which increased costs.

The meeting was told many local doctors were not part of the on-call roster and Dr Bowles urged people to ask them why not.

He said local doctors believed the savings from not employing the higher-paid locums at night were being ‘chewed up by any patient transfers involved in not having an overnight doctor at the hospital’.

Mullumbimby National Party branch chairman Alan Hunter sparked an audience outburst when he said local government minister and Ballina MP Don Page had told him that losing the hospital service was ‘not an option’ but his government’s ‘problem was in trying to maintain a service within a tight budget’.

Mr Hunter, who failed in his bid to become Richmond MP at the last federal election, said ‘no-one likes trial but they have to try something’, to which local documentary filmmaker David Bradbury responded that ‘health care is a basic human right’.

Mr Hunter continued that if it was the case services were affected ‘they’ll soon put it back’.

‘There’s no question we must maintain our services, but we can’t keep borrowing money, that’s why these other nations are in trouble,’ he said in the face of several objections.

Dr Liz Elliott said she’d seen children from the hills around Mullumbimby bitten by snakes who ‘wouldn’t have made it to Tweed Hospital’.

Dr Elliott said one of the problems with emergency services was that limited number of local doctors were paid a ‘pittance’ for being on call at night while their counterparts from the city were paid ‘a lot of money’, up to $3,000 a night.

One local asked why on-call doctors were paid only $11 per hour on-call rate when tradesmen like plumbers and mechanics were paid $60–$70 an hour.

But nurses told the meeting that was an issue between the doctors and health authorities.

Responsibility

Ms Boyle agreed with an audience member there was ‘lots of pressure and stress’ in taking the responsibility of diagnosing a patient without the backup of a medical doctor; ‘it’s extremely stressful’.

There was also concern about nurses misdiagnosing and their legal responsibility.

She said nurses had ‘already saved the hospital hundreds of thousands of dollars with our caseload midwifery model (where a doctor is not involved, so costs are saved) and now we’re being asked to do more’.

‘We actually won midwife of the year award at Mullum Hospital so we’re proud of that.

Ambulance officer in charge of the Mullumbimby station, Inspector Greg Powell, said ambulance services would remain the same but any further load on the hospital could potentially affect local ambulance services.

Two Sydney-based officials from the powerful NSW Nurses Association attended the meeting, vowing their union’s support for the nurses ‘to the hilt’ in their quest to prevent service cuts.

Local nurses and union officials will next meet with chief executive of the Northern NSW Local Health District, Chris Crawford, on 7 June.

Deputy mayor Basil Cameron told the meeting that Mr Crawford, who was invited but couldn’t attend owing to a prior arrangement, should ‘present himself to the public to explain’.

Last night’s meeting resolved to form a steering committee to plan further meetings and actions and urged members to sign petitions and write letters to their MPs and newspapers.