It Might Be The Only Way To Save It!

A medico speaks.

Times are getting desperate at the (now called) Manning Rural Referral Hospital. The title signifies its downgrading. 

In a frustrated and wide ranging talk, a medical specialist from Manning Hospital came to us to share his frank frustrations at the state of Manning Hospital and its fragile future. Needless to say he wishes to remain anonymous to protect his job.

Management tries hard but like a lot of rural hospitals if you want to get ahead you have to know the right people in the right places. If you’ve done all your time in one place it’s hard to progress upwards and you don’t have the experience either. Many staff stay as “acting” in the role. When you have to compete in a bigger pond, you learn to be strong and not be intimidated. You learn to fight for what you want a bit more.

It’s not enough for Management to shrug and say well we tried. We’re going backwards.  Frankly if they shut the Manning Hospital that might get such a reaction there’d be the political will to sort it out. Then a decision would have to be made, though frankly we need new political representatives. 

The lack of specialists at the hospital is a major problem.  So too is the lack of beds, trainees, and support staff. We don’t have the critical number of specialists. 

The emergency department is run generally by CMOs -Career Medical Officers- who may be senior but the College of Emergency Medicine does not consider them to be suitable for supervising trainees. 

But you can’t close down an emergency department of this size without public revolt, so they get people in with very little emergency experience. So we have a terrible reputation as an emergency department even though we pay a lot.

This lack of specialists again gives John Hunter Health a reason to say we don’t meet the standards of  emergency medicine training so we can’t have trainees. With no trainees it makes it hard to get senior staff.  Some come and are keen initially but then they start hitting road blocks at every level so move on, which means resources don’t come to us as we don’t have the qualified staff.  The recruitment rate is low, the retention rate even worse. 

Without trainees and no juniors to support them, senior doctors don’t stay for long. At least half a dozen who recently came from the UK, Ireland, Germany, stayed for some time, then once they’ve made contact with other hospitals they move on.  

Working here is very hard as there’s no junior staff and you hardly get a toilet break. If you’re a specialist you need a supportive team with you as there’s too many patients for just two eyes. The specialist would see the sickest patients then provide guidance to the others as we have only interns and very junior doctors. 

Is it any wonder they soon look around at the private system where they can be paid five times as much as working at the Manning as a staff specialist  on a fixed salary which is capped at 40 hours a week. Even if you work 60 hours you aren’t paid for that.  Sometimes you might get some time off in lieu but that’s almost impossible because of the work load.

Our anaesthetist department is struggling. When everyone is a visiting consultant the majority of the work depends on locums which means we’re scrabbling to find one on a day to day basis which can be thousands of dollars for several days. But for the person responsible for finding staff on a Friday afternoon, and the only available anaesthetist they can find is in WA, what the heck, bring him in we need him.

So when HNEH see us doing crazy things like flying in a locum from WA they probably think, the Manning Hospital has no chance to survive.

ICU Beds

All we are funded for are two ICU beds and two High Dependency beds compared to Port Macquarie Hospital which has 10-12 beds in intensive care, Coffs Harbour has 10 beds,  and I think even Tamworth has 12 beds now. Dubbo is building an ICU unit with 12 beds.

That means no surge capacity (when there’s an increase in demand)  when there’s only resources for two beds allotted to us.  

We have the physical space but it’s not being used, as there’s no budget, no facilities or resources. So it’s always a nightmare for middle management to try and find and chase staff every day!

Car Park Obsolete

When they did get us some money they built a car park which is already obsolete. There’s little chance you can find a parking place in daylight within 200 metres of the hospital. They closed the top floor for all the hospital fleet cars, for visiting staff, community services and so on. Why do we need so many fleet cars? We expected at least there’d be more car park spots. It hasn’t delivered. 80 percent of the nurses park in Aldi up the road. 

When a position was lost the hospital has not chased up a replacement. Once a service is lost and you don’t recruit, forget it.  We have no Ear/Nose/throat person and waiting lists for any ENT procedure is super long. If you need an ENT treatment and are told its not available here then you don’t march outside the hospital and protest. You find somewhere you can go and get it done. 

But as an administrator you should use this as a leverage to show we need someone on a permanent basis, rather than let it slide and look at it as a budgetry saving.  We had a pathologist retire and I don’t think there’s any intent to recruit another one. 

