It has been more than three years since a maternity unit in western New South Wales was used to deliver babies and there are fears birthing services will never return.
In 2015, a $72 million hospital, which included state-of-the-art birthing suites, was opened in Parkes.
Four years later, residents were told they would no longer be able to give birth at the new facility because of short-staffing.
Instead, they would need travel to Forbes, half an hour south, or further to Orange or Dubbo.
The hospital at Forbes has faced its own challenges, with birthing services mostly run by locums, as well as two local general practitioner obstetricians and anaesthetists.
One of those is Greg Whittaker, who has been a GP in Forbes for more than 20 years but plans to retire within the next year.
He was concerned the services at Forbes, which residents of Parkes now rely on, also faced an uncertain future because of endemic problems within rural healthcare.
"I'd be very sad to see them left in disarray," Dr Whittaker said.
He was not optimistic Parkes would ever have fully functional maternity services again.
"They will have a lot of trouble attracting a sufficient workforce of midwives to provide that service, let alone the doctors," he said.
He said that was due to a statewide shortage of GP obstetricians and healthcare workers in general, saying workforce circumstances had declined "to the point that [towns are] lucky to still have a birthing service".
He said a potential collapse of full maternity care at Forbes would overload the system at Orange.
The empty maternity ward
Last year, the multi-million-dollar maternity ward at Parkes was turned into a space for COVID-19 patients.
Midwives have since been providing antenatal and postnatal care in another area of the hospital.
The midwifery team of two will move back into its dedicated ward but the Western NSW Local Health District (LHD) has not been able to recruit full-time specialists to restart birthing services.
The LHD said it "remains fully committed" to reinstating the services "as soon as possible" and has begun searching for both Visiting Medical Officers and locums across Australia and overseas.
It would be under a midwifery-led model, which would mean high-risk births would be transferred to nearby hospitals with obstetricians and anaesthetists.
Dr Whittaker described "soon" as a flexible term with no exact limits.
"It might well be in a 20 to 30 year framework, who knows," he said.
He said it was a failure of long-term planning and also warned operating with locums at Parkes Hospital had cost upwards of $1 million a year in the past.
"I think one would have to divorce the idea of a political commitment to providing the service from the idea of what is actually being planned in the immediate or near future," he said.
A statewide problem
Mayor of the Parkes Shire Council Ken Keith said he was "very disappointed it [the commitment] hasn't come to fruition".
Mr Keith said the budget was there but he did not expect full maternity services to be up and running for about 12 months, as some midwives had to receive clinical training and recruitment was ongoing.
He said in the three years women had not been able to give birth at Parkes, about nine midwives had left the hospital in search of work elsewhere.
As a result the LHD has had to look at alternatives, such as employing visiting staff on a casual basis.
"Locums are starting to be too costly for the health system," Mr Keith said.
But he believed full maternity services would start again.
In the meantime, he said the situation put mothers-to-be at risk.
"What's really important is that maternity at Parkes and Forbes continue to be serviced, otherwise everyone will need to go to Orange and that will overload their system as well," he said.
Mr Keith's daughter from Parkes had a "touch and go" birth 30 minutes after arriving at Orange, and was close to giving birth on the side of the road.
"That's an example of why we need to get full maternity happening back in the Lachlan area," he said.
The extra travel time would mean a more than three-hour trip for residents in Lake Cargelligo to give birth in the Orange Base Hospital.
