Doctors say they have been blocked from attending public patients at Naracoorte Hospital in South Australia’s south-east following an ongoing contract dispute with the State Government.
Three doctors who would normally be on call from an adjacent private practice, the Kincraig Medical Clinic (KMC), said they had their “privileges” to work at the hospital withdrawn and had instead been replaced with a single locum, who was on call for “72 hours” at a time.
The doctors said that instead of three doctors being collectively paid $545 a day to be on call for hospital emergencies, the Government was advertising for locum positions and offering them $3,600 each a day.
Country Health SA acting chief executive officer Rebecca Graham said the cost of the employed locum averaged $1,600 a day.
She said doctors from KMC could continue to access the hospital to treat “private patients”.
But Doctor Jeff Taylor from KMC said the locum had replaced a doctor, an obstetrics doctor and an anaesthetic doctor on call from his clinic.
“So if you come in after having a major crash, or a heart attack, you’re not going to get any anaesthetic support at Naracoorte Hospital, which is terrible,” he said.
He said the sub-regional hospital was the “busiest in the state”, with 180 births a year and four surgical procedures being undertaken each week.
“At the moment we’ve got five women that are due to deliver in Naracoorte this week, some of whom actually come from Bordertown,” Dr Taylor said.
“The arrangements that are being put in place by Country Health SA mean they’ll now have a 400-kilometre round trip in order to receive obstetric care.”
Many sub-regional hospitals rely on doctors at private clinics to be on call for emergency situations and are paid by SA Health.
The new contract says you have to have certain criteria met [to establish an emergency], so you have to be having a heart attack or a major abdominal bleed. I have to then call the director of nursing, get permission to be paid at an emergency rate, then go and assess the patient.
Doctor Jeff Taylor, Kincraig Medical Clinic
The Australian Medial Association earlier this year struck a three-year Standard Rural GP agreement with Country Health SA (SA Health’s regional division) after a protracted dispute.
It included up to eight extra rural GP training positions, a new minimum payment for GPs left out of pocket for attending to road accident patients, and a 3 per cent increase when doctors provided certain emergency and other after-hours services.
At the time, however, the Rural Doctors Association of South Australia said doctors felt “blackmailed” into accepting the agreement and were given an “ultimatum” to accept it or stop working in the hospitals.
Dr Taylor said many doctors in country SA signed the agreement because they were from overseas.
“If they don’t sign the contract, they get kicked out of the country,” he said.
Country Health SA ‘disappointed’ with Naracoorte doctors
Country Health SA said it was disappointed the Naracoorte doctors continued to reject the standard contract it said nearly 100 per cent of rural doctors across the state had committed to.
“Kincraig Medical Clinic is asking for over $500,000 more to provide hospital services, including premium payments for anaesthetic and obstetric services, which other GPs do not receive for similar volumes of work,” Ms Graham said.
“We have consistently indicated for the past four years that the Kincraig Medical Clinic would be required to move to the standard GP agreement once their unique contract expired.”
KMC has 12 doctors at its clinic and usually has three on call for emergencies, 24 hours a day.
Dr Taylor said it was inappropriate for a blanket contract to be rolled out to every hospital, particularly those with “unique” circumstances like Naracoorte.
We will continue to work with KMC to reach an agreement or introduce a new medical model to ensure those services remain.
SA Health spokesperson
“We wanted a fourth doctor on call, which is a rule mandated by SA Health,” he said.
“They rejected that. We said we wanted the definition of an emergency to be made realistic.
“Rather than a nurse calling us, the new contract says you have to have certain criteria met [to establish an emergency], so you have to be having a heart attack or a major abdominal bleed. I have to then call the director of nursing, get permission to be paid at an emergency rate, then go and assess the patient.
“We’re not milking this. If you call us, we’re going.”
KMC said it recruited the services of a lobbyist to approach SA Health Minister Jack Snelling but those efforts were unsuccessful.
Ms Graham said Country Health SA was “committed to providing inpatient, emergency, obstetrics and surgical services at Naracoorte”.
“We will continue to work with KMC to reach an agreement or introduce a new medical model to ensure those services remain,” she said.