It is now up to the Area Health Service to show its bona fides. Meanwhile, Dr Khouri should stop trying to inflame the situation further.

Make no mistake, the downgrading of Pambula Hospital will not just impact on those living in the southern half of the Bega Valley Shire. It will have a detrimental impact on the whole south coast region because, at the end of the day, there used to be two busy maternity units in the region and currently there is one.

Dr Paul Mara

Secretary, Rural Doctors Association of NSW

Fly by nighters?

SIR,

I would like to respond to a letter from Susan Mackinnon in the Bega District News on November 21, 2008 (Locums defended).

Ms Mackinnon asked whether the Rural Doctors Association of NSW (RDA NSW) really referred to locum doctors as “fly by nighters”.

I can advise that we certainly did not, and we never would.

We have a very high regard for locums who provide their services to rural doctors across Australia.

In a media release we issued on October 15, 2008, we stated: “RDA NSW does not accept the solution of fly in, fly out, fly by night service delivery to the country”.

We stand fully by this comment and, as readers will note, we were not referring to locums as “fly by nighters”, rather the type of maternity service that mothers and babies in the Bega Valley Shire will be subjected to unless more GP obstetricians can be permanently recruited to Bega following the closure of Pambula Hospital’s maternity unit.

Distance related logistical problems mean that Pambula’s four local GP obstetricians have decided, much to their regret, that they cannot participate in the Bega roster.

Locum doctors provide an essential role in covering for rural doctors who need to take much needed leave, but locums should not be a longer-term solution for filling in hospital workforce gaps.

The confusion relating to the “fly by night” term appears to have stemmed from comments made by Dr Gabe Khouri.

He was quoted in the Bega District News (Doctor speaks out, November 14 2008) as saying that RDA NSW “referring to locums as ‘fly by nighters’ is an offence to every locum in the country”.

We could not agree more and that’s precisely why we would never say it.

We reiterate that closure of Pambula Hospital’s maternity unit is an issue for the entire Bega Valley Shire.

All our media releases can be viewed in full at www.rdansw.com.au

Dr Les Woollard

President, Rural Doctors Association of NSW

Midwife

support

SIR,

May I add to the maternity services debate from the perspective of a retired midwife?

I trained as a midwife in the UK in the early 70s.

Despite it being a time of increasing obstetric interference in normal childbirth, 75 per cent of all births were attended by midwives only.

No doctor was present.

Midwives in the UK had, and still have, primary responsibility for the care of 75 per cent of mothers and babies through the neonatal period.

This is because the majority of births are normal and because midwives are skilled in the care of women experiencing normal pregnancies, births and post natal period.

Midwives are also skilled in detecting abnormalities and referring to obstetricians who are experienced in handling problems.

Midwives are specialists and primary carers in their field in the UK, Holland and New Zealand to name just a few countries.

Early last century Australia followed the American model of reducing the midwife’s role to being a handmaiden to the doctors, many of whom, ironically, are general practitioners who are not specialists in the field of childbirth.

The economics of the situation are finally making it clear to health service planners that if they make midwives the primary carers of normal birth they will reduce their costs enormously. (Midwives cost the health service less than doctors do as they have not had the political leverage to demand a high income.)

Not only will it be cheaper but it will also be healthier for the women and babies because midwives as primary carers will be able to provide continuity of care throughout.

This includes being with women through the whole labour and not just arriving to catch the baby.

Those women who have spoken out in support of a single birthing facility in the Bega Valley want a facility that will provide very good obstetric, anaesthetic and paediatric care for when things are not going normally. With the number of births we have in this region we only need one such facility.

My advice to all residents in the Bega Valley is to keep the issue of the consequences of building a new hospital completely separate from the decision recently made to have only one hospital delivering specialist maternity services.

We need to support midwives, in co-operation with general practitioners, to be the primary carers of women in normal childbirth (pregnancy, birth and post natal) and we need to support one very good specialist facility where women and babies who are having problems can be cared for by experts and not by generalists.

