Victorian election: Regional hospitals sidelining specialists

Doctors say the situation in Victorian Premier Daniel Andrews’ home town of Wangaratta is not isolated.

Victorian Premier Daniel Andrews and wife Catherine speak with a patient at Wangaratta Hospital in 2018. Picture: AAP

Highly experienced medical ­specialists have been sidelined from a regional Victorian public hospital and replaced with a ­revolving door of locums, in a move doctors warn is having ­adverse outcomes for patients.

Medicos say the situation in Victorian Premier Daniel ­Andrews’ home town of Wangaratta is not isolated, with some ­accusing the Andrews government and health department of a covert agenda involving the replacement of fee-for-service specialists with salaried staff, even in circumstances where no suitably qualified staff are available.

With 32 years’ experience in the northeast Victorian city, Phil Macleish was the most senior of six physicians notified via email by Northeast Health Wangaratta in October last year that their visiting medical officer contracts would not be renewed.

He and his colleagues – who ­include two physicians he recruited from Germany 17 years ago – ­remain living and working in the city, but unable to treat public ­hospital patients.

“Instead the hospital administration has its medical department run by expensive locum physicians whilst they appoint, or ­attempt to employ, new staff physicians … who only work at the hospital and do not provide the vital community consulting, investigational work and visiting services to local towns that have been provided up until now,” Dr Macleish said. “Despite repeated attempts to negotiate a solution to the situation, NHW administration will not enter into any meaningful dialogue.”

Dr Macleish said he, local state Nationals MP Tim McCurdy and federal independent MP Helen Haines had all written to the ­Andrews government and ­received no adequate explanation.

“My colleagues and I are still working in the community. We are very regularly asked by our GP colleagues to see patients who have been discharged from hospital but for whom no adequate physician follow-up has been ­arranged,” he said.

“NHW claim that their ‘new model’ … is a better system. The feedback we receive on how things are working from our GP colleagues and visiting medical officers from other disciplines is quite the reverse.”

The Weekend Australian has been made aware of similar ­instances involving surgeons in Horsham and a dental surgeon in Edenhope, in Victoria’s west.

“All I know is that just about every hospital in regional Victoria is an unhappy place,” said Ian Campbell, who has been forced into an early retirement as a Hor­sham surgeon.

“It’s very definitely Victorian health department policy and Labor government policy that doctors be salaried (rather than paid a fee for service), but the health department won’t admit that’s their policy,” he said.

“It’s really disappointing that people who’ve come to country towns, made a commitment to country people and a country lifestyle are then just being treated shabbily by hospital administration and government.”

AMA Victoria president ­Roderick McRae said his organisation was “agnostic” on whether hospitals employed salaried or ­visiting specialists, but the Wangaratta example “would appear to be an exercise in absolutely how not to manage a negotiation”.

Dr McRae expressed concern about the capacity for locum staff to provide continuity of care.

NHW said it had “enhanced the specialist services it provides the community”.

A spokeswoman for the health department said it “does not have a policy position on the employment arrangements for VMOs or staff specialists”.

“However, the department is supportive of health services changing their employment conditions for senior medical staff, where those changes improve the quality and safety of patient care,” the spokeswoman said.

An Andrews government spokeswoman said medical ­appointments were a matter for individual health services.