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Interview with Jaynie Seal from Sky News Regional on 27 October 2021 on regional hospitals in crisis

Read the transcript of Minister Gillespie's interview with Jaynie Seal from Sky News Regional on 27 October 2021 on regional hospitals in crisis.

The Hon Dr David Gillespie MP
Former Minister for Regional Health

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Regional hospitals are in crisis. Numerous hospitals don't have adequate staff and don't have the right equipment for a safe hand over dealing with COVID patients. Joining me live is the Hon Dr David Gillespie, Minister for Regional Health. Thank you so much for joining us this morning, Minister.


My pleasure, Jaynie.


You worked, Minister, in the regions as a doctor for 30 years, so you know firsthand the barriers and what needs to be done. Just how bad is it?


Well, in some of the smaller hospitals, there is a shortage of doctors and other professionals broadly across regional Australia, you know, physios, pharmacists, allied health as well. But the most acute, obviously, when you have acute emergencies and you go to a hospital and there's no actual doctor there, it's very disconcerting for people. It's part of a broader problem that has developed over the last 20 years.

A lot of the multi-skilled general practitioner that did anaesthetics, as well set a fracture in emergency, or looked after a heart attack and then admitted you to hospital unless you needed super specialist care. A lot of those doctors are retiring. And the system has really limited that sort of multi-skilled doctor being welcomed into a hospital, because the hospitals seem to have estranged themselves from them, they've relied on locums which they pay $2000 to $3000 a day. But the local doctor at the hospital might be on call for $150 for 24 hours.

A lot of them have got jack of that. And in many states, they have become locum dependent, and we need to build it up again and get one health system where your general practitioner in the country town can work reasonably and is welcomed into a public hospital with the appropriate skills so that we can turn this trend back and get more people going into general practise.


And Minister, it's not just doctors and healthcare workers. It's also facilities. Latrobe Regional Hospital, for example, reading in the papers no toilet facilities for their members. Just one example of what's happening to some of the facilities.


Yeah. Well, look, I'm not familiar with that circumstance, but as you understand, the state governments run these hospitals.

They all have slightly different systems and bureaucracies, and that is part of what I'm trying to do is to get the multi-skilled general practise workforce back engaged in both community general practise and working at the local hospital. But we need the states to come with us on that journey. They would like it. Some states worked this out 15 or more years ago, 20 years ago, say in Queensland, when they had all the Bundaberg disasters. Getting a multi-skilled general practise workforce involved in your hospital is a really good quality improvement initiator, and then it leads to other services clustering around that. But once you, say, lose obstetric services or the ability to anaesthetise someone or have a theatre operating, then these hospitals get hollowed out. And that's what we've seen in too many areas of regional Australia. We know what the problems are. There's lots of enquiries that are just finding out about them, but we know it and we have put so many policies in place. We've got doctors from country of origin being trained in regional clinical schools. There's 21 of them around Australia. We know if you train in the country, you're much more likely to stay there. Same for nurses and med students. A third of the cohort coming in now come from country origin, because we know they're much more likely to stay. But at the end of it, they want to know that they can work at the local hospital as well as work in the community, like they used to. The system sort of faded away with the rise of super subspecialties and too many of the young doctors coming through to see the bright lights and the big dollars by going into a speciality. Whereas the most important part of the whole health system is your general practitioner.


And Premier Dominic Perrottet made a pledge to act on his state. That was following concerns over pregnant women given waterproof mats in the event that they deliver babies in cars and regional hospitals where there are no doctors. And we've been talking about the lack of staff around the regions and the facilities. Minister, this is this is just dire and we're just about to see, you know, the city open to regional areas. We are seeing, you know, the TGA just approving vaccinations for boosters for 18s and overs. We're seeing vaccinations rising, but some terrible situations for pregnant women.


It is disappointing. Having an obstetric service in your regional hospital is a really important issue in the health system, because if you enable that, you enable all those other services that are required. But once you remove that from a regional hospital, well, a lot of the other services go with it. So, it's a critical service both for the baby and the mum, and for the town, because young people and businesses won't move to towns if they don't think they've got the full suite of health services. So, it's a really critical piece of hospital and health infrastructure. We've got doctors trained up to do this, but we need to have a rethink from a lot of the state health jurisdictions about the best way to run their health service. Having these smaller hospitals with more services, and more nurses, and doctors, and midwives is the way to go. It's good health economics. It saves absolute motser on ridiculous locum fees, but it also is a better quality of care if you can get attention by an appropriately trained professional quickly in your area. Delayed diagnosis people get a lot sicker, having to be transferred out of town involves costs of transport and then starting all over again once you get to the bigger hospital.

So, I am really trying to de-silo this system, but I can't do it alone.

Many of the professions want to do this. The Rural Doctors Association, the Royal Australian College of General Practitioners, the Australian College of Rural and Remote Medicine, they all want to do this, but the states have got to go on the journey with us, because that's the entity that runs these hospitals. And I really am pleased that Dominic Perrottet has acknowledged that more needs to be done. They don't all have to have a super-duper amazing building. It's more important to have skilled doctors and nurses and midwives in them and, you know, pathology and X-ray services. And then it's acting like a real hospital, not just a triage, treat and transport or use telehealth to deliver care. It's not as good as the real thing.


Yeah. Well, it absolutely needs that team effort, as you mentioned from governments and states and everybody, but really appreciate your time and expertise. Dr David Gillespie, Minister for Regional Health. Take care.


Thanks very much, Jaynie. Any time.




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