The state's regional health service may be called Country Health Connect but residents of two Upper South East towns are only feeling disconnect after their ability to readily access registered nurses were taken away.
Last year the Tintinara Community Health Centre, which was staffed by local nurses and open four hours a day on weekdays for drop-in services including blood tests, wound care and having their blood pressure taken, was closed without any notice.
It has re-opened by appointment only, with nurses travelling from Murray Bridge if Tintinara residents cannot be directed to travel to Meningie, 80 kilometres away, or to Murray Bridge, more than an hour up the busy Dukes Highway.
It is the same situation in nearby Coonalpyn.
Riverland Mallee Coorong Local Health Network chief executive officer Wayne Champion says services are now being provided in line with need rather than "lengthy periods" where skilled nursing staff were waiting in the clinic for "inconsistent community activity".
But Coorong District Council councillor Jonathan Pietzsch says Council has taken up the fight to have local nurses reinstated at least three days a week.
He says local residents are disgusted by the local health network's decision, with a great deal of anxiety among elderly residents, especially those who do not hold a drivers' licence.
It is also a huge inconvenience for all ages having to take at least half a day off to seek simple medical care.
"We can't get our heads around it, they will send a nurse from Murray Bridge here for a 10 minute blood test to then drive back again so probably 2.5 hours and they think that is more economical," he said.
"When the (local health network) acting director came to speak to Council they could not see why Tintinara and Coonalpyn should be treated any differently but I pointed out all of the other affected towns had full-time medical services.
"They are trying to centralise services when Coonalpyn and Tintinara are geographically spread out."
Tintinara octogenarian Thea Keller says the town's health services have regressed decades.
"When I first came to Tintinara in 1960 with a nine-month-old baby there was no doctor but then for many years we had two visiting doctors from Keith and one from Meningie, now we have nothing again," she said.
"When you don't have a doctor in town, you need someone to give reassurance to people about their health or direct them to where they may get help."
SA Health did not answer Stock Journal's question about whether there had been any community consultation about the community health centre but Mr Champion defended their decision to move to an appointment-based system, saying it will maximise the number of clients a specialist nurse can see in their day.
"Country Health Connect clinics at Coonalpyn and Tintinara continue to provide services to community members, including wound care, post-acute care such as drain management, supra public catheter care and injectable medications," he said.
"When patients require blood collection, they are asked if they can travel to a pathology collection centre. If they are unable to travel, a nurse is arranged to visit."
Mr Champion said best practice required doctors to oversee electrocardiographs and to be on hand to interpret results. These will continue to be available at larger hospitals including Murray Bridge Soldiers' Memorial Hospital,
SA Health has also confirmed the Lucindale Community Nursing Service has changed from a drop-in service to a by-appointment service.
Limestone Coast Local Health Network executive director community and allied health Karen Harris says this brings the service into line with other community nursing services across the Limestone Coast and other regional Local Health Networks, allowing their nurses to do more care work in the community and where appropriate, home visits for clients.
"All services currently being offered at Lucindale will continue with the exception of ECGs (electrocardiogram), ear syringing and removal of sutures, which are available from other local providers," she said.
But Robe-based GP David Senior - who visits Lucindale one day a week - says the decision shows a lack of understanding of the work the Lucindale-based nurses had been doing in the town.
"Every service available in a small community, where often the only other option is to call an ambulance, is important. If there is a nurse there to dress a wound or triage some sort of emergency or showering the elderly, it can be very important in keeping them out of hospital," he said.
"We need to be enhancing services, not pulling out of these small towns."
Dr Senior fears that if medical care is not readily available in small towns people will not travel, potentially leading to bad health outcomes. He says this was evident when he started as a GP in the town in 1998-1999 and was far busier than he expected.
