When Joey Gulliford was born he was almost dead.
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He was pulled into the world - blue, unconscious and with his little heart not beating - by a doctor who had to dislodge his tiny shoulder to free him.
He is now a happy and healthy almost one-year-old, but he spent his first five minutes fighting for his life on a resuscitation table at Tumut Hospital before he was taken to Canberra by a specialist retrieval team.
His mum Kim Dent thought she was going to lose him. She said throughout the terrifying ordeal it felt like the hospital was not well-equipped to handle an emergency.
"I looked at my partner ... and I just kept saying to him, 'I'm sorry that I couldn't get him out'. All I kept thinking in my head was: 'He's not going to make it'," she said.
"But he was big and strong and fighting back. As soon as his heart was beating and he started breathing he was just perfect. It was incredible."
Tumut is home to one GP obstetrician, but it has no surgeons, no anaesthetists and no full-time doctor at its hospital. Without an anaesthetist, only women with the lowest risk pregnancies can give birth there.
But Ms Dent, who had had three natural, problem-free births at the same hospital before Joey, now worries that things can go wrong in an instant.
Picturesque Tumut is nestled in the foothills of the Snowy Mountains, an hour-and-a-half from Wagga and two hours and 20 minutes from Canberra, which means a long way to go for the town's only ambulance.
Up to 10 general practitioners who work in private practice also staff the hospital on a roster as visiting medical officers, in line with the model used in other small towns in the Riverina.
However, many community members are desperately calling on local health officials to employ an anaesthetist and an emergency medicine physician to work full-time at the hospital, because they say it does not have reliable access to doctors in emergencies.
A petition has been circulating since 2019 calling on the Murrumbidgee Local Health District to permanently employ the two doctors on-site at Tumut Hospital. It has now amassed almost 9000 of the 10,000 signatures it needs to be debated in NSW Parliament.
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Tania Wallace moved with her young family to the town two years ago and recalls people telling her to be prepared to drive to Wagga Base Hospital in an emergency.
"They said, 'Never go to bed unless your petrol tank is full. So if you ever need to get to the hospital, you can drive and get to Wagga'," she said. "That's how much faith the general population has in Tumut Hospital."
Ms Wallace chose to have her last baby in Wagga in December, because she was worried about the potential risks of giving birth in Tumut.
"Basically, [the MLHD] gave this response saying how wonderful it is, everyone's fine to birth here and that we've got this Special Response Unit that can come if there's an emergency," she said.
"That's really not fine. It doesn't matter if you can ring them. They're not there when your baby is not breathing. We need adequate medical staff on the ground in Tumut."
She was "shocked" by Wagga Base Hospital's hurry to send her back to Tumut after she gave birth and is concerned that the larger hospital is under pressure.
"I was still in the delivery suite and they were trying to send me back. It wasn't a really good experience," she said.
Ms Dent is pregnant with her fifth baby and says she has been losing sleep feeling like she "has no options".
She says she can't book in to have a caesarean section in Wagga for another five weeks, but there is no possibility of the procedure being done in an emergency in Tumut.
"If I go into labour spontaneously, I will have to have the baby here. If you turn up here in labour, you just have to hope for the best. So I'm sitting here now, 34 weeks pregnant and extremely high risk," she said.
"I have 100 per cent faith in Osman and in the midwives. But in an emergency situation when you don't have emergency facilities, it is a real worry."
Osman Darwiche, the sole GP in Tumut with obstetrics training, used to deliver up to 125 babies a year. These days the hospital is "lucky" to see half that, after the town's only GP anaesthetist left in 2017.
Dr Darwiche believes the MLHD urgently needs to secure an anaesthetist and, ideally, another GP obstetrician for Tumut.
"It's a painful subject for me, for everyone in town. We really desperately need an anaesthetic service in town. The town deserves anaesthetists, at every level," he said.
He is devoted to his community and rarely takes a holiday, in part because he says the MLHD won't secure a locum obstetrician to cover him if he goes.
But the town's doctor shortage is made even more complicated by disagreement on the best way to staff country hospitals: using contracted GPs or employing permanent doctors.
"It's a really hard question to say which model is better. I've got a bias here because I am a GP myself and I cover the roster as well," Dr Darwiche said.
"But I'm not sure how we can be able to get the money to employ a certain number of extra doctors just for the roster at the hospital. I can't see it working."
MLHD executive medical services director Len Bruce said the health district was working to attract medical officers to work at Tumut Hospital.
He said this included employing doctors to work in the emergency department and engaging GP VMOs to care for admitted patients in the hospital.
"Attracting medical professionals to work in rural and regional areas continues to be a challenge nationwide, and some hospitals in the MLHD do have difficulties filling their on-call rosters," he said.
Former surgeon and Snowy Valleys councillor Geoff Pritchard says the town critically needs an anaesthetist, though he doubts whether the hospital could employ one full-time.
"But that's not to say you don't need two anaesthetists in the area. You need GPs with anaesthetic skills," he said.
Construction on the NSW government's $50 million redevelopment of Tumut Hospital is scheduled to finish in 2022.
Dr Pritchard fears it will be difficult to attract an anaesthetist to the town.
"It's saying we're not going to have a proper health service in Tumut," he said.
"It's their policy of winding down these small country hospitals. I'm not suggesting we should be a heart transplant facility. But we're a major industrial area."
Local paramedic and Snowy Valleys Council deputy mayor John Larter says the town can be left without ambulance coverage because paramedics regularly have to take non-urgent cases to Wagga.
He claims nothing has been done to improve rostering at the hospital.
"They've thrown us a bone with a couple of scraps. It's just terrible," he said.
He said he'd support any model of getting more doctors, including a resident surgeon.
"Why do people have to go to Wagga Base and wait 15 months to have an operation? You can't do the higher end stuff here but you could be operating the theatre seven days a week," he said.
"It's a bit like selling cars without a car salesman. It's complete madness. You can't rely on GPs working in their practices from 8am to 6pm and expect them to head up to the hospital during their shift."
Wagga-based Nationals MLC Wes Fang has disputed claims of community distress about a lack of doctors, saying that the current system - including the use of telehealth doctors in some emergencies - was "meeting the needs" of residents.
The Daily Advertiser has asked the MLHD how much it spent in the 2019-2020 financial year paying VMOs to cover Tumut Hospital, and what the estimated annual cost would be of employing a permanent doctor there.
The MLHD didn't respond to these questions.
The NSW upper house rural health inquiry will visit Tumut on October 5.
Editor's note: This article originally referred to "significant delays" in the redevelopment of Tumut Hospital, as well as stating the hospital was advertised as "having a day surgery only". The Daily Advertiser acknowledges these statements are incorrect and accepts Murrumbidgee Local Health District advice that the redevelopment is on schedule and will contain an operating theatre. The Daily Advertiser apologises for these errors.