PENOLA'S medical services are in dire straits and something needs to be done.
That was the message at the medical services public meeting at Rymill Hall on Monday night - attended by well over 200 local residents.
Outgoing Penola Medical Clinic doctor Francois Pretorius, who this month resigned from the practice citing an unmanageable workload and unreasonable hours, said the only way forward was to take the practice back from government hands.
"Without taking the practice back into private hands there will be no service," he told the crowd. "(A private practice) gives the ability to get better services, something that grows...in the constraints of a State-run facility that cannot happen."
Country Health SA has run the practice since 2008 after taking over the administration of all hospitals. Before that the practice was run by the hospital board, who took over the practice from the doctors in the late 1990s.
Dr Pretorius said in his opinion, the town needed a better deal.
"If we want something better that suits our needs, we need to privatise," he said.
Penola Medical Services Committee chairman Bill Murray and his group agreed.
"Penola is one of the few practices in SA run by Country Health and as we have seen they have not failed to supply a doctor since taking over from the hospital board," he said. "However we as a group think there may be a better model."
With Country Health's budget being continually trimmed, Mr Murray said it had reached the point where Penola needed to stand together to ensure a better future for medical services in the town.
He said a sole GP would not work - Dr Pretorius was working long hours but even then there was still a two week waiting list to see him.
"It's time we as a community need to do something for ourselves again," he said. "Penola in our opinion needs at least two full-time doctors and one part-time."
Mr Murray presented three options: retaining the status quo, privatising via a community group or inviting an already established private practice to set up in Penola.
"The support group has already spent a lot of time researching the various options," Mr Murray said. "We feel the safest option for the community would be to encourage option three."
He outlined some of the benefits of an established practice moving to Penola - experience, the ability to expand services, good contacts in regards to the supply of new doctors, better use of resources, more intra doctor support, better use of resources with a practice manager and a better ability to manage reasonable after hours service.
Negotiations with the government through Country Health to get a better deal for the practice would also be easier with a separate entity.
"It's easier to negotiate between two businesses rather than two levels of the same business," Mr Murray said.
"That might give you a reason as to why we need to have a private practice."
He felt option three was better than option two - although both would see the practice returned to a private enterprise - due to cost.
The cost of renting the building from the government alone would be hard going for the community.
"In the short to medium term the best option is to look for a private enterprise with two or three doctors," Mr Murray said. "We've certainly put a lot of thought into it."
He said the private enterprise would have a contract with Country Health to help patients in the hospital and aged care centre.
A question was raised about whether the medical services committee had already approached a regional practice to move to Penola.
Mr Murray confirmed this had happened already, and had almost come through.
"Yes - in short we have approached a couple of practices," he said. "The first was prepared to provide doctors but not any after hours care or services to the hospital."
He said the committee had been in discussions with a second practice.
"I can't go any further than that," Mr Murray explained. "If this doesn't come off we'll explore other options."
SE rural regional director for Country Health Jayne Downs was on hand to give Country Health's stance.
"Whatever option is chosen will set the community up," she said. "Country Health SA has a commitment to local health services but also commitment to a strong network of health services in the region."
A question was raised to Ms Downs about who would supply nurses to the practice in the event of its privatisation.
"The (current) arrangement is Country Health SA supply support staff, the hospital is well supported at the moment," she said. "That would be a quite viable proposition."
On the future of health services in the town, Ms Downs assured the crowd: "You don't need to feel concerned...there are services here for you."
Mr Murray thanked the departing Dr Pretorius for his contribution in Penola.
"He has stimulated this group to have a bigger vision," Mr Murray said. "Penola can be the hub of a great practice."
He concluded a strong community needed to have three things: strong medical services, a strong education system, and security.
"Penola is doing well on two out of three...on the third we can do better."
Dr Pretorius will finish at Penola on March 22. Country Health SA will provide locum GP services while a longer-term solution is sought.
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