Matters of State: Health services still at top of agenda, says MP

The Orange Health Service is classified as a Major Hospital, and although it encompasses an array of specialty medical services, there's been deficiencies there, too. It took quite an arm wrestle with the NSW Government and the Western NSW Local Health District (LHD) to reinstate inpatient palliative care services to the hospital.

The Orange Base Hospital housed a palliative ward, and the blueprint of the plans for the new hospital did, too, but ended up being removed from the plan and their inpatient services following the hospital's relocation.

Although the Government and the LHD eventually relented, delivering the inpatient palliative services the community had long been fighting for, the LHD's reasoning for not previously reinstating inpatient palliative services was, one, that people preferred to die at home.

However, as most of us now know, the reality is that despite people's wishes, they often require specialist inpatient palliative care in their final weeks and days. Their other reason was that the LHD didn't have the budget for this service - yet they managed to fund this service before they moved the hospital!

The neighbouring town of Parkes is expected to boom with the future delivery of the inland rail hub and development of the Special Activation Precinct. These projects will attract the establishment of business and create many local jobs in the process. Couple this with three mining enterprises in the district and the prediction for solid population growth in Parkes is fairly-well guaranteed.

In late 2015, a new state-of-the-art hospital was completed at Parkes. Parkes is classified Community Hospital with Surgery. One of the key features of the new Parkes hospital was a maternity ward, supported with obstetrics, anaesthetics and midwifery services.

Following the retirement of several local GP-Obstetricians/Anaesthetists, in 2019 the LHD closed Parkes Hospital's maternity services as they deemed the costs for locum doctors required to continue the service to be untenable.

The Government's and LHD's solution were to replace the Parkes Hospital's maternity ward with a midwife-only birthing model. Their reasoning was that most births often only require midwife care. That's fine when all goes to plan, but childbirth is inherently risky for mother and child - and it can often turn into an emergency without notice.

Midwives are essential to mother and child - before, during and after the birth however, they don't possess specialist skills often necessary in a birth, particularly in an emergency, such as a caesarean or postpartum haemorrhage.

Expectant mothers have since had to either go to Forbes Hospital, by appointment, or make the harrowing dash to either the Dubbo or Orange hospitals, in the case of premature labour or high-risk pregnancy.

There have been expectant mothers who've not been able to make it in time, and I've heard of a mother giving birth outside the Forbes Hospital. There are more stories of roadside births occurring where expectant mothers could make it to hospital in Orange.

In the 21st Century, this isn't good enough. Many health services in regional NSW have contracted or centralised, seemingly going backwards. The removal of a fully functioning maternity service is the antithesis to growth and progress - particularly for a community such as Parkes which is clearly going to grow and require such services.

The ripple effect is that Orange Hospital is now having to cater for additional maternity workloads, and even ancillary or support services such as Ronald McDonald House are under strain with increased visitation from families who've required to stay in Orange for medical services.

I'm fed-up with hearing excuses which government and their bureaucrats make when closing or scaling-down health services. Predictably, their solutions are driven by efficiencies, cost-savings. This approach has seen tragic outcomes, such as the death of a patient at the Gulgong Hospital who was treated virtually via Telehealth by a doctor who was hundreds of miles away!

Surprise, surprise - the LHD appointed a doctor to Gulgong's hospital when news broke and the community became outraged. It shouldn't take tragedy to reinstate doctors, who are essential to hospital services. But what this shows is that when health bureaucrats are motivated, they manage to find the money and get the doctors.

What does all this have to do with Forbes and other communities, you might ask? Well, there's been a trend; There is already a doctor shortage, which is worse out here in the regions. The doctor shortage hasn't yet peaked, so we are yet to feel the full impact. When the LHD cannot staff a service, their solution has been to close or modify the service.

The LHD are still advertising for a GP/Obstetrician for the Lachlan Health Service, to cover both Forbes and Parkes. They haven't provided any clear incentives in their advertisement to attract applicants to what is clearly a hard-to-fill position. So, if, for example, a Sydney-based doctor sees two ads which offer the same, one is at Forbes/Parkes and the other in Sydney, you can reasonably assume the outcome.

If our communities are expected to grow and businesses are to establish, they require confidence in a capable health service to underpin it. The districts of Forbes and Parkes are service and employee residential centres for several mining enterprises, each of which generates revenue for government via taxes, duties and royalties, while employing a large number of tax-paying people who contributing to the economy. It's in the interest of the Government to maintain hospital services, if they know which side their bread is buttered on.

I've been highlighting these issues through speeches I've been delivering on the floor of parliament so that the Government cannot ignore it by burying its head in the sand. They must address it, and soon.

In their recent 2022-23 budget, the Government touted funding for a 10,000-strong workforce boost to the public health sector. Rest assured, I'll be asking for our share of resources to sufficiently reinstate and maintain accessible public health services across the electorate, and holding the government to account.