Ellis releases plan for regional health

Member for Narungga Fraser Ellis has today released his Regional Health Plan, which outlines a number of solutions to South Australia’s regional health crisis.

“As I have publicly stated many times, regional health care is the biggest issue facing the Narungga electorate--and all country South Australians--and it was an issue long before the pandemic and will continue to be one long after it is finished,” Mr Ellis said.

“Over the last 3 ½ years I am proud to have played a part in securing local improvements such as the new surgical unit at Yorketown, afterhours x rays and a salaried doctors model for Wallaroo Hospital under a new Rural Health Workforce Plan,  and decentralising local health network boards. But problems still exist, and it is clear the status quo can’t remain.

“I welcome the Federal Government’s announcement last week of the incentive to pay HELP debts of graduating doctors and nurses who commit to working in regional areas, but I believe more still needs to be done.

“Today I present a plan for Regional Health Care.

“Over the past months I have consulted with rural health professionals from across the State, shared ideas with the Minister for Health and chatted to constituents about improvements they’d like to see in their local health services.

“The critical issue is the shortage of doctors themselves. There are a large number of carrots in place to encourage doctors to work in the country, but few are working. It is time to get a stick out.

“I believe as a priority we need the discerning allocation of Medicare Provider numbers by the Federal Government to ensure efficient distribution of GPs across the State, and for State Government to appoint an Assistant Minister for Regional Health.

“If I am re-elected as the Member for Narungga I give my word to the people of our electorate that regional health care will be my primary focus. We deserve access to basic services that people from the city take for granted and, just like I have delivered improvements over the course of this Parliament, I remain committed to ensuring that we have those services delivered.”

RURAL HEALTH WORKFORCE PLAN

By Fraser Ellis MP

Background

We are currently facing a critical shortage of regional doctors in South Australia. It is not a predicament that has developed overnight, but rather one that has come to be as a result of a lingering contentment with the status quo. It is clear now that something needs to drastically and urgently change to ensure that regional people have access to the basic health services that metropolitan patients take for granted. Without reliable and consistent health services, it is certain that our regions will wither away. The model of regional clinics attracting GPs who will then voluntarily subject themselves to an on-call roster at the town hospital is no longer working. We need a solution to ensure that the local GP clinic can continue to see patients who do not have critical needs and that there are adequate hospital services to ensure those with urgent needs can be seen.

Solution

Local Health Networks to Employ Accident & Emergency Doctors

One of our top priorities should be ensuring that those in need of emergency treatment have access to a doctor. Although it sounds straightforward, it is not currently a guarantee within the public health system, which largely relies on a relatively small pool of expensive locum doctors to staff a majority of the regional hospitals.

Instead, Local Health Networks (LHNs) should be tasked with providing A&E support across their entire district. The Yorke and Northern Local Health Network is currently leading the way by advertising for three FTE doctors to be employed at the Wallaroo Hospital. This should be expanded so that each Local Health Network can employ a sufficient number of doctors to create a roster for each hospital within their network. There needs to be an ability for those doctors to then be dispatched to any hospital in need within the LHN.

Limit Medicare provider numbers

Government needs to ensure that there is an efficient distribution of General Practice doctors across the State. It is undesirable to have some suburbs of Adelaide with an overabundance of doctors and parts of regional South Australia without any. We have tried providing doctors with incentives to work in the country. There is a litany of benefits on offer, but it is clear that they are not working.

In the current system, there is nothing preventing a doctor from using their Medicare provider number to set up a clinic wherever they like, including in the most overserviced areas of our state. Almost completely funded by the taxpayer, through the Medicare system, doctors should be required to go where a service is needed.  It is time to assign a particular quantity of Medicare provider numbers to different parts of our State and only allow GPs to work where there is a vacancy.

In the same way that teachers can only utilise their training at a school where there is a vacancy, doctors need to apply their skills where there is a genuine need.

I will advocate to the Federal Government to make this change.

Rural Training Places

An ongoing, reliable staffing solution is crucial. When it is determined that LHNs are staffed with sufficient doctors, they should then be supplemented with a number of trainee positions, offering under- or post-graduates professional development training. This will ensure that we have a continual flow of potential hospital doctors coming through the system.

Before this can occur, we must commit to funding regional LHNs as recognised training providers, as metropolitan LHNs are. It may also require an audit of regional South Australia’s training capacity, which would summarise all potential training positions that could be available in rural hospitals. Then, where needed, this would be expanded according to supervisory capacity, and medical students strongly encouraged to take up the opportunities.

There are currently various pathways which medical students can undertake to complete rural training, including hospital-based, primary care, rural generalist and more. These options should be consolidated, creating a single, straightforward pathway for students looking to complete rural training.

Redraw Local Health Network Boundaries

The six regional Local Health Networks have been a fantastic step in decentralising South Australia’s health system and putting some control back into the hands of country health services. However, when SA Health transitioned to the new LHN system, the traditional Country Health SA boundaries were retained, and these should be redrawn.  

The Yorke and Northern Local Health Network services over 75,000 people, and encompasses three case-mix funded hospitals and 13 grant-funded sites, while the Flinders and Upper North Local Health Network contains less than 44,000 people, two case-mix funded hospitals and three grant-funded sites. It might make sense to move some of the Yorke and Northern responsibilities into Flinders and Upper North to ensure more efficient, balanced administration. There are certainly additional examples around the state where the delivery of health services would benefit from these boundaries being revised.

Appoint an Assistant Minister for Regional Health

The Minister for Health faces a monumental task, with a portfolio which has always been large, and has only grown over the course of the pandemic. This could be made simpler through the appointment of an Assistant Minister for Regional Health.

Regional health has its own set of unique problems that require special advocacy to solve. Appointing an Assistant Minister to assist in that endeavour would ensure that those issues receive the best possible attention, so regional health professionals have a dedicated point of contact, advocate and an office to work alongside.

Commitment to Rural Medical Workforce Plan

The SA Rural Medical Workforce Plan 2019-2024 was developed by the government and leaders in our rural health sector. It contains a number of highly relevant and important recommendations which should be adopted without delay to ensure the future of our rural health services.