Nurse Pen McLachlan says she has many horror stories about working in a rural hospital.
There’s one of a cook sitting with a stroke patient in the parking lot of Condobolin Hospital in western New South Wales while the two nurses on duty were busy with emergency room.
There’s another about an elderly man in the last hours of his life, whose family cleaned and cared for him in the absence of palliative care.
A nurse agreed to come to work “heartily” to shower the man. He died on the bathroom floor, where his daughter said her final goodbyes.
“Where do we start to fix it and how do we start to fix it? Because it’s a damn big problem,” Ms McLachlan told the NSW parliamentary inquiry into rural health care last year. .
After 720 written submissions and 15 hearings over the course of a year, the inquiry is due to table its report in state parliament as early as Thursday.
Ms McLachlan’s testimony crystallized the frustrations faced by rural communities, where hospitals are without doctors, recruiting GPs is next to impossible and many health services have been centralized in regional towns.
This is the case in the Griffith area, where local MP Helen Dalton says hospitals have no permanent doctors and ambulances are used to transport patients to the larger hospital in Wagga Wagga.
Dalton hopes the grim evidence released during the investigation will lead to cooperation between state and federal governments.
Far-reaching action is needed to address structural issues that prevent doctors and nurses from working in the bush, such as housing shortages and low salaries, she says.
“It’s hard to bring someone from Sydney here and take a job when they think Griffith or Deniliquin is the end of the earth,” Ms Dalton told AAP.
She says rural people have no control over their health care, something many advocates are calling for.
Mark Burdack, head of the charity Rural and Remote Medical Services, says listening to the needs of communities is key.
“Rural people are out of sight, out of mind,” Burdack said.
“The health system was designed to run hospitals in big cities and it’s not well equipped to run services in rural and remote communities.”
State and federal surveys have heard that the distribution of health workers is based on demographics that do not reflect the realities of country life.
Mr. Burdack says that model has failed catastrophically. His organization recommended for the inquiry a rural and remote health commission with an independent board overseen by community members.
At the inquest, senior health official Dr Nigel Lyons apologized to rural patients, saying the department is committed to ensuring equitable health care.
The New South Wales government appears to have anticipated some of the results of the inquiry, appointing Bronnie Taylor as regional health minister and creating a regional division within the health department.
Rural Doctors’ Association NSW chairman Charles Evill said doctors were optimistic that their concerns would be heard by the new division.
But, according to Dr. Evill, the rural health system needs a complete overhaul after decades of centralization, a declining workforce and poor planning of local services.
“It’s not going to be changed quickly. But there’s not that much choice.”
Australian Associated Press