A doctor who has serviced the Jamestown, Peterborough and Orroroo hospitals in South Australia's mid-north for decades has withdrawn her services due to contract disputes with SA Health and the Rural Support Service.
Rowena Conway has worked in the region as a GP and an obstetrician for almost 30 years and the contract only allows one doctor to service one specific hospital at a time.
She said she had tried to settle the dispute with department officials but repeatedly faced roadblocks.
"We're much more flexible than that, since we have doctors who will travel to each town and we have doctors who will be on-call for two towns," Dr Conway said.
"If they're caught up in another town then someone else in the system can back them up.
"We've got flexibility, but the contract doesn't seem to understand that.
"The roster doesn't show what we do and how well we support each other.
"The Rural Support Service (RSS) — who are deciding the contracts — doesn't understand how hard we're working.
"We're looking to get a good contract so we can attract young doctors to the area.
"We feel unsupported, undervalued, and ignored."
Dr Conway said the governing staff at the Yorke and Northern Local Health Network had been supportive but there was a lack of understanding from the RSS.
"I'd like to negotiate contracts with the person who I can see and who will admit responsibility," she said.
"But at the moment, I'm shadow boxing."
Invoices 'rejected'
Dr Conway said she was also six weeks behind on her pay.
"I'm not getting paid adequately and my invoices are being rejected by the Rural Support Service," she said.
"I'm still dedicated to serving the area and I'm not going to leave."
In a statement, a spokesperson from the Yorke and Northern Local Health Network said the contract with Goyder's Line Medical Centre needed to be revised.
"We are working with Goyder's Line Medical Centre to address their concerns as quickly as possible," the spokesperson said.
"We are diverting emergency care at Peterborough and Orroroo hospitals through the South Australian Ambulance Service and MedSTAR as per our contingency plans.
"We will also use the South Australian Virtual Emergency Service where appropriate during this temporary change to services."
The network's chief executive, Melissa Koch, said a locum would cover Peterborough and provide phone support to Orroroo from 6:30pm on Wednesday until 8am on Friday.
"We have met with site leadership to update them, and would like to reassure our staff and the community we are treating this matter with the utmost priority," she said.
Pay delay
Dr Conway's colleague, GP obstetrician Simon Jackson, said he also experienced trouble receiving his pay on time, despite not having had a day off in three weeks.
"There's recurring issues with us getting paid for the work that we do at the hospitals," he said.
"It seems to be every fortnight when we submit for payment there's a delay or new reason or issue for why we can't get paid for the work we've already done."
Dr Jackson said if the issue continued it would make it extremely difficult to attract more GPs to the region, which was already understaffed.
"At the moment we've got about four or five GPs trying to do the work of nine or 10," he said.
"It would just be good if SA Health and the Rural Support Service could just make it slightly easier.
"All we're asking is to be paid for the work we've already done rather than wasting our time trying to chase our payments, so that we can concentrate on the work that needs to be done with this critical workforce shortage."
Premier Peter Malinauskas said he understood the challenges rural and regional doctors faced.
"They are doing extraordinary work under often difficult conditions," he said.
"The simple reality is that we can't afford to lose GPs."
Hope for speedy outcome
Health Minister Chris Picton said he had spoken to the acting chief executive of the Yorke and Northern Local Health Network and that work was underway to find a solution.
"There's a strong desire from the local health network to resolve these issues and to make sure those high-quality services can continue to be provided," Mr Picton said.
"Hopefully we will have an outcome very quickly.
"We need to better engage our rural GPs in our health services, because we need those services.
"Regional service is an area we do need to improve."
Northern Areas Mayor Ben Browne said the issue was a big concern for all the communities involved.
"Doctors need to be properly remunerated to be in the region and they need appropriate rest and time off, the same as anybody else does," Mr Browne said.
"The idea that a doctor has one day off in four weeks — I don't think anybody would regard that as reasonable, wherever you work.
"I've been with Dr Conway at various situations, when she turns up at accidents on the side of the road, and she does a marvellous job."
