Interesting times are upon us. With a Federal election only a few weeks away, two of the most marginal seats in the country are in Northern Tasmania.
In the seat of Bass, the State Government has approved the construction of a mega Pulp Mill on the Tamar River. On the one hand, we have both Liberal and Labor politicians talking up the benefits to the economy and more employment. Getting less exposure in the media is concerns from local residents, tour operators, farmers, fisherman, conservationists and the medical profession about the inevitable contamination of the air, land and sea from the byproducts of the pulping process. Supposedly the mill will be the "World's Best Practice" but us remains elusive just what this means. Also receiving little attention, is information on where the enormous amounts of raw timber, water and power will come from to fuel the whole thing. It is reassuring to see medical organisations like the AMA speaking out on the importance of environmental preservation for the health of the whole community.
In the neighbouring marginal seat of Braddon, we have seen a bidding war by the various government representatives to "save" the Mersey Hospital with the Federal Government taking control of the operation as from November 1st 2007. (It didn't happen as there was a last minute realisation that the largely overseas trained medical workforce would not have the level of supervision required bu the Medical Council, negotiations are are continuing as this newsletter goes to press).
However there are many questions left unanswered. Is it safe for a small general hospital to exist largely in isolation from the rest of the state's health system? In particular, what level of emergency medicine services can be maintained when the workforce consists almost entirely of conditionally registered doctores and fly in fly out locums? Would it be better if the Federal Government took over the entire Tasmanian health system? Some would argue that it's worth a go to try and get rid of the perpetual bickering and cost shifting between state and federal bureaucracies.
And in the real world of Emergency Medicine, Tasmanian hospitals are facing worsening Access Block and staff shortages just like the mainland hospitals. The lack of GP after hours services is also seeing a continued growth in minor presentations to EDs and rising frustration from the patients who deserve better service from our government leaders. Hopefully, the increased numbers of medical students coming through the system, will translate into better staffing of the EDs of the future.
Report on the "Emergency Tasmania 2008" Conference
Cradle Mountain, Tasmania
This is the second time a combined medical/nursing Emergency Medicine Conference has been held in Tasmania. A highly successful meeting was held at Bicheno in 2005 and this second meeting has stimulated interest in making this at least a 2nd yearly event. Some 60 Emergency Medical and Nursing colleagues made it through the snow and ice to the magic location of Cradle Mt in the Tasmanian highlands. The attendees included several brave mainlanders who had ventured across Bass Strait and a smattering of trainees hoping to get the "tick" for their 4.10 papers.
The theme of the Conference was "Innovative Emergency Care" although it was a bit light on for truly innovative talks. The most controversial part of the meeting was the session on Emergency Work Force Issues and the Tasmanian Clinical Services Plan. With a smattering of representatives from the Mersey Community Hospital and the Health Minister, Lara Giddings there to take the flack, we all enjoyed some witty repartee and the predictable ministerial reassurances that our concerns were noted and better life for everyone was just around the corner.
Anyway, full marks to the Minister for being game enough to attend (and participating in the Friday night festivities as well) - it would probably only ne in Tasmania that the Minister for Health would attend such a meeting and be on first name terms with many of the Emergency Medical Profession. Papers were disappointing in terms of numbers and quality but all scraped over the line.
It was decided to award the ASEM prize to Stuart Smith, an emergency nurse practitioner from Lyell McEwin Hospital in Adelaide for his presentation on the Oxford Chair technique of reducing dislocated shoulders. Not only was it a very eloquent presentation, but stuart deserved particular praise for his bravery in presenting to a potentially hostile audience and handling the questions with considerable skill.
As always, the conference dinner was a highlight of the meeting with David Smart, emergency physician at Calvary Hospital and the RHH Hyperbaric Unit, presenting an entertaining after dinner talk on foreign bodies. The non-medical members of the audience were particularly impressed!
Plans are already underway for the next Tasmanian Emergency Medicine meeting.
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