Four doctors in South Australia's Mid North have hit out at a new birthing program for two local hospitals, calling the model "unsafe" and "unsustainable".
In a joint letter to the health minister, the GPs expressed "urgent concern" about changes to maternity service delivery at Jamestown and Crystal Brook hospitals, which took effect this week. The six-month trial by the Yorke and Northern Local Health Network (YNLHN) uses a one-team, one-site birthing model that alternates between the two hospitals, in response to ongoing midwifery shortages across the network.
The doctors said the rotation restricts them from simultaneously providing maternity and emergency on-call roles, and complicates clinical handovers. "Fragmented care and unintentional gaps in handover have been associated with 80 per cent of serious preventable medical errors," the letter said.
The letter warned the model effectively closes one maternity unit at a time, and that closures increase rates of babies born before arrival at hospital and rates of birth trauma. It also cited financial stress, psychological stress and family separation when mothers must relocate to give birth, and said transfers between sites would at times remove a critical emergency ambulance from the region, adding strain to the already understaffed volunteer ambulance service.
Jamestown GP Simon Jackson, one of the letter's signatories, said the change appeared to fix one area of maternity but would have flow-on effects for the whole community, especially non-maternity services. "I'm trained as a rural generalist; I cover primary care, obstetrics ... but also emergency care," he said. Under the new model he was restricted to providing obstetric care only on the day the trial began, which he said resulted in a shortage of doctors in the region and had the potential to affect emergency services in the future.