A new threat to rural Queenslanders?

The Inquiry into Queensland Health, that has brought so much adverse publicity for the Beattie Government, has been a distraction for all sectors of the community in Queensland.

The daily revelations, twists, turns and backflips have been a circus watched from the sidelines by local government stakeholders.

That was until the then Commissioner Tony Morris commented, “We may have to abandon the idea of small, one-doctor hospitals in country towns”. For a host of mayors, councillors and officers from “country towns”, those were fighting words!

Suddenly the ears pricked up, and the inquiry ceased to be of just general interest.

The then Commissioner was suggesting an action that would directly and adversely impact on the communities of country towns. Local councils are very interested in those sorts of impacts.

There are many threats to the survival of many small communities in rural, regional and western Queensland. The loss of any one of a number of critical services or industries in those communities could well be the straw that breaks the camel’s back.

The State Government is a past master at cutting back its presence in rural and regional Queensland - for all of the right economic rationalist’s reasons - but forgetting, overlooking or simply ignoring the cumulative effect on small communities.

For example, a couple of families leave town because the rail maintenance can be centralised, and all of a sudden the local store is less viable, the school doesn’t have the numbers to justify two teachers, and the downward spiral accelerates.

One of the key and essential services that keeps people in a community is the availability of medical and hospital services.

For a one issue inquiry, with a focus on the institution of Queensland Health, to be proposing an action that would almost certainly have wide ranging and debilitating effects on those communities, shows a blinkered and unrealistic understanding of the forces at work in rural and regional Queensland.

Removing hospital services from rural communities would have a real and devastating effect on the health of citizens living in those communities. Ultimately, it would ruin many of those communities.

Not only are hospitals in these communities often the major employer in town, they also support indirect employment in allied health services. The costs of operating medical services in these communities are insignificant when compared to the economic and social costs to these communities if they were to lose them.

These vital medical facilities help keep residents in rural towns and they attract professionals and younger families to settle there because of those services. Transport of patients over large distances to the nearest hospital would also create major problems.

There are several councils in rural and regional Queensland that have already taken action to hold their communities together when essential services were under threat. Councils have stepped out of the “normal” or “core” range of local government services to get involved with non-core services that have been withdrawn by other levels of government or private enterprise.

It is an insidious form of cost shifting - where local councils take on a role in providing services (like medical, banking, postal, commercial and educational services) simply to maintain a standard of living that will retain or enhance the viability of their communities.

A case in point is Kingaroy Shire Council, which a few years ago stepped in to maintain choice and breadth of medical services. The imminent retirement of the resident general surgeon and the uncertain future of St Aubyn’s Private Hospital threatened a continuing system of general surgery in Kingaroy.

The Kingaroy & South Burnett Medical Workforce Strategy was developed, focusing on increasing and stabilising the supply of general practitioners and specialists in the community.

The strategy required a decision on the future of the private hospital. Council took the initiative and purchased the private hospital (34 beds) which had closed, and now employs a management company to manage and report on daily operations. Funding was accessed to assist with the initial operating costs. Now it is locally owned, has a full complement of staff, and provides local employment and economic benefits to the region.

The reopening of the private hospital and its services has overcome the shortfall in medical services experienced since its closure (especially, but not only, to holders of private health insurance) and is helping to provide the service necessary for a regional centre.

It does not take a great deal of imagination to predict that closures of one-doctor state hospitals in small country towns across Queensland would see more councils forced down the same path.

There are many examples of the local councils currently doing the job of either the State Government or private enterprise in subsidising (propping up) medical practices and services in country towns.

Local government simply cannot support the model proposed by Mr Morris because it fails to address the community needs and expectations that there will be access to quality clinical services in their community.

It would be a great pity if an off-hand, knee-jerk reaction to the dysfunctional bureaucracy that is Queensland Health, was the reduction of medical services in the bush - resulting in a gigantic shifting of costs to local communities that struggle to remain viable at present.