Need To Advertise

There should be some yardstick to show why we need more resources. If we are constantly over budget there has to be a reason.  We are not privy to what sort of a fight management and admin puts up for us to truly reflect our needs to HNEH.  

Yet when the whole state recruits for junior medical staff we never advertise in a timely fashion. Do we expect someone to just turn up in Taree looking  for a job? 

Ideally we want people who come here to work and stay here and have some quality family life.

Management’s role is to ask for more resources! Squeaky door and all that.

Going Downhill

For now we just stagger along.   Forster people were keen on Bromhead’s promise to build a hospital there because they feel the Manning Hospital is going downhill. 

In Forster there seems a higher proportion of patients who drive to Sydney or Newcastle for elective procedures and also a lot of GPs in Forster have stopped referring patients to the Manning. 

And when it comes to cardiac patients the most we can do in Taree is an echo cardiogram, but if you think the patient might have a blocked artery why would they want wait to do an Echo in Taree  then wait to be transferred  to Newcastle or Port Macquarie.  Patients get annoyed too they think, why am I being messed around like this when I could have a heart attack. 

OK we don’t do brain surgery or complicated heart surgery in Taree, but we should at least try to offer the same services which are offered in similar size regional hospitals. 

Making our bottom line look good to Newcastle has diminished the role of the Manning hospital in our community.

It’s all very well to say use it or lose it. We need everyone to get out on the streets and demand more.” 

(The point made by the passionate and caring medico above, is that medicine is truly a calling. Doctors who spend years training and honing skills and knowledge, want to practice. Yes, they want a life too, but being able to work in a field of caring, curing, and saving lives is not “just a job.” And if they don’t have the means, the facilities or the support to do their job, they’ll move to a hospital where they can.

We don’t want to lose out hospital. We need to show our support and demand more for the Manning Hospital.

John Hunter Hospital in Newcastle has been given 780 million dollars for a new “extension.”  They have a very pro active and demanding CEO.  We need to demand that the Manning and surrounds also deserve more. Our lives depend on it.  ed.)


  • I’m in full agreement with what was written about the Manning Referral Hospital. But how can we make a noise so it can be heard. Maybe what you said about closing the Manning Referral Hospital down will cause an outcry or would it go the other way.
    I do know we need different politicians in this area.
    If anyone has any ideas about making our voice heard, I’d be interested in your views.

  • Typical disgrace. Coffs Harbour Hospital also has no cardiac surgery other than stents – if you need a bypass after (or to avoid) a heart attack, you have to be flown hundreds of kms to another hospital. In Sydney you can almost have a bypass near any Maccas!…. they have them at numerous private and public hospitals there.
    Manning was a major hospital in the days of the old Pacific HighwaY and all the road traumas.
    These days the idea is to get the population to move to the regional centers like states, Kempsey, COffs Harbour, but it’s a joke if the health care services are deliberately being castrated by incompetent government officers.
    Common sense and insight would indicate that health services need to be expanded and supported to accommodate the future population migration and increases.

  • From what my and others experience had been, I agree whole heartedly. Perhaps a petition to Mr Bromhead or other powers that be?? All other medical facilities, knowing this problem, should also be a part of this discussion.

  • Time for all who live in the Manning to understand that what is happening has been happening for a lot of years.. Not only is the Hospital slowly closing down, but Taree too is slowly closing down.. First the industry in the area either went away or just closed. That meant less jobs.. That in turn signaled people in the service area, including health to not be there as well.. Look around.. empty shops , empty factories..This area is showing the state government that Taree and surrounds will close, when finally the older go-get people finally die. The State Government representative ( Bromhead) delivers a few dollars for a building, But it is empty with out services.. Taree is slowly turning into a Rust Belt town..

    • Don

      Please explain why you say industry has closed or went away. Southcott engineering has expanded to 2 premises. Jamestrong is here and has been under one name or another for eons. Abbatoirs. Steber. Speed flow.

      • You don’t have to be Einstein to see Taree is going backwards…more industries have closed than have opened..major supermarkets , malls and on-line shopping has spelt the end for the small retailer, and lack of infrastructure spending to keep pace with growth have all been contributors to the decline..

      • Steve, how about nameing the ones that have closed ..Just to many to name ?..So when is the Forster hospital going to be completed? You have been quoted as an election promise ” As being in this term” or are you as shown by your banners ” Just making idle promises..? Look around at the empty factories and shops.. or are you blind..? No don’t answer that one.

