Issues affecting local healthcare have not gone unheard following a recent visit to the South East by Australian Medical Association (AMA) South Australia president Dr John Williams.
The Limestone Coast was the third stop on the president’s Rural Tour where Dr Williams and AMA SA chief executive Nicole Sykes met with colleagues in the region.
Dr Williams’ first engagement on the Limestone Coast was at the Mount Gambier and Districts Hospital for a meeting with Limestone Coast Local Health Network (LCLHN) chief excutive Emma Poland and her colleagues, Executive Director of Medical Services Dr Sue Abhary and Director of Medical Services Dr Hemant Diesh.
Later the same evening Dr Williams hosted a dinner with local doctors and LCLHN representatives with a Q&A panel discussion providing participants with the opportunity to engage with Dr Williams and guest speakers.
Visiting the Limestone Coast for the purpose of personally engaging with his colleagues, to share insights and challenges in regional healthcare today, local doctors were invited to a dinner and Q&A night.
Held at The Barn in Mount Gambier, guest speakers included Dr Roger Sexton AM, Avant SA/NT state manager Tim Hall and Australian Medical CPD Standard Rachel White.
Dr Sexton’s topic of discussion was ‘The High-Performing Rural GP’, while Mr Hall talked about support for regional doctors and practices and Ms White presented updates on the Medical Board of Australia 2023/24 CPD programs.
Notable attendees from the region included orthopaedic surgeons Dr Barney McCusker and Dr Afsana Hasan, GP anaesthetics registrar Dr Vienna Tran, GP obstetrician Dr Monique Kanters, Dr David Mills from Kincraig Medical Clinic (Naracoorte) and AMA SA member Dr Hannah Szewczyk.
“This was a way for them to highlight their region and further empower me to be a strong voice for them,” Dr Williams said.
Dr Williams said he is concerned about the ongoing impact on patients due to limited access to anaesthetists and other specialists.
“The lack of anaesthetists on the Limestone Coast is contributing to long delays for patients who are waiting for planned surgeries,” he said.
“Many patients are very unwell and in pain, with their conditions worsened as they wait for essential procedures.
“Those who seek treatment in Adelaide face long waiting lists there, too, due to the months-long code yellow that has led to the postponement of hundreds of surgeries.”
Dr Williams said he had raised his concerns with Health Minister Chris Picton, which triggered the formation of a statewide anaesthetic working group.
“We know there’s a nationwide shortage of anaesthetists, but there are clearly some problems at the state level compounding the shortfall in specific areas, including the Limestone Coast,” he said.
“The working group may not be able to fix everything, but hopefully it will lead to a fair and even distribution of anaesthetist services across the state.”
Dr Williams said he intends to take what he has heard from discussions with Limestone Coast doctors back to Minister Picton.
For Dr Williams the tour was all about listening to local doctors’ concerns so that when he meets with the Health Minister and other health decision makers, he knows he’s speaking on their behalf.
“The voices of country doctors are not always heard as loudly as they should be when our leaders are making important healthcare decisions. I’m trying to change that,” Dr Williams said.
‘My rural tour is an opportunity to listen to rural clinicians, so that when I meet with the Health Minister or speak at a press conference, I can be confident that I’m speaking on their behalf.”
The rural tour started in the Adelaide Hills in May and rolled into the Riverland in June.
Dr Williams will visit Kangaroo Island in October, followed by the Eyre Peninsula, the Iron Triangle, Murraylands and Clare in the months ahead.
“Each region has its own unique challenges, but many of the issues I see from place to place are the same,” Dr Williams said.
‘Doctors I speak to raise similar concerns about the tyranny of distance, limited resources in regional areas and the need to attract and retain more doctors to ensure optimum patient care.
“We took AMA(SA)’s concerns to the Health Minister Chris Picton and that triggered the formation of the statewide anesthetic working group.
“That working group may not be able to fix everything, but hopefully it will allow health decision makers to spread out anesthetist services more evenly and sensibly across the state.”
