The peak body for doctors in regional Australia says it is worried about the future of a western Victorian hospital as a contract dispute continues.
The Rural Doctors Association of Australia (RDAA) said Grampians Health was intent on implementing a new pay structure for its visiting medical officers.
Stawell Hospital merged with four others to create Grampians Health in 2021 as part of a plan to improve patient care.
RDAA chief executive Peta Rutherford said the planned change in contracts was designed to bring consistency to how Grampians Health doctors were paid when they visited other hospitals within the network.
One Grampians Health doctor, who wanted to remain anonymous, said the new contract he was offered involved moving from a fee-for-service model to a flat rate per session, resulting in less pay.
The new contract would result in doctors paid per each session they worked, or via a salary, regardless of the number of patients seen.
Ms Rutherford said the salary model was often preferred by younger doctors because it entitled them to benefits like parental and sick leave, but it also led to less pay for others.
She said expecting doctors to work under the "one size fits all model" disrespected long-standing doctors and undervalued their services to the community.
"A change in structure that triggers a resignation of a number of GPs who worked in the area for an extended period of time is concerning."
Ms Rutherford said competition between hospitals for doctors in Victoria was rife, without the added challenges of trying to recruit a regional workforce.
"We need to look after the [rural] doctors we got because they've got plenty of other options."
Two prominent Stawell GPs resigned earlier this year, with a third practitioner announcing he would leave at the end of the month.
Compromising patient care
Ms Rutherford said doctors should know how much they were paid under each payment structure and be allowed to choose the best option for them.
She said that paying doctors however they wanted to be paid was preferable to having a revolving door of locums — doctors employed casually on short-term contracts.
"The locums don't know the community, they don't know the nursing staff, they don't know the allied health staff," Ms Rutherford said.
She said operating the service with locums would dramatically increase costs and call into question the viability and sustainability of the health service — potentially leading to its closure.
The doctor the ABC spoke to said they were worried about the continuity of care because the region's patients were typically older and had complex health needs that locums would not be aware of.
The doctor was also concerned that surgical wait times at Stawell, which were shorter than Ballarat and Horsham, would blow out under the new payment model.
A different waiting list system
Grampians Health chief medical officer Matthew Hadfield said the waiting list system at smaller rural hospitals like Stawell differed from that in Horsham and Ballarat, so data was not collected.
"The individual surgical specialists traditionally managed their own waiting list so there was no visibility of what the waiting times were," he said.
A Victorian Department of Health spokesperson said data on elective surgery waitlists was only collected for Grampians Health's main campus at Ballarat.
Patients in Ballarat were waiting seven months for surgery beyond what they were told to expect, as of December 31.
Some problems precede dispute
Stawell resident Nancy Gibson is in her 70s with knee problems and is also a carer for a woman with dementia in her 80s.
"In Stawell, most of the staff know who you are, know your kids — it's a family hospital," she said.
Ms Gibson said she had noticed the service deteriorating in the past month during a visit for her patient.
"I rang the [Stawell Medical Centre] clinic before that and was told there were no doctors, and to go to the hospital instead," she said.
When she attended the hospital with her patient, Ms Gibson said they waited six hours before being told to return the next day because there was no clinician to take the X-ray.
"Looking at it from both sides, it must be very hard for them [Grampians Health], but it's very hard for the patients too," Ms Gibson said.
Ms Gibson also travelled to Grampians Health's Ballarat campus for her knee problems and a for a medical procedure for her patient. She said both services were historically available at Stawell.
