I am starting to feel something akin to outrage at the way Kangaroo Island’s doctors continue to hold medical services on the island to ransom.
See my earlier post for more details about the background.
Briefly, after a long period of negotiation between government and doctors’ organisations, a contract was offered to rural doctors under which they would provide medical services through local hospitals.
Doctors were under no pressure to accept the contract. If individual doctors or practices believed they could not take responsibility for providing the specified services, or that the remuneration offered was insufficient, they could decline CHSA’s offer.
Country Health SA would still have a responsibility to provide those services, and would then need to set up their own clinics, or supply visiting doctors. Obviously, local GPs would hardly then be in a position to complain about unfair competition!
The contract was designed to provide consistent services in rural and remote SA, at a fair cost to the taxpayer, and with fair remuneration to local GPs.
The Rural Doctors Association of SA recommended doctors accept the contract, although not perfect, as the best possible outcome for a first attempt at a uniform contract.
Although some practitioners believed that the amount offered as an on call allowance was inadequate to cover the costs of disruption to practice, the vast majority of doctors accepted the contract, knowing that it was essentially a ‘trial run’ that would only last for eighteen months, while further fine tuning was done.
The amount of the on call allowance is $135,000 per annum, or approximately $370 per day. It is the highest rate of on call allowance paid to doctors in any state in Australia. It is a payment simply for being available. If a doctor is actually called out to the hospital both travelling allowances and normal fee for service rates are paid.
Doctors on KI have said they are willing to accept the contract except for the on call services, or that they will agree to provide those services if more money is offered.
CHSA has said said right from the beginning that neither of these are options. One of the reasons for the negotiation of a new contract was to break the old system which was inconsistent, unfair to taxpayers and the majority of rural doctors, and frequently offered higher pay to doctors in monopoly practices for no other reason than that they were willing to blackmail the health department by refusing to provide services until their pay demands were met.
Everyone agreed that this was unfair and had to change. Again, see my previous post for more detail on this. It would simply be wrong for CHSA to agree to a special deal for KI doctors. There is nothing to justify treating KI as different from any other remote SA community.
Sadly, despite the fact that CHSA has been perfectly consistent in its message, KI doctors continue to represent themselves as victims of some sort of government conspiracy.
Claims are made that CHSA has acted in bad faith. It hasn’t. That locums have provided sub standard services. They haven’t. That CHSA has issued threats. It hasn’t.
What CHSA has said is that doctors are free to accept the contract or not. If they do not, then those services have to be provided in some other way.
I am pleased to see that CHSA has finally bitten the bullet on this.
After nearly a year of waiting, discussions, and disruption to local medical services, they have given doctors a deadline, the 12th of November, by which the contract must be signed. If doctors do not agree, then CHSA will begin to consider other means by which services may be provided.
The doctors will say that the island doesn’t need this, and doesn’t need another clinic. That is debatable. What is not debatable is that the people of Kangaroo Island have a right to reliable medical services.
If local doctors choose not to provide those services, they can hardly complain when Health SA does.