Local clinicians raised concerns about Mount Gambier’s ability to attract and retain young doctors.
Dr Tran, who has been working in Mount Gambier for three years, said more efforts are needed to attract and retain junior doctors in South Australia.
“A region’s medical workforce is only as strong as its junior doctors,” Dr Tran said.
“We’re energetic, enthusiastic, we’re willing to learn and work hard – we keep the wards going.
“In a place like Mount Gambier that’s expanding, we need junior doctors more than ever. We need to make sure they do not feel isolated or alone.”
Dr Williams has also championed a junior doctor training model known as the ‘Single Employer Model’, designed to boost the recruitment and retention of regional doctors.
He said improving the culture in hospitals is central to improving junior doctor retention in rural areas and said the SEM is helping in that regard.
The SEM allows GPs and rural generalist registrars to be hired by SA Health as salaried employees for up to four years during their training, giving them continual access to entitlements like annual leave and sick leave.
It is currently being trailed at the Riverland Academy of Clinical Excellence and will be adopted by all other regional Local Health Networks in the next six months.
“The Riverland Academy of Clinical Excellence and its single employer model for training is gaining international attention for its success in attracting and retaining junior doctors, many of whom decide to stay in rural medicine,” Dr Williams said.
“The consistent, ongoing care they provide, possibly over many years, leads to the best outcomes for their patients and I look forward to it being rolled out across the state, including on the Limestone Coast.”
Dr Williams also spoke of the need to remunerate rural doctors appropriately.
He worked with the Rural Doctors’ Association to negotiate a new agreement which significantly improved pay for more than 330 rural GPs and GP registrars contracted by SA Health.
“That boost in compensation recognised the significant work undertaken by rural GPs, who play a vital role in delivering healthcare services to underserved areas,” Dr Williams said.
“It was also a crucial step in establishing and retaining the clinical workforce we all need to deliver world-class care.”
Dr Williams spoke more broadly about the need for smarter and more strategic investment in healthcare at both the state and federal levels.
“More than 20% of people in South Australia live in rural or regional areas,” Dr Williams said.
“We need our leaders to view healthcare as a basic part of infrastructure – like our roads. Proper investment is needed in every corner of the state.”
Dr Williams outlined two priorities in fixing the health system’s woes.
“The first priority is improved data collection,” he said.
“More data is needed to understand where and why patients are sick and to inform decision-makers about what is and is not working.
“The second is greater connectivity in the system. We need to leverage hospital and GP data to better connect general practice with tertiary care.”
On the way back to Adelaide on Friday, Dr Williams also met with Dr Mark Dutney and Dr Sangeet Kaur at the Penola Doctors clinic.
“The trip was a valuable opportunity to gain insights and hear local perspectives, which will contribute to our efforts in advocating for regional healthcare,” said Dr Williams.
“It was wonderful to meet with such an engaged group of local health professionals who clearly care deeply about improving outcomes for their colleagues and their patients.
“I was especially grateful that Ms Poland and her LCLHN colleagues made the time to attend the dinner and really listen to AMA members’ insights.
“It’s clear we’re all working towards the same goals, and I thank them for their willingness to collaborate to ensure the best outcomes for doctors and patients on the Limestone Coast.
“My rural tour is about listening, but it’s also about action.
“What I heard from doctors on the Limestone Coast will supercharge my advocacy so that I can drive positive change for regional doctors and patients.
“When I meet with health decision makers like the Premier or the health minister – or when I address the media at a press conference – I can be confident that I’m speaking on local doctors’ behalf.”
Dr Williams has made it his personal mission to help improve outcomes for regional doctors and their patients.
“I want to personally engage with doctors on the coalface of regional healthcare to understand their concerns and what they see as the way forward,” he said.
“It’s important that I provide a strong voice for all clinicians and patients, not just those living in the city.
“There are so many issues they’re dealing with and it’s really important I support them.
“This is an important opportunity to showcase their regions and help shape our important advocacy work with health decision-makers.”
