On Friday, the Australian Medical Association (AMA), medical professionals from across the nation including those working in our region, along with government representatives, met in an emergency health summit. This was to discuss the need for primary healthcare to be considered an essential service, in line with others, so they too are considered for financial support.

This they say, should be seen as a basic response during and after a declared emergency.

In the past 6.5 months, frontline health workers such as GPs and Pharmacists say they have been delivering critical health services to our community, with nothing more than the same basic business grants, allocated to all business owners in NSW, which many say, is simply not sufficient, to recover and continue to support the community.

Those in attendance are asking for a Health Professional Business Grant to ensure they can continue to provide frontline health services and adequately rebuild their practices, including building repairs, restocking, equipment replacement and staffing support amongst other things required to keep their businesses going.

Lismore health service provider, Dr Ken Gudmundsen, dermatologist shared his experience:

"My practice was located on the ground floor in Molesworth St in the CBD of Lismore near to the Wilson's river.

"In the flood, I lost virtually everything in my medical practice: computers, beds, equipment, stock, lights, loupes, etc. The walls, floors, ceilings, the kitchen, and the bathroom were destroyed.

"Then followed weeks to months of cleaning up the building and sheds, removing debris, dirty furniture, destroyed equipment and stock. I worked with staff and others – in the dirt, the smell, the mould, the rain, and grey days.

"As a solo practitioner, I was unable to see patients at all for three months having to deal with the clean-up, being unable to find suitable rooms, and needing to recreate a practice from the ground up. There were therefore no dermatology services to our community for three months. Luckily, I did find some rooms in St Vincent’s Hospital, Lismore. The rooms are small and were initially shared with someone else. It has been a huge effort.

"We have had to re-create and re-purchase virtually everything down to the smallest detail, including computer systems, phone systems, etc.

"I am seeing less patients than before, due to:

• the new rooms being much smaller and there is less room for nurse-assistants to work in;
• having to recreate a practice anew also distracts me from giving full service to patients;

"It's been a tough time; a distressing time financially, personally, mentally, and physically which affects my mental health somewhat and my ability to help patients as easily as previously.

"We are unable to provide phototherapy treatment, and patch testing to allergens. We cannot provide as much surgical treatment as previously.

"The slow pace of government help for my practice is a scandal. Six months after the flood and we have received woefully insufficient financial help. This neglect and incompetence on behalf of the government(s) has added to my stress and gives me great uncertainty as to whether I can or should keep practising in Lismore".

Image supplied: During the clean-up of Lismore Skin Clinic

Much of the community is now in socio-economic stress compared with prior to the floods. This was also addressed in an impassioned plea from GP's who say they simply cannot afford to continue to offer bulk-billing services in alignment with what the communities needs are, or best practice principles, which will further put strain on a community that already, has reduced access to specialist services due to practices and equipment being lost in the floods and will continue to further marginalise their recovery.

Mr Kyle Wood, Pharmacist said of his experience “I am not a wealthy person - I currently live in my caravan with my partner and young child. We do not have the financial capacity to rebuild and restore to where we were prior to the flood. I feel an obligation to my staff and the community to keep providing the services our business is renowned for, but we need assistance to do so. The small business grant of $50k was welcome but basing grants off staff numbers fails to take into account the many, many variables and costs associated with businesses like ours.”

Image supplied: Kyle Wood's Southside Chempro Pharmacy inundation during the floods (indicated by the arrow).

Health professionals spoke openly about their consideration in the past few months of closing doors altogether, which would mean they would likely, be lost from the community entirely, as Rural Health Professionals are difficult to obtain, but easier to keep.

The Rural Doctors Network recommendations, supported by a letter to the Minister for Health, from the Hon. Bronnie Taylor MLC Minister for Women, Minister for Regional Health, Minister for Mental Health, stated the following as critical for consideration:

That the NSW Government agencies responsible for flood recovery grants consider:

1. creation of a Northern Rivers healthcare businesses grant that:
2. is open to all 2022 flood-affected non-government primary health, health practitioners and health services
3. has a maximum grant amount sufficient to cover the losses faced by these businesses
4. includes lost income in the losses able to be covered by the grant
5. has an approval and funding flow process that provides urgent and immediate security and certainty for these businesses to rebuild
6. In the interim, whilst this is being created, ensure affected healthcare businesses can access the current $200,000 Northern Rivers medium-sized business grant, with the following adjustments:
7. Eligibility is open to non-government healthcare businesses of any size, rather than just the Treasury definition of a medium-sized business
8. Funds of up to the maximum of $200,000 be available immediately to eligible businesses based on quotes or estimates (rather than the current immediate provision of evidence of payment).

State MP for Lismore Janelle Saffin said the medical service was already over-stretched prior to February 28th and that a one off grant would help practitioners to better rebuild, and they need it as much as our farmers, private and business landlords and flood-affected people needed their back home grants.

Federal MP for Page Kevin Hogan spoke about being aligned with Janelle on calling for this additional support while acknowledging the health professionals and said that the whose who nationwide, of medical professionals was there represented by 'heavy-weights' because in his words "we know we are in trouble".

"You don't have to be Einstein to know that if you want a community to be healthy, then you need it's health professionals to be here" he said.

Dr Ken Gudmundsen also spoke about the decline of services and loss of specialties and practitioners, on top of the strain of an extreme housing crisis in the region as being a "death spiral", and one which would ultimately destroy the community.

He and others also said they had expected support to arrive in this way, from the government by now, but the fact it hadn't, had left them and the patients they treat, feeling abandoned.

Professor Nina Robertson, Practice owner and GP from Keen St Clinic said that doctors had been chronically under-funded for far too long, and that the community desperately needed the support to be given so that they didn't fall through the gaps, which are ever-widening, since the poverty brought upon in our region from the floods and increased costs of living.

Image: Surgeon Dr Sue Velovski giving her speech

Surgeon Dr Sue Velovski gave a powerful speech, calling on Prime Minister Anthony Albanese to become the leader and the umpire that is sorely needed so that the political football this issue has become could be put down once and for all and the two teams, could be given some leadership, to rectify this situation, in a reasonable time, given what she says "has taken far too long."

Speakers stated "if this is what happens to a regional community which has lost half its homes and businesses to a flood, unlike the Ukraine which has lost 1/3 of its entire country, we as a Nation are in serious trouble. We have been treated like second-class citizens in a third world country, in what is supposed to be a developed, first world country."

Steve Robson, Federal President of the AMA further went on to say that he has been utterly overwhelmed by 3 things "By the scale of the humanitarian catastrophe that has occurred to this region, and by the courage and heroism of the healthcare workers, the doctors, pharmacists, nurses, and everybody who provides healthcare to this community and surrounding regions, and also by the incredible neglect of the State Government in fobbing this off in terms of funding, and he urges that the support for this request for funding be addressed with an answer by the end of the weekend."

Pharmaceutical Society of Australia President, NSW, Ms Chelsea Felkai said "This for me personally has been a journey of revelations, the first being that healthcare has not been considered an essential service in the first place. We need to get our power up and running, we need to provide shelter and homes for people, and healthcare. It is not a choice, it's a necessity".

"We absolutely need to have that as an immediate action that comes out of a disaster. A pharmacist I spoke to told me that despite the devastation to his and others homes and premises, due to their preparation plan, they were back serving the community by the very next business day. The government needs to have a preparation plan before the next emergency, which sees the provision of these essential services, as well as the basic needs such as shelter, provided by the next business day, not over 6 months later."