Shocking day for YP health services

Monday 26 June 2017
Shocking day for YP health services

Member for Goyder Steven Griffiths MP is disappointed and angry to advise that he has today received notification that the local fight over recent months to retain surgical services at Yorketown Hospital has been lost.

“Today I received two media statements released by Country Health SA (reprinted in full below), informing “some surgical services will relocate from Yorketown to Wallaroo following the completion of consultation with the local community.”

“I am angry the concerns of the Yorke Peninsula community have been ignored and dismissed in such a manner,” Mr Griffiths said.

“The petition of over 2,000 signatures does not rate a mention, and no comments whatsoever are attributed to Minister Snelling or his office.

This issue has been handled disgracefully right from the start – this is a shocking day for health services in our region”, he said.

Mr Griffiths said the statements cite staffing issues and skills retention difficulties as the reasons for the decision, “emphasized to me as being not a political one but one reached on the advice of clinicians.

“That said, solutions can only come from political decisions, around policy and making finances available in state budgets.

“We have long been aware of staffing issues – which, ironically, are linked to downgraded services -- and specific options which could be explored to address these problems were discussed at length at the Yorketown public meeting in April attended by more than 600 people.

“More must be done in the area of recruitment and training for rural practitioners and I don’t accept a white flag as the answer.”

Today’s disappointment adds to concerns already felt that the Weatherill Labor Government’s 2017-18 State Budget announced last Thursday contains so very little for regional South Australia.

“There is no extra funding to address the now $1 billion road maintenance backlog in SA, and the only regional hospital to receive any mention is the Mount Barker Hospital (a 35 minute drive from the city) for its 24-hour emergency doctor.

“I listened with great interest to an answer from the Minister for Health the Hon. Jack Snelling yesterday in Parliament Question Time, in response to a question about Mt Barker Hospital and why it was successful in receiving funding,” Mr Griffiths said.

“The Minister said he had listened to the people; and to the Member for Mayo who ran a campaign advocating need, and who had presented a petition of 2,300 signatures lobbying for the investment,” Mr. Griffiths said.

“My question then is why have the needs of Southern Yorke Peninsula people been ignored? They similarly advocated for investment to retain the surgical services at Yorketown Hospital yet their voices have been ignored so are we irrelevant?”

Mr. Griffiths wrote to the Minister requesting a briefing six times -- on 24 February, 16 March, 21 March, 3 April, 24 April, and 2 June -- and has had no response or action from him.

Two Freedom of Information requests were lodged on the issue, with one still outstanding (overdue and re-requested), and the other revealing no mandatory regional impact statement had been carried out to measure the impact of the decision to remove the surgical services.

“This treatment is not fair to the Southern Yorke Peninsula community which, understandably, feels ignored, and nor is it fair for Wallaroo Hospital staff to be expected to receive the transferred services without additional resources,” Mr. Griffiths said.

It has been advised the relocation of the urology, gynaecology and general surgical services from Yorketown Hospital to Wallaroo Hospital is to take effect immediately.


Title: Yorketown Hospital Update

Some surgical services will relocate from Yorketown to Wallaroo following the completion of consultation with the local community.

Country Health SA Chief Executive Officer Maree Geraghty said the decision to relocate the relatively small number of urology, gynaecology and general surgical services to Wallaroo was based on clinical advice.

“The overwhelming concern from Yorketown residents during the two-month consultation period was that inpatient and emergency services would continue at Yorketown Hospital,” Ms Geraghty said.

“We have reassured the community that Yorketown Hospital will not close and will continue to provide vital health services for years to come.

“Accident and Emergency, overnight medical care and colonoscopy procedures will continue to be provided at Yorketown Hospital.

“Outpatient consultations will continue to be provided in Yorketown, either in person or by video conference to minimize the need for people living in Southern Yorke Peninsula communities to travel.”

Ms Geraghty thanked Yorketown’s experienced GP Dr George Kokar for his specialized service and dedication to the community over many years.

“Dr Kokar has provided outstanding service to Yorketown residents,” she said.

“He has indicated that he intends to retire from full-time medical practice and from delivering anaesthetics at some point in the coming few years.

“Country Health SA has discussed with Dr Kokar our concerns about the sustainability of the skilled clinical workforce at Yorketown Hospital once he retires from full-time medical practice.

“Relocating surgical services to Wallaroo will not only build Wallaroo’s health service, but strengthen health services for people in the region.”

Clinical Director of Surgical Services, Professor Guy Maddern, said the relatively small volume of surgical activity in Yorketown was not considered sufficient for the range of clinical staff to maintain their skills at an acceptable level.

