Rural health in peril

The Rural Doctors' Association of SA says 108 junior doctors could be locked out of country hospitals unless their supervisors sign the new three-year contract by the end of this month.

Ongoing contract concerns from rural doctors have yet to be addressed by Country Health SA Local Health Network, and requests for assistance from Health Minister Jack Snelling have been ignored.

The RDASA first voiced its concerns last November following 10 months of negotiations for rural GPs working as independent medical contractors with CHSALHN.

RDASA president Scott Lewis said the agency had refused to acknowledge key issues identified by rural GPs as being critical to their ability to provide vital medical services to their communities.

"These include recognition for teaching and training the next generation of rural doctors, liability issues and lack of ongoing support for accident and emergency services in some areas," Dr Lewis said.

There were also concerns that the agreement asked rural doctors to commit to using the Enterprise Patient Administration System, despite the $420 million program being put on hold state wide due to technical and implementation issues.

RDASA vice president Peter Rischbieth said the association had asked Mr Snelling to intervene twice with no response.

"We had some more formal proposals (sent) to him last week, but we've had no response from them or from CHSALHN," Dr Rischbieth said.

"(CHSALHN) have sent letters to the junior doctors saying if we don't sign the contract then they won't let the junior doctors into the hospital, and we are not sure, if we don't sign by the end of February, whether we (the supervisors) will be allowed to work at more than 50 country hospitals in SA."

If junior doctors were prevented from working in hospitals, Dr Rischbieth said rural hospital services would be in chaos, with emergency, anaesthetic and obstetrics just some of the services impacted.

"Our work loads will be significantly impacted for those of us who are left behind," he said.

"The issue is the junior doctors are being used as a pawn to make us sign the contract."

Dr Rischbieth said he was aware of only two practices who had signed the contract, and they had signed for one year only, not three.

Some doctors were still waiting to receive their contracts or had only received them in the past week.

The three main sticking points for RDASA include a clause regarding EPAS, which Dr Rischbieth said doctors would be happy to accept once flaws in the system were addressed, but which he currently described as a "lemon".

Improved structures to ensure payments for accident victims and overseas visitor treatments were dealt with promptly was another issue of concern.

The RDASA had also sought a CPI increase in line with other state government workers.

Dr Rischbieth said metropolitan doctors, legal offices, correctional services and many other state government employees had been offered a 3 per cent pay rise each year for the next three years, while rural doctors had been offered just 1.7pc.

CHSALHN chief executive Maree Geraghty said she was confident that the majority of rural doctors would sign up.

"We've got contracts to about 122 practices and nearly half of all the GPs have signed up already, and there's still two weeks to go," she said.

Addressing the concerns of RDASA, Ms Geraghty said EPAS was in one country hospital and "the people who are using it at the moment love it".

She said the treatment of overseas patients was a "complex issue" and CHSA would keep working with the doctors to support them "the best that we can".

Health Minister Jack Snelling's office said he did not get directly involved in enterprise negotiations but would hold a "regular meeting" with rural doctors this week.