Jenny Spinks

Bega

SOBAG responds

SIR,

The Bermagui rezoning debate is about the future of the Far South Coast; the nature of good governance and due process; profit - who stands to make it and how; and, most importantly, it is about truth.

First, let me refute vigorously the lie that SOBAG is against progress; opp-osed to growth; and not concerned about youth unemployment and the aged.

All of these statements are untrue.

But, as history teaches us, if lies are repeated often enough, some people begin to believe them.

SOBAG is opposed to the Country Club’s plans to build close to 400 dwellings, thereby effectively doubling the population in much less than 20 years if, council’s own planning staff has noted, sales of these dwellings are “aggressively marketed”.

The club says it is in serious financial difficulties and the development will “save” it.

Just how and why the club got itself in such difficulties are questions that have never been properly answered.

We believe they need to be.

In any event, zoning decisions of this magnitude (or any magnitude) should not be made on the basis of the applicant’s financial need.

They should be made on the basis of sound planning; due diligence; unbiased professional advice; and in true conformity to local and larger regional planning instruments.

Further, in these precarious economic times, when major institutions inv-olved in financing developments similar to this one are teetering on the edge of collapse, council must undertake due diligence and apprise itself fully of the financial health of all of the entities involved in this enterprise before voting.

It is not an unfair question to ask what the council’s own liability would be if such due diligence were not undertaken.

The President of the Chamber of Commerce was quoted as saying “We need to encourage development here. People are not going to invest millions of dollars if the town is not going to prosper”.

Well, SOBAG actually agrees with her, but we disagree on the nature of the development.

Bermagui deserves the right development, not a modular Canberra suburb cut and pasted to the coast.

Another Shellharbour, Mollymook, Tura Beach, Batemans Bay, Kianga is not going to attract the good infrastructure, good jobs and thriving tourist activity that we all want.

By taking advantage of our unique environment and asset as the northern gateway to the Wilderness Coast, appropriate, sympathetic development could enhance Bermagui’s tourism profile immeasurably, allowing us to prosper with real jobs for our residents of all ages.

What if we encourage a smaller development of architect-designed dwellings, fully-powered by renewable energy, which becomes a model for others throughout Australia?

One that is conceived and executed by an entity - perhaps a community-owned Trust – that will guarantee that 75 per cent of the jobs involved in building it will be filled by Bermagui residents?

What if partners were invited in – among them the University of Wollongong; the Marine Discovery Centre; Clean Energy for Eternity; the Fisherman’s Co-op, and even the Chamber of Commerce, to develop and build the Australia Coastal Wilderness Visitor and Conference Centre, where visitors learn about the local flora and fauna; where research and teaching are conducted by scientists; and where a thriving local tourism industry will have its headquarters?

This is SOBAG’s vision for appropriate development, growth, and true prosperity for Bermagui, its citizens and businesses.

We invite council to consider it on Tuesday.

The mayor stated recently that the club deserved a vote because it has been waiting a long time.

If we do indeed destroy the village in order to save it, we and those who come after us will be living with the consequences for far longer.

Mary Cunnane

SOBAG president.

Remarkable

observation

SIR,

Having been a member for the past 10 years of the Bermagui Chamber of Commerce and Tourism, and a past secretary, president and former public officer, I was surprised to read in Tuesdays’ edition of the BDN, the statement the president Carol Carmody made that the vast majority of Chamber members were “fully supportive” of the proposed new development at the Country Club.

As I have not seen any questionnaire sent to the members on this issue, nor am I aware that an official vote has ever been taken or minuted, I find Ms Carmody’s observation remarkable.

How can such a statement be made when the proposition has not been put to a vote by all members?

Many BACCT members do support appropriate development and growth in Bermagui but not on the scale being proposed by the Country Club at present.

Beverley Bray

Bermagui