Huon Valley Guessing Games Cygnet’s federally funded, Huon Valley Council-run medical centre is failing, says a retired neurosurgeon, David Cull — and he has written to Canberra to complain about it. Also, a general practitioner believes the centre, Cygnet Medical Services (CMS), is being held together by “BandAids”.
On April 17, Cull, a Cygnet resident, emailed federal Minister for Health Peter Dutton explaining why he thinks CMServices is failing. His email to Dutton reads:
I write to you as a concerned patient living in Cygnet. I am also a retired neurosurgeon who moved here eight years ago. The Federal Government funded a state-of-the-art medical centre here in Cygnet, which opened last year. It is administered by the Huon Valley Council [HVC]. It has become apparent that the council does not have the expertise to run a medical centre. There is no on-site practice manager. The inflexibility of the council in the terms and conditions on medical practitioners applying for a position there has resulted in only one experienced GP being appointed. Other potential GPs failed to sign contracts because of the above. The only GP [Dr Phil Crawford] has resigned because of the council’s inability to administer a health centre. The local population failed to support the centre because it is run by the council.
The other medical centre in Cygnet [Cygnet Medical Centre — CMC] is closing in June because their present premises at SETAC [South East Tasmanian Aboriginal Corporation] have not enough rooms to accommodate the two GPs there.The current GP [at CMC] has attempted to negotiate with the council about leasing the [council’s] medical centre and running it. The other is leaving Tasmania. There are two older GPs in Cygnet. One operates from his car, doing home visits only. The other has a solo practice, is in poor health, and has been saying he is retiring for as long as I have been here. They both have loyal followings.
The local council member, Liz Smith, has attempted to find out the conditions imposed by the Federal Government on the administration and medical appointment processes of this under-utilised federally funded facility. She has been stonewalled. I am writing to you in the hope you will let me know the terms and conditions, if any, imposed on the centre when it was built and ready to operate. Cygnet is one of the few towns in Tasmania that is expanding in population. It has demographically mixed groups of citizens.
Kind regards, David Cull, MB BS FRCS FRACS.”
This week, Cull told me he had received no response to his letter to Canberra.
Cull’s criticism of HVC’s running of CMS is believed to be the first to be directed to Canberra. However, he is not the only one with medical expertise to be frustrated at the way HVC is running CMS. And the criticism does not stop with the medical profession. Several people, among them patients and former patients of CMS, have privately expressed concern about the uncertainty surrounding its provision of general-practitioner services.
One CMS patient willing to speak is Stan Armstrong of Cygnet. He told me that, in March, he had taken a letter to both of the Huon Valley’s main publications — the Huon Valley News ($1) and the Cygnet & Channel Classifieds (free). His letter expressed his concern about the performance of the council-run CMS. Each publication, he said, had refused to publish his letter.
Armstrong said his letter read: Being a patient at the Cygnet Medical Services centre, I received a letter from the Huon Valley Council on 14-2-14 informing me of the resignation of Doctor Phillip Crawford, who I consider to be a brilliant doctor. It could be said that there is more to be told regarding Dr Crawford’s decision to resign from his position at the Cygnet Medical Services. Cygnet Medical Services as from the third of March 2014 will have one female doctor 4 to 5 days a week plus another female doctor 1 day a week. Huon Valley Council are saying that GP Keith Anderson will be employed at Cygnet Medical Services, but they fail to say how many days a week he will be there. Cygnet Services could possibly become another council white elephant. Time will tell. Doctor Crawford will be missed, but I believe that many of his patients will travel to Hobart to see him there for medical care.
That seems a harmless enough letter to me: it’s certainly not a rabble-rousing criticism of council; and that’s a nice tribute to Crawford, which other of his patients would likely endorse.
One wonders what it is with the Huon Valley’s excuses for newspapers that makes them so protective of council? Surely it’s not a fear on the part of the Classifieds that it is produced in offices in the Cygnet Town Hall building, where council is the landlord?
The Huon Valley News — although it serves council generously well by unquestioningly publishing practically every self-promoting media release it puts out — will usually publish letters critical of council as long as they are respectfully argued. So what was it about Stan Armstrong’s letter that HVN found unacceptable?
WHICH gets me to thinking about all those voices in the valley that are privately critical of council, especially its elected leadership, yet don’t want to be heard in public. I have always found it hard to believe that people in the Huon Valley are afraid of being openly critical of their council. Yet, down the years, many, especially ratepayers, have told me they are afraid to make public their criticisms in case they should be subject to some form of retribution. One person, a patient of CMS, told me the other day that he was upset about the way CMS is being run, but he had decided to make no complaint because he had a “planning application in the offing” and he didn’t want to prejudice his chances of having it approved by council.
