THE Snowy Valleys community has ramped up its campaign to establish full-time doctors at Tumut Hospital following claims that the lack of dedicated doctors is putting lives at risk.
A Tumut Community Association statement last week claims that the hospital's lack of on-call doctors with anaesthetic and emergency qualifications has been an "ongoing saga" and that it is also adding pressure on Wagga Base Hospital.
"During these periods, paramedics ferry patients to Wagga Wagga Referral Hospital, a three-hour round trip leaving Tumut without any emergency services for hours," the statement reads.
"On many days, they do several transfers increasing the risk for poor outcomes for patients due to a delay in receiving treatment and fatigued paramedics."
Currently, the Murrumbidgee Local Health District works with private GP practices to provide visiting medical officers to support hospitals.
The association's statement requests two full-time doctors employed by the hospital to provide 24-7 coverage.
The campaign comes as the government in June confirmed its $50 million commitment to rebuilding Tumut Hospital, which will begin by the end of 2019, subject to approval.
As part of the campaign, the association has created a petition, which is aiming to get 10,000 signatures, set for tabling in state parliament.
'Irrational' to rely on only one
Snowy Valleys councillor and former surgeon Geoff Pritchard said the expanding populations in smaller pockets of the Riverina meant that "putting all your eggs in one hospital is really irrational".
"If anything happens to Wagga Base Hospital, you got to have competent surgical services in other areas," he said.
Cr Pritchard said some of the surgeons and anaesthetists at the hospital travel from Wagga and that the practice is "a complete waste of their travel".
"They're better employed at Wagga hospital," he said.
"If we get dedicated doctors in Tumut, they wouldn't be only waiting for emergency surgeries to come in, they'd also be doing elective surgeries."
The latest Bureau of Health Information data shows that emergency department presentations across the Murrumbidgee increased by 2143 cases, or 7 per cent, between January to March this year and the same quarter last year.
Drilling down further, there were increases across all five triage categories, with emergency (triage two) recording the highest at 17.9 per cent.
"More people attended NSW emergency departments during January to March 2019 than in any previous quarter on record," the BHI said in a statement.
Cr Pritchard said there are wider implications on Snowy Valleys' economy as the Tumut Hospital area of emergency responsibility is more than 15,000 square kilometres.
"It's becoming the norm and I'm worried that it being the case, we won't able to attract procedural doctors to the town," he said.
'Pretty painful': man recalls experience
One Tumut man who had to wait for surgery is 51-year-old Mick Hannah.
Mr Hannah sustained a broken ankle in March when he went up an embankment while doing maintenance work and fell over.
"I went in on a Saturday afternoon and there was no one to conduct an x-ray, so they put a cast on it and sent me home," he said.
"They told me to get an x-ray on Monday. No crutches, so I hobbled my way back to my car.
"The following week, I had to ring them every day to chase it up - I called my doctor and said I hadn't gone in.
"So he rang the hospital and got me in to do the x-ray before taking me to Wagga."
Read more: Tumut is to get new $50 million hospital
Mr Hannah said he finally received treatment one week later - his ankle was set with a plate and eight screws.
"Waiting was pretty painful," he said.
"It was like living in a third world country."
While he was recovering, his wife was transferred to Wagga after becoming ill and experiencing liver complications.
Mr Hannah said the travel compounded both of their situations.
"There's a lot more stories out there in the community to be told," he said.
"It's amazing what people tell you."
The national fleet manager said it did not make sense to build a new $50 million Tumut Hospital without the medical professionals needed.
"The industries around us need doctors - from Visy [paper mill] to Snowy Hydro," Mr Hannah said.
"The demand is only going to grow.
"How do you say to people in Sydney: 'Move to Tumut but you won't get the appropriate medical services'?"
Ambulance services impacted
The Tumut Community Association's statement last week also mentions the flow-on effects onto the town's ambulance services in which their resources are directed to transferring patients to Wagga instead of servicing emergencies in the town.
Bureau of Health Information data shows that Tumut's ambulance response times across all three categories of cases - emergency, life threatening and urgent - in January to March this year dropped compared with the same quarter last year.
Paramedic and Tumut Station Officer John Larter said that an appropriate triage system with dedicated doctors is needed.
"Any patient who goes up there [Tumut Hospital's emergency department] would be transferred to Wagga," he said.
"It could be anything, including a head cold.
"Nobody's saying certain cases aren't urgent. Some of them do need to go to Wagga, but demand is better determined with an appropriate triage system."
Mr Larter said the ambulance could also employ specialist doctors at control centres to then provide assessments via telehealth to smaller regional hospitals.
"The ambulance has been doing this for years with regard to helicopters," he said.
While there is a helicopter for transfers to Wagga and telehealth is available, the association said that appropriately trained doctors are still needed.
"The current model of care is not working. GPs can't be on-call 24 hours per day and continue to provide safe and quality care to meet all their patients' needs during the day," the statement reads
"We are losing GPs and it is obvious a different model of care is required. Some small hospitals already employ doctors."
Health district finding solutions
In response, a Murrumbidgee Local Health District spokesperson said that since Wagga Base Hospital is the region's largest referral hospital facilitating almost all sub-specialties, it is "clinically appropriate that any patient assessed at Tumut Hospital as requiring specialist care should be transferred to Wagga".
However, MLHD aims to provide 24-7 medical cover via visiting medical officers using an on-call roster.
"There are a number of GPs working in Tumut, and four of these doctors make themselves available to work at the hospital," the spokesperson said.
"Attracting medical staff to rural and regional areas and providing them with the volume of procedures needed to maintain their clinical skill set is a challenge Australia-wide and not one isolated to our region.
"Despite the range of financial and training incentives offered by both Commonwealth and state governments, attracting and recruiting specialists to regional facilities in general is challenging."
The spokesperson said MLHD is exploring different models for doctors to support smaller rural hospitals, including developing a rural generalist GP training pathway to grow more locally trained doctors with the required skills to work in rural hospitals.
MP labels doctor shortage 'deeply concerning'
Wagga MP Joe McGirr said that anecdotally, there is an increased workload for Wagga Base Hospital because doctors are not available at outlying hospitals.
"There is no Band-Aid fix, but I am hopeful infrastructure builds like Snowy 2.0 and the hospital rebuild will attract additional medical professionals to the area," Dr McGirr said.
"While it is a few years before we will see its benefits, the expansion of the UNSW Rural Medical School is also set to inject a number of medical graduates directly into the area and I am in the process of pushing for an alternative rural generalist training program to add specialist skills to general practitioner graduates.
"I understand MLHD is ready to commence training, we just need the Commonwealth to fix the problem of trainees accessing Medicare."
Dr McGirr said the doctor shortage is a "deeply concerning" problem across the nation.
While he applauds the petition, he also acknowledged the difficulty in hiring full-time, on-call physicians in rural and remote locations.
"We also need to address any reasons behind a reluctance to apply for the roles and/or relocate to district hospitals like Tumut," he said.
In Wagga, the final stage of the hospital's health service redevelopment is expected to be finished by next year.
This evening, a health summit will be held at Snowy Valleys Council's Tumut chambers with key stakeholders, including Tumut Community Association's president Colin Locke and secretary Christine Webb.