Rural towns fight to save services 

Forbes, Parkes nurses lead community campaign to safeguard maternity, surgical services. 

 Residents of the central west towns of Forbes and Parkes have joined nurses and midwives at public rallies to protest against downgrading of local health services.

The well-attended rallies were organised by NSWNMA branches at Forbes and Parkes district hospitals, which are 33km apart.

Parkes maternity service has been “temporarily” closed and shifted to Forbes due to a shortage of GP/obstetricians and anaesthetists.

Management said the closure would last two months.

However, it follows a review of maternity services within Lachlan Health Service, which covers 
both hospitals.

The review recommended Parkes maternity service be downgraded from Level 3 to Level 2 and elective surgery possibly shifted from Forbes to Parkes.

Parkes shire has a growing population of about 15,000 and Forbes shire’s population is around 10,000. Each maternity service handles about 150-160 low to medium risk births per year.

NSWNMA branches at both hospitals have called for the formation of joint management/union consultative committees to examine options for change.

Forbes’ NSWNMA branch also called for an emergency plan to manage the increased maternity workload and workflow affecting the rest of the hospital.

It said current staffing levels are unsafe to cope with a doubling of birth numbers.

Another blow to the bush

Nurse Kristin King, president of the NSWNMA’s Forbes branch, said downgrading health 
services threatens the viability of rural communities.

“This is not a fight between Forbes and Parkes. Both towns deserve a decent medical service,” she said.

“Management say they are looking at ways of managing the Lachlan Health Service budget blow out. 

“The state government needs to step in and help the health district to encourage doctors to come to our regional areas, and if necessary offer incentives to help keep them.”

Kristin said Forbes operating theatre has averaged 640 cases per year over the last three years.

“Losing elective surgeries would have an enormous impact on Forbes and the surrounding district. Some patients will choose to go to Orange or Dubbo instead of Parkes and there is no guarantee our surgeons will go to Parkes.

“With all maternity cases coming to Forbes we also have to provide emergency theatre staff. We don’t know how we will do that if our theatre staff are made to go to Parkes.”

She said Parkes maternity patients should not have to travel to Forbes or vice versa.

“The two maternity units ran quite successfully for a very long time. The thing that has brought Parkes undone is they have lost their doctors.

“What is the health ministry doing to solve the doctor shortage in country areas other than closing down hospitals and taking services away from country people?

“Take away hospital services then the teachers and other workers leave too. If your job is movable and you have other options why would you stay in a town without a fully functioning hospital?”

Doctor shortage “long foreseen”

Midwife Hannah Wilton, NSWNMA branch steward at Parkes hospital, said the two-month closure, with no anaesthetists or obstetricians booked thereafter, meant the maternity service had been effectively downgraded without any risk assessment or consultation with staff and the community.

Parkes midwives who work under a midwifery group practice (MGP) must now travel with their patients to Forbes, which faces a doubling of its birth numbers.

She said this was a blow to many local women, including Aboriginal women, who would be removed from local support services and families.

“This will affect the ability of women to receive timely, appropriate and cost-effective care in their community.

“A lot of our mothers don’t have their own transport, and there is no public transport. Even if we take them to Forbes by ambulance, how do they get home?”

Hannah said reducing the Parkes service to level 2 would restrict births to category A (low risk) women with no obstetrics coverage.

“That would effectively make the MGP non-operational.” she said.

“Parkes midwives have not been trained to work without an obstetrician. Even a low-risk woman with a secondary degree tear would have to be sent somewhere else to be sutured.

“By downgrading Parkes midwifery service to level 2, we would be unable to treat obstetric emergencies on sight and the lack of infrastructure would prevent timely transfer of women to a higher level of care.”

Parkes Shire Mayor Ken Keith said the doctor shortage had “long been foreseen” and “should have been proactively planned and managed by Western NSW Local Health District.”

“We certainly feel confident in the ability of the amazing team of Parkes midwives. However, they should be supported by a suitably qualified doctor,” he said.

Councillor Keith said the community had done its part to attract doctors by raising over $100,000 through programs such as the GP Working Group and fundraising initiatives like the GP Cup.

The Forbes Advocate newspaper said Scott McLachlan, chief executive of Western NSW Local Health District acknowledged the closure of Parkes maternity unit had been “sudden, and not communicated well.”

“I know it has been distressing for our communities, pregnant mums, and our staff, and I apologise,” Mr McLachlan told the paper.

“We’ve struggled for a number of years now to maintain the service with the right number of doctors and midwives and that’s not something that is going to go away any time soon,” he said.