One rural birth unit is a “brink-on-the-brink teaser” that moves from one disaster to the next disaster due to a serious staff shortage.
Another maternity service in an agricultural town of 15,000 people was closed four years after opening the door, kicking professionals and healthcare workers out of town.
Fly-in Fly-Out Locam Doctor supports two birth units in a prosperous agricultural district in northern New South Wales (NSW).
These are some stories about the state of rural obstetric care in NSW that led the Congressional Committee to declare an imminent crisis.
“The decline in rural obstetric services is detrimental to women, their families, and the broader health care systems in remote, rural and local NSW,” the Congressional Committee’s report, released on March 27th, said.
“As a result of unavailable and/or under-staffed birth and obstetric services, the committee has heard that women must travel up to… hundreds of kilometers.”
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Many of these challenges have been experienced nationwide, with half of Australian birth units closed between 1990 and 2015, and only 15% of rural obstetricians working there were closed.
The NSW Committee has been looking at years of what advances have been made in rural healthcare since a 2022 survey found that medical outcomes were far worse for rural areas.
That second report focuses primarily on access to obstetric care, mental health services and bush pediatricians, and has painted equally disastrous pictures for nearly three years.
The committee found that many pediatricians working in local public hospitals have lost the ability to see non-emergency patients and that children drift through developmental conditions.
Waiting lists for viewing public pediatricians in your area can vary from 18 months to 6 years.
Royal Far West, a charity that connects rural families with experts, provided evidence that children with developmental delays were presented at 10am.
Rural mental health care and drug and alcohol services have also not improved since the 2022 survey.
NSW health executives have given evidence of reforms to improve rural care, but the report says there has been a “significant disparity” between the government’s views and the staff and patient experience.
“The impression of the committee from the government’s response is that NSW health is not approaching some areas of local health reform with a proper sense of urgency,” he said.
The committee has made 32 recommendations, including an urgent assessment of the rural obstetrics department to develop plans to reestablish services.
After evidence that obstetricians view rural work as “dangerous” and “unwanted,” the committee recommends that NSW health activities identify and remove barriers at training colleges.
We also recommend auditing and investigating cancer care, palliative care, drug and alcohol services.
The NSW government will formally respond to the report at a later date.