“Multiple medical and clinical staff are required for any surgery, and they need to be involved in surgeries regularly in order for them to maintain their skills,” Professor Maddern said.

“While there is no doubt surgeries provided over many years at Yorketown Hospital have been of the highest quality, it’s important to secure the future of surgical services in the region.

“That’s why this move of a small number of surgeries to Wallaroo is the right decision.”

Urology, gynaecology and general surgical services will relocate to Wallaroo Hospital effective immediately.

Background: In 2016, 59 surgical procedures (excluding colonoscopies) were performed at Yorketown Hospital. So far this year, 23 procedures (excluding colonoscopies) have been performed at Yorketown. This small number of procedures makes it difficult to ensure Country Health SA meets its obligations under national Safety and Quality Standards, governed by the Australian Commission on Safety and Quality in Health Care. Yorketown patients will be able to access a range of transport options to and from Wallaroo, including services provided by Yorke Peninsula Community Transport. Patients may also be eligible for the Patient Assistance Transport Scheme (PATS), which is a subsidy program that provides funding for some travel, escort and accommodation costs when eligible rural and remote South Australians travel more than 100 kilometres each way to see a specialist. During the two-month community consultation period, which concluded on June 9, Country Health SA received 18 submissions on the proposed relocation of services to Wallaroo. A further 26 people attended the four consultation sessions at the hospital. END


Title: Joint statement from Dr George Kokar and Dr Peter Joyner, Country Health SA:

For many years, Yorketown Hospital has provided its local community with safe, high-quality surgical services. It has been essential in providing patients needing less complex care and with reduced risk of complications with these services, delivered closer to their homes.

Yorketown’s local General Practitioner, Dr George Kokar, is a highly proficient medical practitioner with significant knowledge and experience in providing anaesthetic services in rural communities. His role has been one of the essential components to the delivery of high-quality general surgery, urology and gynaecology procedures at Yorketown Hospital. Dr Kokar has indicated that he intends to retire from full-time medical practice and from delivering anaesthetics at some point in the coming few years.

Decisions about when and at what point in Dr Kokar’s long and distinguished career he chooses to retire are private and entirely for him to determine in his own time.

Country Health SA is working with Dr Kokar to ensure surgical services provided on the Yorke Peninsula continue to be delivered safely and that they are of the highest quality.

It has discussed with him concerns about the sustainability of surgical services at Yorketown Hospital once he retires from full-time medical practice. This concern about the sustainability of the skilled clinical workforce led Country Health to consider the option of providing some of the services that are currently provided in Yorketown from Wallaroo Hospital instead.

As Country Health SA looks to the future delivery of long-term sustainable surgical services on the Yorke Peninsula beyond Dr Kokar’s retirement from full-time medical practice, it must take into account a range of factors. These factors include the availability of a local GP with experience delivering anaesthetic services, the willingness of skilled surgeons to visit isolated communities, being able to maintain the skills of nursing staff in providing operating theatre nursing services, as well as the need to invest in the infrastructure that is required to provide a safe environment in a location that has a relatively small volume of surgical activity, with Occupation Health and Safety standards now required of standard operating theatres.

Nationally, the number of skilled GPs available with the experience and competency needed to provide specialist services, and particularly anaesthetics, is reducing. Medical graduates with anaesthetic training and experience will be required to undertake short placements in tertiary hospitals. In these environments, they are exposed to a range of complex and simple anaesthetic services to ensure they develop and maintain their skills and competency. Their continuing ability to provide anaesthetic services in rural communities depends on their continuing exposure to a range of anaesthetic services, including more complex cases, and their commitment to and participation in a complex program of continuing medical education. In the past this has been done, mostly on a voluntary basis by a large number of rural GP anaesthetists anyway to stay up to date. This is soon to become mandatory.

Country Health SA will continue to work with Yorketown Hospital, the Yorke Peninsula Health Advisory Council and local GPs to support ongoing appropriate medical services in the area.

There will always be a need for appropriate Accident and Emergency, in-patient and after-hours services for the community and visitors to the Yorke Peninsula.

These and the range of other complex medical services treating both acute and chronic conditions currently provided at Yorketown Hospital will continue to be supported. It is also important to note that services will continue to be supported by the nursing staff, who continue to deliver high quality nursing care both in the theatre and other hospital-based services.

Yorketown Hospital will continue to provide accident and emergency, overnight care and colonoscopies. Visiting specialists will continue to provide outpatient consultations locally; however a small number of surgical procedures including general surgery, gynaecology and urology will instead be provided in Wallaroo Hospital. END