Surely such thinking is irrational? Whatever is it that puts such fears in ratepayers’ and residents’ minds? Surely, if a planning or development application goes to council, it is dealt with on its merits; and, should it meet regulations, it will be approved. It is disturbing to know that people keep their mouths shut for fear of being penalised in some way.
In the case of the letter Stan Armstrong was unable to get published in the Huon Valley media, it surely couldn’t have been rejected because his uncle, long-time Huon Valley mayor Robert Armstrong was standing for election to the Legislative Council on a platform of “honesty and integrity”, and, therefore, the local media would not publish anything that could cast a shadow on his capability as the municipality’s elected figurehead? (Incidentally, I cannot see why Mayor Armstrong needed to stress “honesty and integrity” in his LegCo blurbs and posters. Surely we all should be able to expect our politicians to be models of such qualities, and not feel the need to remind us that that, in fact, is how they are?)
THE first hints that all was not well at Cygnet Medical Services emerged in March (see Tasmanian Times, http://oldtt.pixelkey.biz/index.php?/article/medic-alert-in-cygnet/). In weeks previously, Mayor Armstrong had been on a publicity offensive, insisting that there was “a bright future ahead” for CMS, and making promises that the resignation of part-time GP Crawford would be covered with “three days of GP coverage”.
Since then, council to my knowledge has said nothing officially about what has been happening at CMS, even though staffing arrangements have changed significantly.
Now fresh questions, from past and present patients, are being asked about what is happening at CMS. And David Cull is still waiting for a reply to his email to Canberra.
I am told that staffing arrangements have changed at CMS since Mayor Armstrong, in February, via advertising and media outlets, reassured the valley that CMS had a “bright and viable future”. Now, I am reliably informed, CMS’s weekly GP services comprise Dr Nirosha Athukorala (on 4.5 days a week); Dr Angela Retchford, based at council’s Geeveston medical centre (one day — 8.30am to 4.30pm — a week at Cygnet); and three rotating locums (Drs Ken Clare, Patrick O’Sullivan and Keith Anderson), who are taking it in turn to do a full day on Monday until the end of the financial year. At most, this sounds as if fewer than 60 GP hours a week are being provided by CMS.
A GP, not wanting to be named, on being told of this staffing arrangement, responded: “It’s BandAids. They’re just going to rotate. That’s no way to run a medical service.”
With Dr Annette Hackett’s Cygnet Family Practice (CFP) closing soon (and her practice partner, Dr Neil Cremasco, leaving Cygnet for New Zealand for a couple of years), it appears that, by mid-June, the people of the Cygnet district will have available to them a total of fewer than 150 GP hours a week — including, say, a total of 80 hours from Cygnet’s long-serving GPs, Denis Dubetz and John Wilkins, the latter doing only house calls. Only patients of Dubetz and Wilkins will be sure of who they will be seeing.
Only a few months ago, Cygnet had services equivalent to more than five full-time GPs (providing well over 200 consulting hours a week).
Should either Dubetz or Wilkins — both of whom, after discussions with council, are understood to have decided against working with CMS when it opened last year — retire, and Hackett does not get her practice going again, the chances of CMS building its patient list, and becoming viable, should improve. But to become reliably viable, CMS would need to attract more contracted full-time GPs, and give patients GPs that they can reliably call their own.
Quite a few people seem to know a lot about CMS. One person, still a patient at CMS, said he liked the service he was getting, but wanted a regular doctor to serve his needs, rather than having to take whoever might be on duty. One male patient was worried he’d have to see a woman GP. Another said it was a “lovely clinic”, staffed by “lovely people”, including a “good nurse”, but, he observed, the reality was that CMS did not have enough patients to make it viable. In fact, he said, he believed council was making a loss earlier this year on its venture into medical-practice management in Cygnet — and probably still was.
One GP said he believed that council, when it decided to go into the medical-centre business in Cygnet, had expected that there would be little competition, with the township’s two longtime doctors either joining CMS or retiring.
News that Hackett’s practice at SETAC was closing would have further raised council’s hopes of CMS becoming profitable.
It is to be hoped, for the sake of the people of Cygnet, that council does get its act together at CMS — or, preferably, that it decides to give up its role as a medical-facility manager and allow the centre to be run as a private practice.
That way, at least, council would profit by receiving a substantial and reliable rent, and it would not have to struggle to provide a community service that councils are not trained to handle, nor are expected to play. —Bob Hawkins
