Campaigners against the controversial plan to replace Mullumbimby Hospital’s overnight doctor with a video-link to Tweed Hospital remain sceptical about an upcoming trial for the new system, despite assurances by health authorities at a big public meeting last week.
Save Mullumimby Hospital group says it still has serious doubts about the trial for the new tele-medicine system and whether a supervising doctor will be used as a backup for nurses on the overnight shift.
Northern NSW Local Health District (NNSWLHD) chief executive Chris Crawford told last Thursday’s third public protest meeting at Mullumbimby High School that both a doctor and nurse would be on shift at night during the trial to familiarise themselves with the new system.
‘If patient safety concerns can’t be addressed, then the trial on a nurse-to-doctor basis won’t be undertaken’, Mr Crawford said.
But in a later statement, Mr Crawford said, ‘under the pilot, on the more difficult to fill overnight shift, the trained clinician who sees a patient would be a highly skilled nurse with the backup of a clinician at Tweed Hospital via telehealth if needed’.
Chair of the NNSWLHD board, Hazel Bridgett, was loudly applauded at the meeting after she said ‘we will never go ahead without the consent of nurses, which has always been the case’.
Both nurses and doctors do not support the removal of the overnight doctor because they fear patient care would suffer and safety be compromised.
Save Mullumbimby Hospital steering committee chairman Frank Lynch told Echonetdaily his group is not convinced that even the trial is a good thing.
Mr Lynch suspects the trial could ‘quietly’ be fully implemented as a permanent arrangement ‘without addressing community concerns properly’.
‘Since there is no truly independent process of review of any such trial the community is understandably sceptical,’ he said, adding that the trial should be consigned to the ‘rubbish bin’.
‘In my opinion, there remain major unanswered questions about such a trial and these are reasons for rejecting the actual conduct of the trial.
‘Firstly, any trial is not going to resolve the major problem of more transfers to Tweed in the absence of the night-shift doctor. This is simply not something a trial can resolve.
‘A retired surgeon and a local doctor both said at the meeting that the remotely located doctor in Tweed, if uncertain, would not rely on the telehealth vision and would require transfer at the rate of one extra transfer a night.
‘Mullumbimby ED (emergency department) would become something like a medical transit station. Though they had the opportunity to deny that there would be a significant increase in transfers, the health service representatives chose not to do so.
‘Secondly, residents’ experiences of the ambulance service were truly alarming: waiting four hours for transfer for an ambulance that didn’t arrive to take their son (acute appendicitis) to Tweed and then driving themselves to John Flynn Hospital and paying for surgery themselves; the ED doctor’s report of a recent wait of six hours for an ambulance; the elderly people’s concern that having moved into town, or staying in town, to be within minutes of quick attention at their local hospital, they would now have to make the long trip to Tweed for emergencies.
‘Thirdly, it is my view that resolving a remote doctor’s uncertainty is something that cannot be adequately addressed under a trial simply because a local doctor would be present in Mullumbimby ED during the trial.
‘The local doctor could answer questions to satisfy the remote doctor’s uncertainty whereas a nurse, without local doctor, could not. That effectively means the validity of a trial process is compromised.
‘The Health Department continues to state that it will run a trial during hospital “quiet-time” (11pm–7am). A trial at that time of night will not allow for adequate investigation of whether telehealth and nurse (without on-site doctor) will be able to handle multiple serious presentations during busy times.
’It thereby avoids the critical issue of dealing with concurrent serious cases which can only be adequately addressed by on-site doctor and nurse.’