'Going to get harder and harder': Health chief talks nurse recruitment

Murrumbidgee Local Health District chief executive Jill Ludford spent more than two hours giving evidence to the Special Commission of Inquiry into Healthcare Funding during a hearing in Wagga on Friday, March 22.

Her testimony covered hospital staffing, interaction with GPs, cross border concerns and liaison with the Albury Wodonga Health chief executive.

Ms Ludford reflected on the "fragility" of hospitals serving lower population areas and the struggle to service them with doctors and nurses.

"My thinking is that it is going to get harder and harder for us to attract nurses, who want to work in a smaller rural hospital because having the skills to work in an emergency department ... is very challenging," Ms Ludford said.

"If we're not training nurses to be those generalists then we've got a fragile system on both sides."

Ms Ludford said across her district, which includes all Riverina hospitals outside Albury, there had been an 18 per cent rise in the two highest level of triage patients in the past two years.

She said 90-plus nurses had been recruited from Britain and Ireland and recruiting now involved managers in each community working alongside health district staff after a blowout in hiring times.

Ms Ludford said recruitment timeframes had been cut from 45 to 31 days and that also meant jobseekers who finished runner-up for one role could have found a place elsewhere.

Nevertheless, she said "it was still very, very challenging" before noting how a virtual assist program had been adopted to allow less senior nurses to work at multipurpose services which operate in towns such as Berrigan, Culcairn, Henty, Tocumwal and Urana.

"Previously to work in an MPS you needed at least five years' experience and you needed to have experience working in an emergency department, so it was quite a change in the model to be able to allocate new graduate nurses to those facilities," Ms Ludford said.

"The message that we give people now is that you're never the only nurse because there is always someone that is there that can guide you through a process.

"It's like having a nurse in the other ward, except they're virtual."

Ms Ludford said she worked collaboratively with the Murrumbidgee Primary Health Network and relations had improved in the 10 years of her being chief executive.

She said there were many challenges with cross border matters along the Murray River, but stated that retrieval and ambulance services worked "absolutely beautiful".

"But there are complexities around accessing different community services when people are discharged, access around information flow and handover sometimes can be clunky," Ms Ludford said.

She said she spoke regularly to Albury Wodonga Health chief executive Bill Appleby.

"I talk to the CEO of Albury base hospital every fortnight, early in the morning we have a formal catch-up and we talk about issues and try and sort them out from an operational perspective, because Albury base hospital is operated through Victorian Department of Health," Ms Ludford said.

"We have joint executive meetings as well because some of those operational flows and some of those nuances around the services can be worked out more effectively at a local level than going back through our various departments."

Asked if anything could be done at an administrative level to solve those differences, Ms Ludford replied she could not answer that question.

"I don't have enough visibility about what our various departments ... interaction might look like," she said.

Ms Ludford was the last of several witnesses who appeared before the inquiry as it sat in Wagga.

It will resume taking evidence in Sydney on April 15.