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Sydney Doctors Say No

Illawarra Mercury

Monday June 6, 2005


FIVE months after health officials promised to bring emergency physicians from Sydney to work at Shellharbour Hospital, no Sydney doctors willing to help out have been found.

Illawarra doctors claim Shellharbour's dangerous lack of emergency physicians is part of a much wider medical workforce problem the merged South Eastern Sydney and Illawarra Area Health Service has been unable to solve.

Wollongong Hospital sees more patients per year than Prince of Wales at Randwick, yet has only half the number of medical staff.

SESIAHS figures reveal that Wollongong Hospital admits 39,000 patients annually compared to Prince of Wales' 36,000 and has 4000 more Emergency Department presentations.

Despite this, Wollongong Hospital has almost half the number of staff specialists, registrars and residents available to the Sydney hospital. Both hospitals have about 400 beds, but Wollongong has 95 Visiting Medical Officers compared to Prince of Wales' 121. There are 14 clinical academics at Prince of Wales, while Wollongong has none; Prince of Wales has 15 fellows, Wollongong none; and Prince of Wales has nine honorary specialists, Wollongong none.

The redistribution of medical workforce resources was a main plank of NSW Health Minister Morris Iemma's radical plan to overhaul the state's area health services.

But a year after the revamp was announced, Illawarra clinicians say serious inequities exist between the southern and northern ends of the SESIAHS mega area.

Illawarra emergency physicians withdrew their services from Shellharbour Hospital on January 1, citing intolerable workloads.

Since then the hospital's casualty department has been operating without any specialist emergency physicians, a situation clinicians say is unsafe.

The move to withdraw from Shellharbour followed the physicians' decision in October to withdraw from the Bulli Hospital roster.

Doctors said filling rosters at Wollongong, Shellharbour and Bulli was unsustainable, with some physicians caring for as many as 100 new cases a day.

The crisis came to a head on January 1, when the stressed emergency physicians pulled out of all but Wollongong Hospital.

It was seen as the first major test of the state's revamped health system.

As a short-term solution SESIAHS administrators promised to bring emergency physicians from Sydney. But five months later, no Sydney doctors have arrived.

In fact, no Sydney doctor has worked in any Illawarra hospital since the merger officially took effect at the beginning of the year.

Convincing Sydney-centric medicos to venture south is a major headache for administrators of the largest of the state's new health areas.

In March, Northern Illawarra Hospitals Group general manager Sue Browbank confirmed the reluctance by South East Sydney doctors to travel to the Illawarra, saying the freeway was "an issue".

SESIAHS clinical operations director Matthew Daly said the area was working on ways to get Sydney doctors to the Illawarra. However, he did not want to divulge the planned solution yet, for fear of upsetting those affected.

"It's about making it a more attractive package down here," he said, adding that a vital step would be setting up academic chairs in the Illawarra.

Dr Daly wouldn't comment on why a four-year link with the University of NSW had failed to get any academic chairs for Wollongong.

He said the administration was pinning its hopes on the University of Wollongong's plans to establish a medical school. Once accreditation was approved, academic recruitment would begin.

Dr Daly said South East Sydney now acknowledged the Illawarra's unique workforce issues.

He denied plans to set up a sector within SESIAHS covering the former Illawarra Health area was an admission that the new mega area was unworkable.

Commenting on the perception that administrative jobs were growing while clinical jobs appeared stagnant, he said the increase in bureaucracy in the Illawarra was a natural by-product of the decision to move the area headquarters to Wollongong.

Wollongong surgeon Paul Kovac, chair of the Illawarra's Patient Safety Committee, is concerned about the lack of emergency physician cover at Shellharbour.

"... there's no-one there to appraise staff," he said.

As a result, the normal quality assurance checks that an appropriate clinical manager would do were not being attended to.


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© 2005 Illawarra Mercury

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