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A Medical Centre on the Moon: the story of the first ten years of the Ochre Health Group

17 Dec 2013

By Graeme Brosnan
AKA Publishing, RRP $24.95, ISBN 9780987203991, pp362
Review by Dr Peter Thomas

People and terrain, the eternal Australian duet, inextricably linked and given voice by two of this country’s finest poets.

Banjo Paterson wrote of the blinding glare of the sun, of the saltbush plains that are burnt and bare, by Walgett out on the Barwon side. In his poem “Bourke”, Henry Lawson praised great hearts that broke and healed again, the hottest drought that ever blazed could never parch the souls of men.

Looking for a better life, people followed the rivers and the tracks of the early explorers. Most prevailed, some prospered, but it was never easy.

Some settled in central and north-west New South Wales and adjacent parts of Queensland, where towns with mythic resonance grew; Bourke, Brewarrina (simply called Bre by the locals), Walgett (“the gate” to the region), Lightning Ridge (where people worked and often lived underground), Cunnamulla and many more.
The land, nourished by artesian water, reluctantly gave up wealth in pastoralism, in opals and other resources.

Historian Geoffrey Blainey captured the moment, the tyranny of distance he called it, and how distance could lead to a feeling of abandonment.
On the coast, of course, it was much easier.

Equity of access is a tenet of Australian health delivery, universal and free. Fine in principle, but hard to implement when people choose to live remotely.
And it became even harder with the advent of “big medicine” in the 1990s, driven by diagnostic machines, high-tech clinical units and new and powerful drugs unimaginable thirty years before. Professional indemnity crises didn’t help either, with the attendant deskilling that followed. The impact on rural and remote towns, medically self-reliant until then, was profound. It became the norm to transport the patient from their home to centres on the coast for even simple treatment, to use aircraft and road vehicles as therapeutic “tools”.

This was a reversal of the existing natural order.

Medical relief generally came as short-term locums, or reluctant juniors from city hospitals on a rural rotation or, suspiciously, international graduates.
Into this environment, in the late 1990s, came two young doctors, one from Tasmania, the other a Kiwi. Until then, they were strangers to each other, and arrived in Bourke as locums. Their necessary skills were limited, and they sought further training in anaesthetics and obstetrics.

The totality of the rural experience soon proved seductive to them and they stayed on.

The state Department of Health was slow and proscriptive in meeting their requests for relief, and they felt they could do a better job themselves in organising these and other matters.

Bureaucratic absurdities and the dead hand of managerialism forced them to find a way through.

They were supported by at least one iconoclastic local administrator, probably at the risk of his career.

This highly readable book, whose title evokes the scenery around Lightning Ridge, is the loose chronicle of the formation of the Ochre Health Group, the successful company they established to provide health services to Bourke and, later, the larger environment. Eventual expansion into medical education and training, provision of allied health services, and the establishment of Super Clinics, followed.

It is a jolly read, full of fun, fishing and photos, that doesn’t try to hide the determination of the two principals to improve the medical lot of the great hearts of Lawson’s poem who live on Banjo’s burnt saltbush plains.

More strength to them.

Published: 17 Dec 2013