Next bookings ...

Intermittently in Gladstone, then booked for three weeks at Mossman over Christmas and New Year, where Lesley and possibly Caroline will come for part of the time.

Locums not being paid by Queensland Health ??

The regions responsible for paying locum doctors under the new directive from Queensland Health that obligates locums to be paid by a third party, not directly by QHS, (see the document here) seem not to be paying as required under the new policy. You work after hours and get called back, no pay ?? ... the regions concerned appear to be insisting on the old "daily rate for all work" but happy to proceed with the disadvantages imposed on us by the new arrangement.

Have it both ways hey ? if you are locuming in Queensland, watch your back and your purse !

ps ... I actually have my first locum coming up next week under the new system. I am in possession of a signed contract (signed by the district CEO) that states clearly I will be paid call-backs at the rates specified in the QHS policy. I will post here the outcome of whether or not I get paid as they have agreed to.

Update 18th September :

I am uncertain of the circumstances any more than what I have been told by the locum service but it now appears that the two regions in particular who were appearing to be not paying for call-backs will pay. There may also be an issue with locums charging for oncall time as call-back time ... hopefully this teething stupidity settles quickly.

I have also been told that the QHS policy is going to be changed. Bet you they will attempt to remove call back payments all together. Watch this space.

Apparently ...

... the med super here booked a long time in the past a training weekend this weekend in Cairns.

Apparently the locum that was booked to cover this weekend let the administration services who look after locums three weeks ago that he could not cover this weekend.

Apparently the administration services forgot to let the med super know this - she found out this morning.

The advanced rural trainee registrar is also on pre-planned training leave, starting tomorrow and over the weekend.

Today is Tuesday. A locum who will be arriving tonight to start tomorrow will be doing a 24hr shift Friday and a 24hr shift Sunday. Obviously that locum cannnot also do 24hrs Saturday to make it a 72 hours shift without a break. Safer to have no doctor than a "dead tired" doctor.

Apparently if urgent cover cannot be found Mossman Hospital will be without a doctor for 24 hours 08:00am Saturday to 08:00am Sunday.

Interesting ... very interesting.

*waves at the minister's office media monitors*

PS. I plan on being up here 21st December - 10th January ...

How long is too long ?

I wonder sometimes how one knows if you have been in a place too long ... is it when you start getting emotionally attached to the local politics of an area ?

This place suffers from the disease of many ( I can't say "all" as I have not been "everywhere" yet to find out, but it would be fair to say that every rural area I have worked in has so far qualified) rural communities - the lack of resource.

And why would this be so ? ... I ask myself tempting myself to make a gratuitous, opinionated reply ... would it possibly be due to the lack of political will of those possessively grasping the purse strings ? What does it take for the focus of attention to be placed where it needs to be ?

Did you know that this area used to have two helicopters for medical transport ? ... there is no local airstrip so RFDS cannot provide a fixed wing service. Well apparently one of those helicopters is broke (rumoured permanently) and the other has been relocated to Townsville. It also appears that this gap in service has not been compensated for by increasing the resources to the local ambulance service who are now required to do the three hour round trip to transfer patients to the next level of medical care at Cairns. Earlier this week I needed an urgent transfer of a patient to Cairns but because the local service had been already overworked and for safety reasons was off duty, "fatigue leave" I think its called, an ambulance was required to drive the hour an a quarter from Cairns to pick up the patient. Fortunately the delay did not compromise significantly her care, but it could have.

The doctors who work here (currently three but a minimum of four is required for safe, quality service) work, when they do their 1 in 3 nights oncall, can work quite long hours, and sometimes unsafely so ... who provides them with fatigue leave ? .. yeah you guessed right, no one ... well actually they could, but then no one is available to provide the medical service needed (unless of course a doctor was able to come from Cairns to cover the 8 hours fatigue break .. its only a short helicopter flight !!). Maybe the local GPs could organise a roster to help out ?? And of course the penny-pinchers looking at the costs of the services in Mossman are complaining because the medical services budget is running "over budget" ... cut costs ? ... well where are those excess costs ? .. the overtime and the additional cost of employing locums of course. Cut costs ? ... Yes Minister, sure easy, no after hours medical service for the whole of the region, including the very significant population of Port Douglas who would no doubt prefer to travel the 20 minutes to Mossman instead of the well over an hour to Cairns.

Funding needs to be urgently found and committed - not like the funding that just mysteriously disappeared to employ an allied health worker just this week - really committed, to employ four doctors here full time (this would actually be cheaper than the current three doctor costs). This place is the perfect place for advanced rural general practice training leading in the a Rural Generalist specialty recognition. There should be no shortage of people wanting this sort of work - it just needs the funding.

And why not have an intern rotation here ?? ... in the next year or so there is in fact going to be a shortage of internship positions and it appears that only australian citizens will be guaranteed a position. Overseas students paying (very big) money to train in Australia may not be guaranteed a place for their first year after graduation. Give interns 3 months here under the mentorship of the doctors here and they will get a life-time of experience here. There is "good medicine" to be had here for all.

Caveat ... no I did not get paid, bribed or receive favours for this, as those of you who know me will be aware, I speak my mind.