When Lindy Newsome was pinned beneath her ute in the middle of lambing season, she didn’t call triple zero.
Newsome had been struggling to unlatch a set of double gates when the handbrake failed, pushing her under the car and on to the road just outside Deepwater in the New South Wales northern tablelands.
“It was in the middle of the road but nobody came and I was pinned,” she says. “I started trying to rock the car and managed to get myself out from underneath.”
She had a crushed hand, an injured hip and plenty of scrapes and bruises.
Instead of making an emergency call, she called a neighbour who worked as a nurse.
“She came and did all the alarm bells, she knew what to do,” Newsome says. “When the ambulance came they were able to give all the technical terms … The ambulance officer was well informed by them, he called the helicopter.”
Their help meant she bypassed the usual protocol for ambulance calls in her area, which would have seen her sent three hours away to Tamworth, and on a further three hours to Newcastle. Instead she was airlifted to Lismore hospital, which is only three hours’ drive.
“I had these two friends who knew exactly what to do,” she says. “I wish it was like that for everybody.”
Deepwater is in the local health district of Hunter New England. Crossing health districts, like crossing state borders, is only done in critical cases, for “time-urgent” patients. Other injured and ill patients are referred to the closest tertiary hospital in their health district in an emergency – even if it means travelling further.
In 2022, an inquiry by the NSW parliament into the delivery of rural health services “repeatedly” heard of people being let down by the health system. In its report, released in May 2022, the inquiry chair, Labor MP Greg Donnelly, said the committee “heard stories of emergency departments with no doctors; of patients being looked after by cooks and cleaners; of excessive wait times for treatment; and of misdiagnoses and medical errors”. It highlighted the particular difficulties for border communities, singling out Tenterfield, just 50km up the road from Deepwater and a whisker away from the Queensland border.
A second parliamentary inquiry looking into the response to the first inquiry began this week.
Lismore MP Janelle Saffin was elected in 2019, one year before Queensland closed its borders to NSW residents, cutting many of her constituents off from their closest hospital.
“Tenterfield is in my area, and people regularly say they want to go over the border to Queensland but they get shunted to Glen Innes or Armidale and could end up at John Hunter in Newcastle, a long way away,” she says. “There are hospitals in Queensland that can accommodate all their medical needs.”
The recently opened Tweed Valley hospital will “take the pressure off”, she says, but it’s not enough; she’s calling for all 44 recommendations of the 2022 inquiry to be fully implemented. “You don’t change big bureaucracies overnight,” she says. “There have been some changes, we just need to see [the recommendations] implemented.”
In Tenterfield, cleaner and NDIS support provider Tanya Langdon says residents who need healthcare but cannot drive have the option of a bus to Lismore, which runs three days a week, or the once daily bus to Tamworth or Armidale.
“The hardest and most exhausting task of tending to and maintaining health in our town is the travel that’s all too often required,” she says.
“Services like telehealth and traveling specialists and mobile clinics are helping … however sometimes you must travel to hospitals for treatments, operations, equipment, it’s unavoidable.”
Langdon says the burden of care is being placed on to patients and their loved ones, left to organise appointments across state and district lines, and battle growing waitlists in regional doctor’s clinics.
Rural chair of the Royal Australian College of General Practitioners, associate professor Michael Clements, says GPs are “caught in the middle” of complex cross-border health arrangements.
“What we need to see is that the state and federal fund holders – those that hold the money and make the decisions – are actually in the same room with the GPs, with community members and community representatives, the mayors and the councillors, and actually finding out what needs to happen,” he says.
It’s a similar situation on the Victoria-NSW border. The federal member for Indi, Helen Haines, says state and federal governments are looking for a “cheap deal” at the cost of patient health.
“People write in to me and tell me that, with a population our size, they’re shocked that they can’t have cardiac intervention surgery,” she says. “We have a cardiac catheter laboratory, it can’t be opened every day of the week because we don’t have the staff to do so … they have to fly or drive to Melbourne or Sydney.”
Haines says there needs to be a “serious investment” in regional healthcare to bridge the rural-urban divide in health outcomes.
A redevelopment of the biggest hospital in that region, the $558m Albury base hospital project, which is jointly funded by the NSW and Victorian governments, has been criticised by healthcare workers who say it will “barely cover the significant gap in beds and theatres that we have now”.
The Victorian government said a $13bn investment in public health, announced in last month’s state budget, would help residents on both sides of the border access the healthcare they need.
“We’re making sure everyone that lives on the border – no matter which side – can get the care they need, no matter where they live,” they said.
A spokesperson for NSW Health says the processes behind cross-border patient transfers are “specific” and “robust,” based on the clinical situation at hand and the need of a patient and their family.
“Patients are always referred to the most appropriate health facility based on multiple considerations including the level of care required, the location of the patient and demand for services,” he said.