  • One can only be amazed by the lack of performance by our elected leaders and in the next election let’s make a change happen and Make Myall marginal.

  • When ever issues are raised by the MGLCAG (action group) to state politicians including the minister, the response is a letter from HNELHD. That it not representation or reviewing policy,it is a politician becoming a burocrat and responding to a letter not the issues.
    The talk pre election of stage 2 funding and then the ludicrous duplication of scarce resources by even contemplating a second hospital in close proximity, was ridiculous given stage 1 of the redevelopment is made up of 1a to 1d. So far only half of stage 1 has been funded

    Bromhead realises the error now and communicates as planning stage 2 and completing stage 1 with the money allocated pre election that won’t be seen until 2022.

    There was no costing completed to arrive at the numbers so there is doubt if project costs for stage 1 will come close.
    The fundamental issues go beyond the built infrastructure, it’s the human resource issues that are the challenge.

    Those issues are not contained to Taree but we are starting from a position of weakness .

    In recent meeting with Federal Member Dr David Gillespie, the action group called for Federal intervention to review training incentives in regional areas with a “grow your own” concept. It was pointed out that both state and federal joint initiatives are needed.

    Unfortunately this is all too big a challenge for some of the intellectually deficient clowns that get re- elected.
    Last state election gave voters a chance to shoe their patience had run out but instead the locals returned a ribbon cutter of car parks and toilets with an increased majority.

    The die hard nationals would vote for Pinochio if he was the candidate.

    Perhaps this shows that the alternative side of politics that can’t even contemplate private public arrangements has its own issues which the voters can’t support either.

    The staff at Manning Hospital are hard working and dedicated. They are going beyond time and again and are the glue that keeps the together.

    To them this community is eternally grateful.
    Alan Tickle
    president of Health Action Group.

  • I agree with every Word in the statement above I have for the last 3 1/2 years then going to Port Macquarie hospital my specialist is in Port Macquarie also my GPs in Port Macquarie I live in Harrington and the services in our area absolutely horrific they closing everything down and there is never enough room in the hospital they always send your home even though you are well enough to go home the emergency section is always full to capacity as well the beds on the wards something has to be done now I think because we are on the fringe area of the Jahn John Hunter health district New England have a much better allocation of funds going to their hospitals Port Macquarie has a lot more funds going to the hospital with all the equipment that they need a friend of mine had to have an MRI and was told to come back in three weeks because Tyereese had broken down all the equipment is old and dated and so is the hospital itself we need a hospital in Taree not in foster and the only reason I believe they’re pushing for one in foster now is because our local Council are all going tat all going to foster everything gets done in foster as everything gets done in Port Macquarie Taree is going to be a ghost town with no health care for the elderly all the young if I get picked up in Harrington by ambulance where will it take me Foster or Port Macquarie that is a lot more for the public health system do you have to deal with we need a hospital that functions as well as Port Macquarie base hospital and we need it now the nurses are understaffed and have the cheapest of all equipment compare to what they have in Port Macquarie It’s almost as if Tara is a third world country hospital and they should not be happening in Australia the politicians need to stand up and look up at the disgusting health mess they have put our country in

  • I think a lot of the Local residents in the area feel exactly the same and have the same frustrations and it’s so disappointing for all involved. I’m interested to know how we get our voice heard to get more in to the hospital that we all may need at some point in time.

