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House of Assembly - Fifty-Fifth Parliament, First Session (55-1)
2024-03-05 Daily Xml
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Regional Community Nursing Services

Mr McBRIDE (MacKillop) (15:10): I rise today to highlight changes announced by the Riverland Mallee Coorong Local Health Network and the Limestone Coast Local Health Network, where the Coonalpyn, Tintinara and Lucindale community health clinics have transitioned from a drop-in service to an appointment-only service with no consultation with the community. This has negatively impacted the delivery of community nursing services to these towns. I am calling for an immediate review to this change with the view to have it reinstated to its original form as soon as possible. I disagree with SA Health's assertion that:

An appointment-only service will provide certainty for consumers, who can book in their care either in the clinic or at the consumer's home and know that the care will be provided.

This has certainly not been the experience of many of my constituents who have raised this issue with me.

I would like to provide a small snapshot of some of the negative feedback that has been brought to my attention in recent weeks. This includes people required to drive 50 kilometres from Lucindale—a 100-kilometre round trip—to get a blood test in Naracoorte, after fasting for 12 hours. Or, in the case of those who live in Tintinara, having to drive to Murray Bridge on the busy highway, which is a 2½ hour round trip.

Many of these people are elderly and after fasting for such a long period of time, the risk of an accident is increased. Some elderly patients are also unable to drive or have restricted licences and do not have family or friends to take them. There is also no public transport available for these people.

Nurses local to the area have now been replaced by nurses from out of the region, compromising continuity of care. The nurses are also required to fill out extra paperwork for patients, adding an extra 30 to 40 minutes in patient consultations prior to any treatment commencing. People are resorting to doing their own wound care because they cannot get an appointment. The intent of the change was justified by SA Health, which said:

These services are extremely valuable to the community and the intention is not to reduce services but rather to deliver them in a new model that maximises the precious resource of nursing care.

Again, this has not been the experience of my constituents in these towns.

It has also been justified that the service is not large enough for exclusive administrative support, so appointments will be managed by the central Country Health Connect line. For those in Coonalpyn/Tintinara, it means ringing the Murray Bridge hospital, and for those in Lucindale, the Naracoorte Hospital.

Centralising of the switchboard has left many patients with no idea when they can come in and receive care. A constituent in Tintinara phoned to make an appointment for a blood test, left a message on an answering machine and was called back a week later to be told they needed to go to Murray Bridge due to the service no longer being available in Tintinara. So, a five minute walk down to their local community nurse in Tintinara has now become a two to three hour round trip to Murray Bridge.

The clinics have also changed the scope of their practice and no longer offer certain services, including ear syringing, ECGs, removal of sutures and point of care INR testing services. To think that patients who present needing sutures removed now have to book an appointment with the doctors at Lucindale whose waitlists are already close to four weeks makes no sense and is far from an efficiency gain.

I reiterate: locals in regional areas rely on community health nursing services. They negate the need to travel to larger towns such as Naracoorte, Keith or Tailem Bend. These services have helped keep people out of hospital or from needing to see a doctor. We know there is a major doctor shortage and these changes will impact the entire medical system.

I honestly believe that if community nursing is not easily available, people, especially the elderly, will think it is too hard. They will not bother trying to make an appointment and so their health outcomes will suffer. Rural communities need experienced nursing staff who can do a broad range of procedures. There is no one-size-fits-all approach when it comes to the health needs of small communities.

In small towns like Lucindale, whose resilience has been tested in recent years with three fires and, more recently, the tragic loss of their police officer, Jason Doig, why change a healthcare model that was servicing a community well and providing a huge community value? I am calling for community nursing services to be reinstated to their original form in Tintinara, Coonalpyn and Lucindale as soon as possible.

It is very sad to hear all of these sorts of issues come to a head where it has been well catered for. It has been suggested that Gayle's Law is getting in the way of security for some nurses, but it is not even meant to apply south of Adelaide. We know that GPs are being backed up by community health nurses and services. It is absolutely outrageous to think that the doctor shortage in regional South Australia cannot be backed up by better community services, which these clinics used to provide.

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