I am up in Adelaide this week, doing some anaesthetic upskilling, catching up with friends & family at WOMAdelaide, then jetting off to Sydney to present a short piece at #SMACC2013. Bit daunting being in the company of gurus like Mike Cadogan, Scott Weingart, Cliff Reid, Casey Parker and Minh le Cong etc.
Meanwhile the KI Docs dispute is spilling out into the media. Hopefully some common-sense will prevail and the current status quo will be allowed to continue. Sadly I am learning that common-sense is not that common. Rather than retain local doctors’ services in A&E for 21 out of 28 days and 24/7/365 cover for both obstetric and anaesthetic rosters, it seems that the faceless bureaucrats at CountryHealthSA would prefer to sack the lot of us, pay locums bucket loads (going rate is reputedly $1700-2500 per day) and collapse anaesthetic and obstetric services on Kangaroo Island
You can read more about the dispute here, here and here.
At the heart of the dispute is almost a philosophical question – whose responsibility is it to staff the roster for the State-owned public hospital? Whilst rural doctors have always fulfilled that role, the insistence that they are responsible for the entire roster even to the point of paying a locum to do the job does stick in the craw – on KI we have enough doctors to run our Clinic…but not enough to cover three rosters for each of A&E, Obs and Anaes…unless we work ourselves into the usual outcome of days gone past – early death, alcoholism, relationship breakdown, major depression and medical error.
So, here is a round up of media reports (to date) on the KI crisis – CLICK on the links to read associated news articles or media releases.
4 March 2013
Adelaide Now “Locum cut unhealthy for Kangaroo Island say GPs”
See also the comments section – mostly supportive, although one Islander did wonder why the six local doctors could not work as hard as the 3 doctors 20 years or so ago. Fair comment and I would encourage such questions. Suffice it to say that the three doctors are no longer working on KI – one has left rural medicine entirely. When we talk to them, they cite the unbearable workload and not one wishes he had worked as hard. New doctors want to spend time with family, to relax…they still work a 40 hour week in the Clinic plus are on-call another 30-90 hours per week depending on the roster.
The Islander – “GPs in new hospital row”
Leading with a photo from the dispute some years ago, The Islander will no doubt invite comments (both positive & negative) from readers. Regardless of what you think of the Doctors, it is important to realise that this is happening and will affect delivery of services. The docs simply cannot work more than they are currently.
ABC News “GPs upset as locum withdrawn”
Sadly no ‘comments’ section, but hopefully local ABC will continue to repo this both on line and on radio.
RADIO NEWS BROADCASTS
KI doctors say the State Govt wants them to work dangerously long hours
“Doctors on Kangaroo Island say that the State Government wants them to work dangerously long hours because it won’t cover the cost of a locum. The island’s six GPs work normal hours in a clinic and then provide around the clock services to the Emergency Department at the Kangaroo Island Hospital for 40 weeks a year. Country Health SA employs a locum to staff the Emergency Department for one week a month to provide respite for the doctors, but that will stop at the end of this month. Negotiations over a new arrangement for the island’s doctors have failed. The doctors are hoping the Government will reverse its decision.
Local Kangaroo Island GP Mark Raines says doctors could compromise their standards of care by picking up their workload:
(891ABC 7.45am & 639ABC 7.45am/8.30am) “It’s about keeping the job sustainable and a position where we can provide a good quality service where we’re not sleep deprived and over-stressed and burnt out.”
(891ABC 9am & 639ABC 9am) “If somebody has been up all night dealing with a problem and then they have to go to work the next day to work in their general practice, or they get called back and they’re sleep deprived, then yeah I think it’s been well and truly shown in clinical studies that sleep deprivation leads to mistakes.”
KI GPs say a new workplace agreement will see them working dangerously long hours
Country Health SA has disputed claims by GPs on Kangaroo Island that a new workplace agreement will result in them working dangerously long hours. From next month Country Health SA won’t be funding a part-time locum to staff the Emergency Department at Kangaroo Island’s hospital. It means that the island’s six GPs, who already provide on-call Emergency Services most of the year, will have to pick up the locum’s workload.
Country Health SA’s Peter Chapman argues that standards of care won’t be compromised:
(891ABC 11am & 639ABC 11am) “If they did have to work significantly overnight and therefore were feeling ‘how can I do my clinic in the morning’, they are able to cancel that clinic in the morning so they can get their sleep et cetera and we make a payment for that.”
(891ABC 12noon) “Obviously for us to pay for them to cancel their clinic and reinvest in the morning is a very major initiative of the GP agreement so yes, we do understand very much the requirements of general practitioners.”
6 March 2013
Local MP Michael Pengilly has been working in the corridors of Parliament to raise the issue and issued a media release and was interviewed on 5AA with Leon Byner, transcript below.
Michael Pengilly, Member for Finniss (5AA 12.12-12.15) Reduction of locum support for Kangaroo Island GPs
(Byner: … the Weatherill Government’s inability to negotiate a sensible deal with local General Practitioners on Kangaroo Island … has threatened future health services … this Member of Parliament … is demanding that the Government disclose what arrangements are being put in place to install an adequate team of doctors into the local hospital on KI from March 31. Michael … what’s your understanding of what’s happened here?) … it’s like a long playing record that’s run off the track … I’ve been on this before, I’ve been on it again recently. What’s happened is that Country Health are trying to bulldoze the doctors into signing an agreement they don’t really want to sign. The current situation is that one week a month the locum comes in and takes the pressure off the local doctors to do the on call at the hospital but what they’re not doing is saying what arrangements they’re going to put in place after March 31st … it’s creating some major headaches on the island, I spoke briefly to the Minister about the matter yesterday … (Byner: …what did he say?) He wasn’t in a position to make too much comment but I’m sure that he’ll pick up on it. I just want to get a sensible outcome. I’m comfortable with contracts across the state but they have to have flexibility to work in localised areas and places like the island is indeed a localised area. (Byner: …so what’s the problem?) Well the Government don’t want to pay … (Byner: …pay for what?) … pay for the locums and what they’re also saying is that they want the local doctors to do the four weeks all the time … a month at a time. The doctors are saying well if someone’s on and then on Monday morning when they come off call, they could’ve been up all night, they could’ve been treating patients, then they have patients in the clinic to deal with – they’re just saying that it’s beyond them to do all that, they could make mistakes potentially, so they are saying that why bust up a good system that works well now – the community’s very anxious about it over there, they don’t want to have – Leon Byner might have an appointment for 11 o’clock on Monday and get there or get rung up and be told no the appointment’s off because the doctor simply can’t work … it’s a common sense approach … my view is that the Weatherill Government’s got a self-inflicted budget crisis and that should not become the Kangaroo Island community’s emergency and it just needs fixing and fixing properly. (Byner: …alright …we’ll take some interest in this because … you’re not allowed to drive a truck past certain hours of service because it’s not deemed that you’re a safe driver, well doctors are still human and surely the same laws apply to them.)
That is all for now. More updates as and when they occur.