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Regional health workforce in the spotlight
for AMA(SA) president’s visit to Port Augusta, Port Pirie 

27 July 2018 | Media release 

AMA (South Australia) president Associate Professor William Tam and chief executive Joe Hooper have been hearing from local doctors on the issues close to their hearts in their visits to Port Augusta and Port Pirie on 26-27 July.

The AMA(SA) has undertaken the trip to visit local health services and speak with doctors about what they need to keep practicing in rural medicine, and provide high quality care, and how the AMA(SA) can best help rural doctors serve their communities. The trip has included Port Augusta Hospital, Pika Wiya Health Service, the University of Adelaide Rural Clinical School and Port Pirie Hospital.

“It has been fantastic to visit local services in Port Augusta and Port Pirie, and find out firsthand about some of the great work being done here, and also some of the challenges,” said AMA (SA) state president A/Prof William Tam. “It has been a most informative and enlightening trip. The dedication and commitment of the medical, nursing and allied health staff in the region is admirable.”

“We will be taking what we have heard on this trip with us, and it will inform our advocacy to both the state government, and nationally. Workforce has been a strong theme on the trip, and in ongoing AMA state and national advocacy. Another key theme has been supporting the role of women in rural health, and safe working hours – for everyone”.

A/Prof Tam has been told of the many challenges facing the health services, and whilst they are not new, the seriousness of the situation is becoming increasingly concerning, he says.

“One of the key topics has been the current workforce model recently introduced to keep the Port Augusta Emergency Department open. Many will know the service was being crippled due to the unsustainable reliance on a few hardworking GPs to provide the services. Two dedicated and hard- working doctors are working in the ED and serving the hospital over a 7-day roster, and without that support I fear the service would be in dire straits”.

“Port Augusta Hospital is like the canary in the coal mine for rural health services. It was in a critical situation due to the increasingly heavy demand and the lack of medical support staff. The rest of rural South Australia is no doubt watching what happened in Port Augusta and how the new investment and medical staffing model will help with providing a sustainable medical workforce in the future. Certainly the AMA(SA) is watching this service closely.”

“Another important area to be addressed is the GP shortage in the area. Having once had around 21 GPs to serve the community, Port Augusta has been reduced to effectively 11 full-time equivalent GPs, and yet it does not qualify as an area of medical workforce shortage. Somewhere in Canberra there is a flaw in the assessment. Port Augusta needs to be able to attract more GPs to provide relief to those working many hours a day to look after their patients in the community and those they admit to the hospital. This must include the ability to recruit from overseas, if necessary, and the current block from denying the area a workforce shortage classification is a significant barrier.”

“With our visit to the Rural Clinical School, we have spoken with a group of highly motivated medical students who provided us with great confidence that the future supply of doctors for the town is in safe hands, but this will take some years.””

“We have heard about the rural generalist pathway – which has merit in helping doctors have the necessary skills for the community – but we also need to make sure that the SA Government recognises that there is much more to do in rural health. The government needs to commit to increased funding to deliver expanded medical services in our major rural hospitals, and deliver care where the patients live. This has been ignored or addressed in an uncoordinated way, and it’s time the clinical services that should be delivered in the country are delivered there. We also want to see standardized equipment among hospitals offering comparable services.”

“There are also other infrastructure challenges, such as reduced flights to the region, which can have a significant impact on doctors travelling to the hospital to provide treatment. How can a doctor fly in and deliver four hours of care, then have to leave to catch the next flight because there is no flight the next day? These types of basic issues all impact on the ability to provide medical services to the region.”

“Mental health and Indigenous health remain extremely important areas. It has been great to visit Pika Wiya and see the terrific advances that have been made there to look after our Indigenous community. Whilst Indigenous people are around 17% of the broader community, around 30% of the people admitted to the local hospital are Indigenous, and any support that can be delivered in the primary and preventative care space can help reduce this need for in-hospital care.”

“It was also great to visit Port Pirie Hospital, a great hospital providing very good services and with good morale. Our visit there only served to reinforce the importance of a sustainable medical workforce model with doctors ‘on the ground’ in the hospital. The local GPs are providing a crucial service to the hospital, but it would be a significant improvement to support their work with an in-hospital doctor to assist with day-to-day medical tasks such as ordering medications. Another pressing need is for increased development of the chemotherapy area, which currently has five chairs, but would benefit from infrastructure investment in order to provide services to more patients.”

A special highlight of the trip has been the opportunity to congratulate longtime AMA(SA) State Council member Dr Nigel Stewart on his admission to the prestigious national AMA Roll of Fellows. Although now retired from the State Council, Dr Stewart has had a significant role in the AMA’s advocacy on rural and regional health. He has lived in Port Augusta for over 20 years and has worked as a regional paediatrician with the Port Augusta Hospital since 1993, and since 1995 as head of the Northern Regional Paediatric Unit. He is one of only five doctors nationally admitted to the Roll this year.

“Nigel has made a tremendous contribution not only locally but much more broadly through his advocacy, passion and great commitment,” said A/Prof Tam. “We are very glad to acknowledge his contributions and see this recognised with one of the AMA’s top honours.”

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