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2006-06-05

Access to obstetric services in rural Australia as "third world" standard

Tonight there will be a Four Corners programme on shortcomings in rural medical care, particularly for obstetrics and cancer patients.

"RDA federal president Dr Ross Maxwell has told Four Corners that, on the current trend, there will not be a single rural doctor trained to deliver babies in five years' time.

"It will be catastrophic for the people, the women who live in rural and remote Australia, and there will be a group of women who can afford or it may suit to come to Sydney to have their babies, but the majority of women that won't be the case," he said."

Successive governments at both State and Federal levels have stood by while rural medical practitioners are not replaced. What needs doing to attract more and better trained doctors and nurses to our rural areas?


Crossposted at Larvatus Prodeo.

9 comments:

kate said...

The GPs who are in rural Australia, many of whom used to deliver babies, no longer do because they can't afford the insurance.

The way the government and medical colleges have limited the number of places in medical schools and Medicare Provider numbers means that we don't even have enough doctors in the city. Community Health Centres in inner city Melbourne can't fill positions. It really irritates me that The Powers That Be completely ignored the fact that:
a) most doctors don't want to work 24 hour days any more (so we'll need more doctors to cover the workload)

b) as more doctors are women these days, it's reasonable to assume that many of them will take maternity leave, and want part time work for a few years (so we'll need more trained doctors to cover the workload)

Both of these trends have been obvious for more than a decade, so now they are starting to think about maybe possibly doing some research into considering training some more doctors.

tigtog said...

These trends were already being talked about as a future problem when I lived in country NSW 25 years ago, before the medical compensation blew out the insurance costs to their current level.

You are so right about the systemic failure to look into correcting the supply of medicos generally, but it's especially hard outside the cities.

It will be interesting to see what conclusions the 4 Corners report comes to.

morgan said...

My cousin is an obstetrician. Even if insurance fees were reasonable I couldn't imagine her living in rural Australia, for pretty much the same reason I can't imagine living in rural Australia. Why did you move, tigtog?

tigtog said...

25 years ago I was there because my dad had been transferred there. Then I went off to Uni in Sydney. About 15 years ago I spent a year in a different part of rural Australia as a secondment and quite enjoyed the fresh air and the treechange, but I do prefer the bright city lights. I wouldn't write rural Oz off in terms of arts/crafts/gourmet appeal - cosmopolitanism creeps on apace.

Of course, as well as the doctor shortages there are also the issues of cellphone coverage and broadband distribution to blight the rural idyll, but I can imagine doing a treechange again someday.

kate said...

It doesn't help either that university gets more and more expensive, and harder for rural kids to get into (because they don't have equal access to resources, like university libraries and uni-educated parents) so we have fewer uni graduates who have ever lived in the country. Praps we could have better high schools in the country, and scholarships that are actually enough to live on, so that rural kids CAN study. Then tie those scholarships to jobs in the country, and make a more concerted effor to promote the growth of interesting culture in rural areas so that people want to live there.

Lots of other countries have cities the same size as Australia's regional centres and they manage to support arts, culture and decent cafes. There's no reason why more of ours can't do the same.

That said, my rural cousins who had tertiary education (including the midwife) all live in Melbourne now. The ones who didn't go to uni still live where they grew up.

tigtog said...

Yep. All my rural-reared friends with uni educations live either in the city or in the more cosmopolitan rural areas of the coastal hinterland.

I can't think of anyone offhand from uni days who's chosen to live further west than Dubbo/Tamworth/Armidale/Wagga, and that's very few.

morgan said...

I found the programme disappointing: lots of human interest discussion about the impact of the lack of doctors, but nothing significant about why.

tigtog said...

Me too, Morgan. It lacked the deeper analysis that one expects from 4 Corners - inexperienced reporter, maybe? The costcutting at the ABC starts to show with them unable to keep up the quality of their signature current affairs programme.

Jennifer said...

Another rural issue is that these days, most doctors are in two career families - it's hard to move two careers to the country. Easier if they're both doctors, but still tricky.

And if you do become a doctor in the country, it's pretty tricky to have reasonable working hours - I've read many stories about the last doctors in a rural town working 7 day weeks.

The crazy thing is that our market oriented government isn't prepared to countenance market solutions (like paying the rural doctors more, instead of choppering the patients to cities). And, of course, as you say let more doctors train to reflect the more human working conditions these days.