Rachel Fieldhouse “ WHILE we continue to have locums

the health system and doctors . “ It means credentialling for a

paid as handsomely as they are , we

particular post does not come at the

will continue to have excruciating

whim of health service management

workforce shortages .”

desperate to have a bum on the

Dr Rod Martin , ACRRM ’ s presi-

seat ,” he added .

dent-elect , told a state parliamen-

“ For locums , it means they only

tary inquiry last year that the fees

have to do that process once a year ;

locums were able to charge “ explain

they get ticked off as being able to

why we can ’ t attract more regular

provide a particular level of service

doctors ”.

for a particular location .”

Simply , doctors were earning far

He also said a cap on locum fees

more doing the same job as locums

was needed .

— $ 4000 a day in some examples —

“ A town north-west of here had

than they were ever likely to do as

a VMO that cost maybe $ 250,000 a

permanent doctors .

year to provide emergency services

“ The sting in the tail for having

to the hospital .

very well-paid locums is that people don ’ t want to get into a training pro-

Dr Rod Martin .

“ When [ the VMO ] left town , the cost for locums to replace them

gram because they can be a locum for

grew to $ 1.25 million .”

5-10 years and pay off their mortgage ,”

“ We had one who seemingly did

“ But we will have plenty of times

presentations , but they are hot

Queensland Health has already

Dr Martin added .

not do arterial and central lines , so we

where locums in outlying towns

zones , really busy .

gone down this path : locums are

The rural generalist in Armidale ,

had our rural generalist emergency

— either well-meaning or money

“ Some RMOs come out and , on

paid a maximum daily rate , such

northern NSW , told Australian Doctor last month that there were other problems .

“ We will have specialist anaesthetists who are very experienced , but they will say , ‘ I have not done

doctor , who was also an anaesthetics trainee , come in to do those lines .”

‘ They can be a locum for five years and pay off their mortgage .’

chasing — are under-experienced , underskilled and under-confident , which means our

paper , look like they can work to a more senior level .

“ But in practice , running an arrest or dealing with a busy ED with lots of layers of clinical requirements is probably five years

as $ 1485 for a senior registrar , with additional payments based on remoteness .

“ Do not get me wrong , we have had great locums ,” Dr Martin said .

“ But the dependence on locums

an obstetric anaesthesia for 10-15

He reiterated that many “ fantastic ”

ED here in Armidale gets swamped .

ahead of them .”

is imperilling safety and work-

years because my hospital does not

locums wanted to relieve pressure on

“ They think that a town of

Dr Martin believed centralised

force security for rural and regional

do obstetrics .’

rural doctors .

3000 might only have a couple of

credentialling would benefit both

hospitals .”

Dr Sue Page

Past president of the RDAA .

WHEN Australian Doctor was first published , it allowed a blending of hot-off-the-press news with social content that understood our dark medical humour . It revved us up and brought us together .

During my various political

roles , walking the corridors of the federal Department of Health , you could also feel the excitement ( or angst ) that each edition created . It gave us shared language in the way that The House of God shaped our university years .

In the ’ 80s , two-thirds of doctors were GPs , specialists were in a minority , a quarter of my graduating year were female and just 2 % of surgeons were women .

There have been changes . But

there are constants . The people who most need medical care can least afford to pay for it .

And general practice is still seriously under-resourced for the differences it can make to people ’ s lives .

But without Australian Doctor to help us advocate for general practice , many of the changes for the better we have made over the past 40 years would not have been possible .