Some colleagues and I once toyed with starting an online publication called The Bleeding Heart. The title, reclaiming the pejorative, was something of a reaction to the prevailing political climate, but the idea was also that good news stories have some merit.
The intent was not soft or promotional journalism. We have as much to learn from critically investigating and analysing success stories as from stories of mistakes, failures, and wrongdoing.
Understanding why some individuals/communities/programs/institutions are doing well might, amongst other things, help those who are not.
In the spirit of The Bleeding Heart (which is yet to find a beat), here is some alternative reading from the relentless doom and gloom of the daily headlines:
A special first birthday party will be held later this year in the Queensland border town of Goondiwindi, with those attending celebrating their success in breathing new life into what had been a critically ill maternity service. Rather than let the service go the way of so many others, a committed group of local health professionals decided to develop new, more sustainable ways of working together that better met the community’s needs.
The result, as I report in the latest Australian Rural Doctor magazine, is a team-based service that provides continuity of care before, during and after birth and is already showing benefits for measures such as breastfeeding rates.
So could it work elsewhere? Members of the Goondiwindi team believe their model will only work where there is open and frank communication, as well as respectful, co-operative working relationships, and agreed policies and procedures to ensure clinical governance. They were also fortunate, it should be noted, to have hospital managers prepared to do the hard slog of implementing new work practices.
“I would consider it to be a model that other sites should consider but I do think it working well has depended on so many lucky coincidences of local flavour”, says GP Dr Sue Masel.
“I know there are towns of a similar size to us where the GPs are much more in competition than they are here and, therefore for reasons not to do with obstetrics, are not as willing to work together as we do.”
We hear so much about the professional turf wars inhibiting health reform — the ones between midwives, GPs and obstetricians, for example — that it’s useful to be reminded that the barriers within professions can be just as big a stumbling block.
Meanwhile, another good news story is emerging in the southern suburbs of Shellharbour, an area just south of Wollongong in NSW that is experiencing rapid population growth but has limited health services. If all goes according to plan, the locals will gain a state-of-the-art primary health care service in a few years, as a consortium led by the local division of general practice has recently won a Federal Government contract to establish the Shellharbour GP Super Clinic.
Despite its unfortunate name (talk about leaping into the future backwards), the clinic will offer multidisciplinary care and training, with doctors, nurses and clinical psychologists working collaboratively. It will also be a health promotion agency, running walking groups and health education sessions.
At this stage, however, it’s looking like one significant profession will be MIA due to protectionist regulations prohibiting pharmacists opening up shop within a certain distance of an existing pharmacy.
“Had we been able to acquire land on the next block south, we would have been able to place a pharmacist in our clinic,” says Dr Andrew Dalley, the CEO of the Illawarra Division of General Practice.
“The fact that one residential block represents the difference between gaining or losing a pharmacist is a sad reflection on the dogmatic requirements of existing regulation.”
One consequence is that the many patients in the area who rely on buses for their transport are going to be particularly disadvantaged.
On one hand, the Feds are trying to promote multidisciplinary care designed around patients’ needs, while on the other they seem more concerned with protecting professional patches.
Even in the good news stories, there is a sting.