The Labor Government’s radical health cuts plan will undermine medical training and risks an exodus of medical practitioners from Adelaide’s hospitals, Shadow Minister for Health, Stephen Wade said today.
“The hospitals slated for a downgrade are at particular risk of not being able to offer accredited training and accordingly not being able to recruit and retain medical practitioners.
“For example, medical practitioners training to become surgeons must treat a certain range of cases.
“When TQEH, Modbury and Noarlunga hospitals are downgraded, life-threatening cases will be diverted to the mega EDs. Surgical registrars working at the downgraded sites won’t get to see the more serious and complex cases necessary to meet the College of Surgeons training requirements.
“Medical practitioners are likely to leave these hospitals which will seriously undermine the hospitals ongoing capacity to operate.”
Placements and internships are on the chopping block with the Repatriation General Hospital and Noarlunga Hospital currently being important teaching facilities for the Doctor of Medicine course at Flinders University.1
It is not just a matter of a hospital having an employment place for practitioners-in-training; they also need senior staff who can provide supervision in an accredited hospital. As the AMA puts it:
If Noarlunga becomes a day-only hospital there will not be enough patients or medical supervisors to teach these students. This will be a major blow for the university and the future of medical student training.2
It is particularly important that medical students, staff and their professional associations are fully engaged on changes. Accreditation is done on a site-by-site basis and takes time – training of current and future students will be disrupted unless changes are planned and implemented carefully and in a timely manner.
“The quality and sustainability of our health system is fundamentally underpinned by medical education and training. Labor’s radical health cuts plan threatens both,” Mr Wade said.
“Our hospitals are the people who deliver the care, not the bricks and mortar, yet this Government is treating health professionals as mere pawns on a real estate plan.”
WHAT THE HEALTH PROFESSIONALS SAY:
Royal Australasian College of Surgeons:
“Stand alone elective surgical hospitals are unlikely to meet standards for training requirements by themselves.” 3
Australian Medical Association (SA):
“…the reforms will result in a reduction of training places for our future medical practitioners in this state. Unless we have FACEM [Fellow of the College of Emergency Medicine] run EDs outside of the three ‘Super EDs’ we will lose future training capacity at Noarlunga, Modbury and TQEH and these positions will move interstate. In addition, as the EDs wind down at some hospitals, reducing the acute patient mix in those sites, and clinical services are reconfigured, more medical and surgical specialty training positions will be lost interstate.” 4
Australasian College of Emergency Medicine:
“If the upgrading of LMH and downgrading of QEH and MDH proceed, it is conceivable that Emergency Medicine will become undeliverable in South Australia. … As a large proportion of the medical staff working within SA EDs are trainees, this could also have serious implications on the overall delivery of emergency care across the State, and ultimately the long-term sustainability of SA’s medical workforce.” 5
Australian Medical Students’ Association President, James Lawler:
“It looks as though these reforms will reduce internship positions, specialty training positions, and leave many medical students without an appropriate place to learn”. 6
Flinders Medical Students’ Society President, Nicholas Stock:
“If these changes go through, we will see further congestion of the training pipeline and fewer learning opportunities for future doctors, ultimately affecting the quality of South Australian doctors”.7
Other medical bodies to express concern about the impact of Transforming Health on medical education and training include the Royal Australian and New Zealand College of Psychiatrists, SASMOA and the Australasian Faculty of Rehabilitation Medicine.
1: Twenty-five per cent of Flinders University medical students spend time on the Repatriation General Hospital site. In addition, Flinders students spend 12 months at Noarlunga Hospital.
2: Australian Medical Association, Submission to Proposals Paper, page 11 (February 2015)
3: Royal Australasian College of Surgeons, Submission to Proposals Paper, page 3 (26 February 2015)
4: Australian Medical Association (SA), Submission to Proposals Paper, Page 11 (February 2015)
5: Australasian College of Emergency Medicine, Submission to Proposals Paper, Page 8 (February 2015)