Story and Photo Luis Feliu
More than 250 people packed Mullumbimby’s Civic Centre last night to protest the controversial plan to replace the town hospital’s emergency overnight doctor with a nurse-operated video link to Tweed Hospital.
The public meeting, which included many lifelong locals as well as doctors, nurses and several councillors, was the second such protest forum in weeks and saw a doubling of the crowd that attended the initial one.
Northern NSW Local Health District’s plan to foist the cost-cutting measure on the hospital has met stiff resistance by the campaign to stop the ‘trial’ introduction of the telemedicine technology, which nurses and doctors say will lead to the eventual demise of the hospital.
Health authority chief Chris Crawford recently met with NSW Nurses Association delegates and announced a deferral of the planned start of the new rostering system from 12 July to the end of October.
But nurses still have concerns about operating the new system and the cutting of 24-hour emergency medical services as a result.
NSW Nurses Association organiser Nola Scilinato asked last night’s meeting if it was ‘optimal care to have a nurse-led emergency unit when you have so many doctors in the town’.
Ms Scilinato said nurses had asked Mr Crawford at their meeting for supporting data on any other NSW regional hospitals using the new tele-conferencing system and its reliability.
She said nurses also rejected the health authority’s figures of an average of around two patients a night in emergency used to justify the cost-cutting plan, as it was ‘more like five or six a night’.
The campaign’s steering committee chair Frank Lynch said the local hospital had been supported by the community over 100 years and any changes to health care and its impacts should be subject to community consultation.
Mr Lynch said the hospital, which serviced a population exceeding 16,000 at the last count in one of the fastest growing regions in the state, could expect further growth with Mullum hospital taking any overflow.
‘It’s not a good look for our shire if we can’t give adequate health care to our guests,’ he said, referring to increasing numbers of tourists visiting the area needing emergency care.
He urged people to write letters to MPs and newspapers to protest the plan.
‘We also have significantly more elderly folk than the state average and they too have a higher representation in hospitals, especially the emergency departments; also many young people under 15 years old with a high rate of infections and respiratory illnesses,’ Mr Lynch said.
‘Being a smaller hospital, Mullumbimby is able to provide quicker response times than the larger Lismore or Tweed hospitals. It’s for this reason it receives patients from other outlying areas, such as Rosebank, even though those patients are closer to other hospitals; in big hospitals they wait for long hours that is not so good for the very young and the young and elderly.
‘If it’s the case with this telemedicine system there’ll be more transfers to other hospitals, where is the benefit for us?’ he asked.
He added that under the telemedicine system the doctor does not see the patient, whose symptoms have to be relayed by a nurse.
‘If the doctor decides the patient needs a transfer, they then have to wait longer in a new queue, depending on the cases at Tweed Hospital.’
He said it was vital for cardiac-arrest patients to be treated within an hour so chances of survival improved, but with a forced transfer and waits for ambulances and travel time, treatment would be outside the ‘golden hour’.
He said it ‘would be a much better scenario for the person to be at Mullumbimby with a doctor and nurses onsite’.
Mr Lynch said young children needing treatment were also comforted by being close to their families and could be stabilised and discharged more quickly with local care.
‘Telemedicine reduces local human medical resources so health care is better decentralised.’
Mullumbimby Hospital Auxiliary stalwart Elaine Robinson gave the meeting a short history of the hospital and the long involvement and commitment of her volunteer group and the community in raising tens of thousands of dollars for the hospital over the years, ‘making it the best A and E unit in the region’.
Mrs Robinson said the community-owned land and buildings of the hospital were managed by a community trust till 2010 when the state government suddenly dismantled it and its role was taken over by the Land and Property Management Authority (LPMA).
‘There was no warning to the community; the funds were frozen and went to the LPMA. How it happened was a complete surprise.’
Mrs Robinson, a member of the auxiliary for more than 45 years, said she believed the land was gifted to the town for the hospital by the original landowner ‘in perpetuity’.
‘Our auxiliary over the years has raised much money for the hospital, but it couldn’t have happened without the community and it shows how important the hospital is being there, and for 24 hours a day,’ she said.
She said many elderly didn’t need the ‘fear of transfers’ and the town ‘needs a doctor on call all night every night’.
Longtime town doctor Liz Elliot said the new technology was welcomed if it was value adding, but nurses would be ‘frightened’ having to deal with certain emergency procedures without the backup and expertise of a doctor.
Dr Elliot said the new system would be inconvenient and inefficient and doctors were much more experienced and better placed to rapidly assess illnesses by taking a quick look at the patient’s skin colour, which a video could not do.
‘Doctors and nurses need each other, and local hospitals provide local care, easy access and familiarity, and we’re fast,’ she said, adding that they were ‘part of the rural fabric’.
‘We need staff support, kinder shifts and better remuneration for night work but basically a health department that cares about staff.’
Deputy mayor Basil Cameron said the community wanted ‘a quality health service’ and not the ‘technological bureaucratic model’ of service proposed.
Cr Cameron called for and received unanimous support from the meeting to request the government stop the plan.
A further public meeting is planned while negotiations between the health service and nurses continue.