Clermont Hospital’s $1.5m for four-person team too high for MHHS

A $1.5m proposal to solve a country town’s doctor shortage was deemed unjustifiable factoring in the number – and seriousness – of hospital admissions.

Clermont’s doctor shortage remains in limbo after a proposal for a four-person outfit was deemed too costly for the expected patient load.

Mackay Hospital and Health Service chief medical officer Dr David Farlow said Clermont Hospital averaged 10 emergency department presentations a day, the majority considered category four and five patients.

The Australian Triage Scale considers category four cases to be potentially serious with patients recommended to be seen within 60 minutes of arriving at hospital.

Category five are less urgent and should be seen within two hours.

Dr Farlow said MHHS “could not agree to the proposal by “Clermont4Doctors for three doctors and a nurse practitioner at Clermont MPHS”.

“The proposal put to the health service was for one full-time doctor, two doctors working 0.8 of a full-time position and a nurse practitioner,” Dr Farlow said.

MHHS chief medical officer Dr David Farlow.

“We cannot justify paying three doctors and one nurse practitioner for so few patients.

“Additional requests to be paid 25 per cent above what other doctors in similar roles receive, less on-call than other rural doctors and additional annual leave made this proposal unsuitable.

“We cannot in good conscience spend more than $1.5m on this proposal at the expense of our other rural hospitals that have triple the activity of Clermont with fewer clinicians.”

Clermont, about 290km west of Mackay, has struggled to recruit a permanent doctor and instead has been serviced by the town’s two GP clinics and a MHHS locum doctor.

Advocacy group Clermont4Doctors has been liaising with MHHS to secure a permanent doctor at the hospital.

The group, supported by mining company Glencore, on Thursday hit out at MHHS, saying the packages offered to prospective doctors have “continued to fall short of what has been discussed and agreed upon”.

“Clermont4Doctors in collaboration with Clermont Country Practice had recruited two doctors that were willing and able to relocate their families to Clermont for permanent positions,” the group, in a lengthy post on social media, said.

Janelle Otto of Clermont4Doctors. Picture: Contributed

“The Clermont Medical Model negotiated and developed by all local stakeholders and agreed upon by Mackay Hospital and Health Service executive exemplified sustainable and equitable medical services for the Clermont community with built-in redundancy to combat professional isolation, burn out and fatigue.

“Unfortunately one of our doctors have now withdrawn their application due to the inability to obtain an offer of employment from MHHS that is clear and transparent within a timely manner.

“The inability of MHHS executive to effectively attract and retain interested doctors both now and on previous occasions, due to contractual negotiations and a history of unsafe workload expectations, has become the stumbling point in securing and retaining doctors for the Clermont community.

“The two interested doctors we recruited were a fantastic fit for our community and promised the dynamics of an integrated health team that we so desperately needed for our community.”

Clermont, about 290km west of Mackay, has struggled to attract and retain doctors. Picture: Tara Miko

A current job listing for a medical officer with private practice in Clermont specifies remuneration up to $234,784 a year, with a salary between $159,479-$169,424 per annum, and employer superannuation contribution up to 12.75 per cent, and annual leave loading at 17.5 per cent.

The doctor’s responsibilities include attending “to patients in accident and emergency as required at the hospital” and conducting “a daily inpatient ward round”.

The position, to be based at Clermont Hospital, was listed on December 9, 2021.

“Mackay Hospital and Health Service is committed to establishing a sustainable medical model to support hospital patients and aged care residents in Clermont,” Dr Farlow said.

“However, this cannot be at any cost.

Clermont Multi-purpose Health Service.

“We must make judicious use of public money and could not agree to the proposal by Clermont4Doctors for three doctors and a nurse practitioner at Clermont MPHS.

“The health service still believes the best solution will be a generalist medical model that not only supports Clermont, but the whole of the Isaac region and our hospitals in Dysart and Moranbah.”

Dr Farlow said MHHS was prepared to have the four-person outfit Clermont4Doctors proposed based in Clermont “on the proviso the full-time doctor also works on expanding the model for the whole of Isaac”.

“We also were prepared to offer the other two doctors a 0.5 position so they could work the other half at the GP surgery,” he said.

“Mackay HHS will continue to use locum doctors to care for emergency department presentations, hospital patients and aged care residents while we work on a solution for the whole of Isaac.

“The solution also has to include the Commonwealth government which has responsibility for primary care (GPs).”

Queensland Health payroll system data shows Clermont has one doctor and 24 nurses on staff, with one health practitioner/professional/technical position.

Dysart Hospital has nine available beds and available bed alternatives, with a nursing staff of 15.

Long-term Dysart GP Dr Sunday Adebiyi has a contract with MHHS to provide medical services to Dysart Hospital, which was awarded following a tender process and includes provision for Dr Sunday to employ a number of doctors needed to meet demand at the hospital and his private GP.

The same data shows Moranbah Hospital has a nursing staff of 22, and a contract in place to meet doctor requirements.

The data does not include “staff who work at this facility but are attached to positions of other facilities”, and zero staff “does not necessarily mean there are no staff working at the facility”.