More maternity cuts the final straw for Milton Hospital's senior doctor

Dr Thomson has fought for the retention of services and expansion of the hospital for 17 years, but says he has run out of energy and can’t keep up the fight on behalf of the community.

After working for almost 18 months with the Illawarra Shoalhaven Local Health District on a new maternity plan for the hospital, he said he was disgusted that the recommendations of staff were not being taken seriously.

Dr Thomson has refused to continue working at the hospital in any capacity, while three of his colleagues are also considering walking away from the obstetrics service, meaning expectant mothers could be forced to travel to Shoalhaven Hospital to deliver their babies.

He claims hospital management is pushing for an end to the current low risk maternity service, with emergency deliveries only.

“The irony is that we are forced to practice high risk obstetrics in an unplanned way, but not supported to perform low to medium risk obstetrics.”

“In the past month alone we have delivered two premature babies at 34 weeks, managed a woman with severe fetal distress in late labour and also supported and non-booked patient labouring at home requiring an emergency caesarean section.”

Dr Thomson said local women and families would “soon be confronted with no local doctor involved in hospital obstetric services and assessment, with any emergency being performed by non-maternity trained doctors”.

“We are being told this is what women and the public wants.

“It is my opinion this will potentially put lives at risk.

“This means that families at Milton Ulladulla will receive a lower grade of service and assessment than those in Nowra for example”.

Dr Thomson said he was “worn down” after “trying to maintain an obstetric service and emergency service” at the hospital and was “gutted” to be walking away.

“We have worked and worked with the current administration to try and to get solutions,” he said.

“We’re not viewed as safe operators, we’re not viewed as people who are worthy of operating a safe service.

“I have no more energy left in me to fight what I think its futile battle.”

Dr Thomson claims “the district does not care if services in Milton disintegrate”.

“We have many critical problems at Milton, including an overcrowded emergency department and under-staffing of doctors, when compared with workload in other hospitals in our district.

“Adding maternity emergencies to our existing strained emergency service is not a solution.”

He claimed cuts were “inevitable” as demonstrated by the removal of vital fetal monitoring equipment from the hospital last week, due to “limited capacity”.

“This type of response and management makes no sense and places lives at risk,” he said.

“It is irreconcilable with any clinical management principles to remove vital life saving equipment.”

He demanded the equipment be returned to the facility, and it was.

Dr Thomson said, as part of the maternity review, management had “promised us great hope to restore a reasonable service to Milton”.

“That process has stopped and started several times with no real progress,” he added.

“In the meantime many of our midwife colleagues have discontinued with their practising certificates in maternity care.

“Many of our skilled nurses have had a gut-full and walked away.

“The doctors doing obstetrics have struggled on, despite being viewed as not fully competent in the eyes of our district.”

Health district Chief Executive Margot Mains told the Times “a final decision on the model of care for birthing services at Milton Ulladulla Hospital has not been made”.

“A full and robust external review of the maternity service at Milton Ulladulla Hospital was carried out,” she said.

“A group of local midwives, nurses, and GP obstetricians, have since worked closely to review the findings of the report and develop a range of potential options for the long-term future of maternity services at the hospital.

“They’ve looked at options for delivering a new model that would support women and their babies through all stages of pregnancy, birthing and postnatal care.

“The local clinicians involved have now delivered a proposal to the LHD on how they envisage the model to run.

“They are now working with the district to strengthen some of the quality and safety aspects of the proposal.”

Dr Thomson said the management’s response to his concerns was “a mothering statement” and has called on the public to “make the health system accountable for its management and decisions”. 

“I no longer have confidence to work with an administration that does not consider the needs or opinions of the public and can treat staff and doctors as they do,” he said.

“I call all the public to go to their politicians and tell them what they want for Milton.

“This area is growing and we need to be providing more health services locally, not reducing them and placing more pressure on hospitals up the road.”

He said, despite being only an hour by road from Nowra, Milton-Ulladulla residents were “in reality quite isolated”.

“It is also doubly insulting that there are significant problems in the maternity services across our region, including at Shoalhaven Hospital,” he said.

“We are not convinced that the service is superior to what we offered here for low and medium risk.

“Clinicians at Milton always worked within the New South Wales Towards Normal Birth Policy.

“Opinion regarding our capacity is often made by individuals who have never set foot in Milton.”

Despite Dr Thomson’s concerns, Ms Mains said management was “committed to re-establishing an appropriate maternity service for the Milton-Ulladulla community”.

“As I have said on a many occasions, we certainly understand that being able to access services as close to home and family as possible is an expectation of the community,” she said.

“As a health service, we have a responsibility to balance that expectation with quality services that are appropriate for the community and that can be safely delivered within the hospital’s clinical capacity.”