Our hospital Doctors are going, going, gone
Mass exodus is feared over funds shortage
Unacceptably long surgical waiting lists and a lack of proper equipment in region's hospitals expected to spark revolt by doctors, nurses
By ZOE SATHERLEY
UP TO 50 specialists are threatening to walk out of the region's hospitals en masse.
The executive of the Lismore Base Hospital Medical Staff Council has confirmed the doctors have refused to sign new contracts because they are sick and tired of not being able to operate on their patients.
They say massive under-funding has left all hospitals in the Richmond Valley region in crisis, with unacceptably long surgical waiting lists and a lack of proper equipment.
If nothing is done to remedy the situation the executive fear a mass exodus of doctors will cause a snowball effect, with nursing and other specialist staff also deserting the region.
With no doctors to operate, patients will be referred elsewhere, leading to the downgrading of one of Australia's foremost regional hospitals, Lismore Base.
The chief executive of North Coast Area Health Service, Chris Crawford, said the doctors' concerns were being taken seriously and he will be meeting the LBH Medical Staff Council on Monday to further discuss the issues raised.
Strategies already in place include $1.5 million of extra capital funding for an additional 14 beds at LBH, which he agreed is a very busy hospital.
Mr Crawford did not expect a large number of doctors to leave the hospital and hoped the present negotiations would produce a mutually acceptable resolution to issues of concern.
But his views are at odds with more than a dozen specialists interviewed by The Northern Star who have said they were prepared to leave the public health system and possibly even the area, unless more effort was made to address the underlying causes of the crisis.
Some, like urologist Dr David Sillar, are getting their house ready to put on the market.
Vascular surgeon Dr Deepak Williams is considering three different interstate job offers.
If they go, so too will renal surgeon Dr Wil- liam James. The three disciplines are inter-
related and he can't adequately treat his patients without the other two.
Gastroenterologist Dr Howard Hope has left the public health system. Vascular surgeon John Graham is considering early retirement.
There are many more.
These doctors, as well as many of the region's obstetricians, paediatricians, general surgeons, ophthalmologists, physicians, orthopaedic surgeons and anaesthetists are in open revolt.
All of their contracts with NCAHS have come up for renewal at the same time and they are refusing to sign new three-year contracts until a long list of major problems are resolved. (See panel 'The Problems').
"I don't want any more money. I just want to be able to do my job and care for my patients," said Dr Deepak Williams, who encapsulates the problem facing doctors ? they claim they cannot operate and patients are suffering.
The doctors are united in their concerns and are prepared to resign en masse if that is what it takes to get the State Government to take notice.
Problems at LBH have intensified because at present there is a dispute between the North Coast Area Health Service and anaesthetists, 16 of whom have already walked off the job.
All but life-threatening surgery has been cancelled until further notice.
But this is just the tip of the iceberg. The underlying problems which have provoked this crisis are long-running and deep.
Central Health Department sources have shown the LBH Medical Staff Council documents which prove that under the State Government's funding formula, known as the Resource Distribution Formula (RDF), the NCAHS is missing out on at least $30 million a year. The region's major operating and teaching hospital, Lismore Base, is missing out on at least $5 million a year.
The budget allocation is not enough to pay for the amount of operating time, equipment and services required, say the Medical Staff Council executive.
They say that to keep the budget in check elective surgery is stopped for up to eight weeks a year, which is dangerous for patients and unfair to doctors.
Surgical waiting lists are often cancelled at short notice, and waiting lists continually blow out ? up to three years for hips and knees.
Vice-chairman of the Medical Staff Council, paediatrician Dr Chris Ingall, says Lismore Base is a hospital lurching from crisis to crisis. And while the under-funding is having a catastrophic impact on the lives of patients waiting for surgery, another insidious attack on the hospital is quietly happening without public scrutiny, he said.
Dr Ingall said it was now NCAHS practice to send most patients from Mullumbimby and Byron Bay to Tweed Hospital, and those from Maclean and Yamba to Coffs Harbour Hospital, even though their regular doctors work out of LBH which is geographically closer.
He sees this as a short-term cynical solution to bed shortages and an underhanded attack on the long-term future of Lismore Base.
If the pressure for beds is deflected from Lismore Base then the State Government is not likely to see any reason to move forward with its proposed $19m redevelopment of the hospital, he said.
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