Kapunda birthing services to close permanently

The services resumed as scheduled, according to an SA Health spokesperson, following a planned temporary diversion to Gawler, to allow staff members to take annual leave.

But the reasons for the final decision to close the service are not clear, with an SA Health spokesperson saying birthing services at Kapunda remained operational.

"Our local health networks provide specialist maternity services," they said.

Rural Doctors Association SA president Bill Geyer was disappointed by another country town losing its obstetrics team but he was not surprised Kapunda was the latest to fall by the wayside.

"This has caused a lot of disappointment and it is very sad the service will cease," he said. "It is important to acknowledge the huge effort Dr Max Van Dissel has put in over the many years of supporting its services. Often, at a personal cost, he fulfilled the obstetrics services at Kapunda."

Dr Geyer said he believed the reason for the closure was a lack of midwives and was concerned the direct entry midwife training model had contributed to the issue.

"These midwives are often straight out of high school or other areas of work, and have no nursing background," he said.

He said this meant they did not have the necessary nursing skills to take up other tasks when obstretics was not needed.

"This makes it incredibly difficult to staff a country hospital trying to provide obstetrics services. This also contributed to the demise of Tanunda birthing services," he said.

Dr Geyer was also pessimistic about the reinstatement of Waikerie's birthing services, which were closed in January, 2021.

"It is very difficult to recruit people to work at a service which is closed. This was always going to be the issue at Kapunda as well," he said.

"I believe it will be difficult for it to be reinstated. I would be pleased to hear if it was but it will take the recruitment of several GP obstetricians and midwifery staff."

Dr Geyer was also concerned about the removal of necessary equipment when an obstetrics service closed.

"The resuscitation tables, CTG machines and forceps equipment is taken away so, given how long services as Waikerie have been closed, it would suggest all of that has been moved to another service," he said.

This problem compounded staffing issues, according to Dr Geyer.

"It is not just about staff, it is about getting the gear back, too. All of these parts have to be reinstated if a hospital is going to provide a service," he said.

With Whyalla birthing services expected to be reinstated soon, Dr Geyer believed the state government had poured its energy into hospitals in larger regional centres, to the detriment of smaller towns.

"They are trying to maintain services at Whyalla, Port Augusta, Ceduna, and it has become a bit of a battle to maintain all services because of it," he said.

Mount Gambier obstetrics services could also be the next big problem, according to Dr Geyer.

"An obstetrician is retiring and that service will be under pressure in the near future. You would hope it did not end up like the smaller country hospitals," he said.

"The short-term solutions are not working. There is a nationwide shortage of obstetrics staff and direct entry midwife training needs to be rethought. It take years to improve workforce shortages and it won't help reinstate Kapunda services on July 1."

The SA Health spokesperson said the relocation of the Whyalla birthing unit and women's and children's ward, was a key recommendation of the independent review into birthing services.

A review was commissioned in July 2023 after birthing services at Whyalla Hospital and Health Service were suspended on June 2023 because of a critical midwifery workforce shortage.

"Building works are near completion to allow opening of the ward in early March, and to be available in the future when birthing services can be safely reinstated at Whyalla," the spokesperson said.

"We are implementing every recommendation made in the report and are looking to reinstate birthing services at Whyalla as soon as possible."

Expecting mothers were given alternative locations for birthing, including Port Augusta and Adelaide.

Recommendations also included financial and training incentives, more flexible working options, improving senior leadership support and partnering with metropolitan hospitals.