  • There is an old saying – ‘When you always do what you always did, you always get what you always got’. The Manning Valley is a truly great place to live. My wife and I would not want to live anywhere else, particularly after going away on holiday and returning home. It’s a great place to come home to, especially after peaking Five Mile Hill, and dropping down into the valley by car from the south. That view warms our hearts every time, even after a just a weekend away. But sadly – the region is stuck in a time warp. We have so much potential however, I feel we essentially lack vital forward and proactive thinking in our future and longer term development. That is not to say there are some really good people and individuals doing some really good things. These are mostly well-intentioned mavericks who unfortunately are often seen as interfering with the status quo. As a region, we have seen many developmental opportunities squandered and lost. These were opportunities that would have realised so much long term potential for Taree and surrounds. What happened to the Northern Gateway funding? This was a staged process that would have realised genuine ongoing employment and business development potential for the area through a lucrative arrangement with the trucking and transport industry? Unlike Pt Macquarie, we live on the fringe of a busy highway. We also have a railway and a rail head, which I feel does not really take advantage of what it has to offer, in association with local industry. How about the earlier proposed funding for the development of the foreshore, in association with Chase, the development entrepreneurs, who offered grand plans and generous finances to take our wonderful riverfront well and truly into the 21st century and beyond? Why are these examples the case? What is that really about? What did we actually learn from that, and, most importantly, what do we need to do differently? Moreover, we should certainly not be thinking, or even talking about winding (if that is the case) down our hospital. Obviously, this is an absolutely vital infrastructure that provides for the critical health and well- being of our current and future population. That kind of conversation only serves to further dent the morale of those who work tirelessly and sometimes selflessly within our local health industry, not to mention the minds of those in the broader community. We need to be having very different, ‘outside the box’ conversations. Dialogue that is proactive and encouraging rather than reactive or constricting. This kind of critical thinking also requires a collaboration that encompasses what is possible?. To sustain this area and its existing population, we much invite others to come, and to live, build and grow here. That may not rest easy with some however, we are not going to grow without planned and intentional business and growth development, and encouraging those who would bring a multitude of skills and employment opportunities to our region. They must however, have a genuine reason to come. We must therefore begin engaging more in open and transparent conversation about these sorts of things. In terms of our current somewhat static situation as region, I think we all know where we have arrived at. The critical question however is – where do we truly want to be as an up and coming regional model in say 3 to 5 years? And – more importantly, how are we going to get there? And – who can help and support us in that journey? They cavalry it not coming over the hill. We are it! So – what do WE need to do about that??

  • With the increasing influx of sea changers to our region and our aging population the idea of losing the hospital is sheer stupidity . We need the best facilities available the equal of Port Macquarie and the John Hunter units . Something must be done to encourage trainee medical staff to remain in the area and promised funding by our illustrious state and federal parliamentarians to follow through with their promises of funding . Remembering their inaction when elections are due again .

  • This article somewhat explains my mothers despicable treatment at this so called hospital! A horrible culture is now created and it’s the patient’s that suffer. More staff and more resources could never fix what is sadly so broken.

  • Resident from Bulahdelah through to Tuncurry get taken to Manning Base so if you are in a serious situation you aren’t going to make it i’m At Smiths Lake had to get an ambulance 6 weeks ago had to come 38k’s to get to me if it was from Tuncurry would have been 30k’s just to get to you. The promise for a Hospital in Forster has been going on for over 10 yrs we have been told funds are their but nothing is being don Forster Private which the community raise the fund for then it was made private the one thing that could save lives is if it went back to public had a few departments that are needed like ED ICU 24 hour XRay & Pathology it would take some of the strain of Manning Base but the problem is they can’t get the staff they need A couple of Dr’s for ED ect. & nurses as it is it has a renal unit, oncology unit, rehab, I go to oncology unit every 6 weeks & always see spare beds. What it would cost for the so called promised hospital we already have half of one here& the land seems to me the cheapest way is to extend the private with the departments & make it public, the fund they would save could go towards the staff that is needed. Even at Taree you don’t get all the specialist that you need so either to Newcastle or Port Macquarie if you done have private health you go on a weighting list which we have been on since March & have been told that it will be over 12 mths even for Taree we had to weight 3 addiction to Forster private to make it public would take the strain of Taree the we might get staff to stay. If you have empty beds like in Forster Private they aren’t making any money having those bed full they are making money & also able to keep staff on with being paid what they deserve. From Bulahdelah to Coff’s Harbour has the largest number of retirees on the NSW Coast every resident needs to be able to have the medical service that they need with out having to go to Newcastle or Sydney or to Port Macquarie Private. I know of 2 Dr’s specialist that come up from Sydney. When you have to travel long distance to see the specialist it take it out of the older ones then the extra cost. It certainly isn’t any fun getting older then you get a few health problem & have to wait & travel long distances. Something needs to be done to make all 3 hospitals public so we can get treatment.

  • NLP Governments have NO desire for public utilities; it is not in their psyche? Private enterprise is their panacea but we can see that does not work. ALL public enterprises have been either destroyed or handed over to religious orders (see local refuge). They tell you this but I dont think people listen nor do they realise what it really means….mayhem! Government must run the Army and the police so why not health?

  • We have lived in Taree for three years now and just reading all the negative reviews about Manning Base Hospital is really depressing…. it must be a reginal thing as we come from Benalla in north east Vic , if you think the Hospital system here is bad its a nightmare in Vic.
    I am going into the Manning Hospital tomorrow for an op…. (to be continued.)

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