The Pambula hospital action group, Save Our Hospital Inc (SOHI) is determined to continue its fight to restore services to Pambula hospital including maternity and has vowed to take the fight to a financial level.
After a meeting on Monday evening, February 20, SOHI will be preparing its financial argument which the group believes has added impetus given the annual $20 million black hole that the Southern NSW Local Health District is battling.
SOHI member, Russell Fitzpatrick said: “We believe we can come up with a proposal that proves the financial case (to return maternity to Pambula hospital) and that will save the Local Health District $0.75 million a year.”
He said that whether maternity is located at Pambula or Bega shouldn’t come in to it but he pointed to the availability of a greater number of GP obstetricians at Pambula.
The number of GP obstetricians has been one of the key staffing requirements throughout the battle to return maternity services to Pambula hospital, including the last review which was carried out by deputy director of the Ministry of Health, Nigel Lyons.
In January, a review by Dr Lyons concluded it would not be safe to introduce a full midwifery-led maternity services model to Pambula. Dr Lyons said he consulted widely with local clinicians, community groups and hospital employees.
But Merimbula GP obstetrician, Frank Simonson said the latest review did not include the views of another local GP obstetrician, Rob Morton.
It is understood that in deference to Dr Morton, who is spending time with a very ill relative, Dr Lyons did not consult with him but Dr Morton has since spoken with Dr Lyons.
If as Dr Simonson reports, Dr Morton is willing to carry out GP obstetrician duties at Pambula hospital, it will mean that there are three GP obstetricians available locally, Dr Simonson, Dr Morton and Dr Janet Watterson.
Bega hospital currently has one GP obstetrician, Pattie Salisbury, and relies on using locums at over $2000 a day to cover the rosters.
This, Dr Simonson has said, makes the financial case for returning maternity to Pambula.
Much of the debate over whether maternity could be returned to Pambula hospital had focused on the number of GP obstetricians available.
President of Save Our Hospital (SOHI) Sharon Tapscott said that she was told by the board of the Southern NSW LHD there was a problem because one doctor was not willing to be part of a Pambula hospital roster. “But it turns out that he wasn’t contacted,” Mrs Tapscott said. “The review wasn’t complete.
“I’m hoping they will now do what they said they would do in the first place, speak with all the doctors. If they are totally reliant on one doctor at Bega supported by locums, why can’t we have maternity at Pambula with 2.5 doctors,” Mrs Tapscott said.
CEO of the Southern NSW LHD, Max Alexander said that the number of GP obstetricians available was only one factor involved and that the availability of anaesthetists was another issue and that rosters couldn’t be set up to provide for acute maternity conditions. In the original Pambula Maternity Review, Dr Alexander also said that Dr Simonson was the only GP obstetrician credentialed for caesarean sections and that it was unsafe for one person to be on call 24/7.
He said that Dr Lyons had been sent down to talk to local employees who would be involved in midwifery, talk to local clinicians and to examine the recommendations made in the Pambula Maternity Review.
Dr Lyons review was seen as an endorsement that the board’s concerns for the restoration of services were valid.
But Mr Fitzpatrick still believes there is a good financial case to be argued for the return of maternity services to Pambula and has said that SOHI will be working on the figures.
He believes that as well as saving money through restoring maternity services to Pambula, income could be generated from the facilities at Pambula hospital.
“Max Alexander and the board just seem to look at cutting costs and not at generating income. We’ve got a theatre not being used and it could be used for private operations,” Mr Fitzpatrick said.
He is also annoyed that there is still no Local Health Advisory Committee for Pambula hospital, something that was flagged last year but has failed to materialise.
However part of Dr Lyons’ non-clinical recommendations was the establishment of better consultation with the community.
The News Weekly asked chair of the LHD board, Eve Bosak how the new Local Health Advisory Committees (LHACs) would work and whether they would be in addition to the existing committees or replace them.
Mrs Bosak said: “The new community consultation process has been designed by the existing LHACs. They will have flexibility to design their own process around the hub and spoke concepts they came up with late last year. Chairs and members will be asked if they would like to continue. Additional members will be sought to reflect various areas of demographic, geographic and experiential interests of each region within the district.”
Dr Alexander said: “The LHACs will be re-energised. There needs to be wider representation on all LHACs across the district. What was clearly heard from SOHI was that the interests around Pambula hospital and the Pambula community were not being represented by the LHAC.”
Not surprisingly the local community has struggled with the concept of representation by a committee which does not have public meetings and easy access and it has been a considerable bone of contention that Pambula hospital had no representation from a community perspective on the LHAC.
Mrs Tapscott said that she hopes Mrs Bosak’s “hub and spoke concepts” will finally put this right and give the community a voice when so much has been talked of openness and transparency.
Privately health officials recognise that the community has had to work very hard to get its voice heard with one person commenting: “Democracy is not always an easy thing to work in.”
Mrs Bosak said: “The board is committed to ensuring that the collective views of the people of the Pambula-Merimbula, Eden and surrounding areas are represented in regional health service deliberations. We expect to call for expressions of interest in membership of the new advisory bodies in March.”
In the meantime Dr Alexander has said that he will be talking with SOHI and other community groups as well as key stakeholders in Pambula hospital.
Dr Alexander is visiting the area at the end of this week and will meet with the Pambula and Bega hospital auxiliaries, Eden Chamber of Commerce and staff at Pambula hospital.
He will be returning to the local area for several days over the next two to three weeks when he aims to meet with “a whole range of community groups” including Rotary Clubs.
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