South Australian doctors warn health services outside Adelaide will “self-destruct” if negotiations for a new contract covering regional doctors are not successful.

Key points:

  • The agreement under which regional doctors work in SA hospitals has expired
  • Negotiations with the state government to renew the agreement have stalled
  • Doctors want more pay, support and professional development opportunities

The state’s Rural Doctors Association (RDA) and the Australian Medical Association have been in talks with the state government to renew the agreement under which doctors work at country hospitals.

The organisations said the discussions had so far come to nothing.

RDA vice-president Scott Lewis said doctors were asking for “significant change”.

“It comes as no surprise to anyone that we’ve seen an absolute degradation in the health services around rural South Australia,” he said. 

“What we’re looking for is a commitment to the future of rural medicine from the government and from our Local Health Networks, and a contract that actually reflects the importance of having a highly trained, highly skilled and locally resident health workforce.”

Previous contract expired last year

Doctors were still being paid under the previous agreement, which ended last November.

Dr Lewis said the current arrangement provided an incentive for doctors to fill in as locums at regional hospitals on a temporary basis, rather than moving to a community.

Dr Lewis warns health services will continue to deteriorate in regional SA unless action is taken.(

ABC Eyre Peninsula: Samantha Jonscher

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“It really is quite disheartening to see locations around us where those locum doctors, who are coming in to ostensibly fill a gap, are being paid upwards of $2500 for a 12-hour shift,” he said.

“They come in, they do their 12 hours, they leave, they don’t have any added responsibility.

“But those of us who are residents in our towns, been residents in our towns for many many years, provide 24/7 cover, and we are being remunerated at a rate of about $315 for 24 hours.”

Several hospitals in regional SA, such as Port Lincoln’s health service, are staffed entirely with locum doctors.

“Back of the envelope sums suggest that the cost that the Port Lincoln hospital is now paying just for a locum doctor workforce to maintain the services there, is somewhere in the vicinity of $3 million a year,” Dr Lewis said. 

‘We would like to see a solution as soon as possible’

Hendrika Meyer, the chief clinical advisor for SA Health’s Rural Support Service, said she was hoping the parties could reconvene for more discussions soon.

“Clearly there are areas that the doctors are unhappy with, but we are yet to sit down and re-meet to work out exactly which of those areas they have the greatest concern with,” Dr Meyer said.

“We most certainly want to be able to have something that encourages … those who are there already to stay in the area and continue to contribute as they do now, but also to be able to attract more doctors to be able to come and experience what we have.”

All doctors at the Port Lincoln hospital are locums, says Dr Lewis.(

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She said locums were an important part of the staffing mix, and were often paid a significantly higher rate because of the emergency need for their services.

She said the state government had developed a program for doctors to train as “rural generalists”, broadening their skill set and increasing their utility.

Doctor shortage forces hospital closures

Recently, at least two emergency departments were left without a doctor in the space of a month on the Yorke Peninsula, at Minlaton and Maitland.

In April, the hospital at Balaklava in the mid-north was left without any doctors on site for part of the Easter long weekend.

And the GP clinic at Peterborough, also in the mid-north, closed because it was unable to continue staffing the practice.

Locums are crucial to the operations of hospitals in regional SA like the one in Port Pirie, pictured.(

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That service is now provided entirely by locums.

It was also revealed recently that doctors at the Yorke and Northern Local Health Network have complained about bullying, poor management and inappropriate clinical interference.

Dr Lewis said resolving the situation, and increasing remuneration and professional support for regional doctors, was a matter of urgency.