A Victorian mum says there are times she looks around her house, wondering what she can sell to pay for her children's paediatric appointments.
Tanya, who did not want to give her full name, said all five of her children had needed paediatric services while living in the Bendigo area.
She said getting in to see a paediatrician locally was a struggle even 10 years ago.
"But in the last six years it's been even worse, so we've now had to go to Melbourne," she said.
Seeking support
Tanya and her family can't afford the time or expenses that come with travelling to visit a paediatrician.
"We have to go without a lot to pay for it," she said.
She said her family was on a pension.
"And then when it comes to the travel, I have other family members that are high needs as well," she said.
"I have had to think, 'Can I really afford this?' Because I've got to find hundreds of dollars.
"It is very stressful."
But Tanya said the sacrifice was necessary due to the lengthy wait to access a private paediatrician in the region.
"We've already been on two separate waiting lists for a paediatrician here in Bendigo," she said.
She said her children's GP referrals had often expired by the time their names reached the top of the waiting list.
She said she then had to see her GP for a new referral before the paediatrician appointment.
"And my doctor … I've [got] pretty much a 10-day wait for [a] bulk-billing GP," she said.
"In the end, we've gone to Melbourne."
Tanya is not alone in the experience, with many of her friends also experiencing a wait of up to 18 months to see a paediatrician.
"It goes beyond just a health system delay – these are delays that affect a child and their wellbeing," Tanya said.
'A significant issue'
Rural Doctors Association of Victoria president Rob Phair said it was extremely difficult to access general paediatric services.
"Statewide, we know that it takes our families anywhere from four to six months to even get in to see a paediatrician," Dr Phair said.
"It's a really significant issue, and there's no quick and easy solution."
He said paediatric services – like many branches of the healthcare sector – were under the pump and under-resourced.
"And when we have, as rural doctors, quite limited resources, it's really difficult to fight all these battles at one time," Dr Phair said.
There are many layers to the issue, from the way services are funded to incentives for GPs to take on community paediatrics in rural settings.
"About 90 per cent of paediatrics, we would call community paediatrics, so it's not all based in hospitals and emergency departments," Dr Phair said.
He said community paediatrics would include behavioural and developmental problems, including anxiety and depression.
"This has become a huge issue during COVID and has become worse and worse," he said.
"We also have noticed in rural areas that we can barely access any child and adolescent mental health services."
Hope for change
Graem Kelly has seen the local pressures firsthand in his work at Bendigo Community Health Services (BCHS).
"Paediatric children's support services, access to allied health, family support services, and mental health supports have been fairly restricted," he said.
BCHS has had to close its waiting list for paediatric services in the past 12 months to clear a backlog of patients.
"We didn't want to set people up with a false expectation of being able to be seen immediately, in the short-term," Mr Kelly said.
"So, we took a responsible action to catch up with the persons that were already on our list."
But Mr Kelly said a new Infant, Child and Family Health and Wellbeing Hub would allow greater access and expand services to better support families and communities in the Loddon area.
BCHS is the lead provider for the new hub, which focuses on families with children from birth to 11 years.
"It allows us to collaborate with a number of health service providers across the Loddon area to better meet the demand of paediatric services, children's mental health and family services case management," Mr Kelly said.
"What we hope to do over the next 12 months is — in partnership with other service providers — look to restructure and expand the way we do business in those areas."
Addressing demand
The Loddon hub was one of three announced by the state government in July. The other two hubs are in Melbourne.
"This will assist families that have been stretched in having appropriate support to access the NDIS," Mr Kelly said.
"They can feel assured that we're trying to free the wheels so people can get quicker, more responsive access to a paediatrician, mental health supports, allied health support in the near future.
"Over the next 12 months we will inform people as new services and new opportunities become available."
Work to reduce the wait for paediatric services is already under way.
"We face the challenge that people from other areas, of course, when we open up the waiting list, will seek to try and access that and we will deal with that," Mr Kelly said.
But the expanded services the hub will provide will come too late for Tanya and her children.
"I've been waiting five years — I don't have any more time to wait," she said.
"It's now affected the health and development of my children.
"My son is 16 — he's nearly an adult, and there are services that he's missing out on because I don't know what he needs because I need a paediatrician to take me on the next step."
