What of nurse practitioners? We just don't know!

After so much media speculation in recent weeks, we, the doctors of the Woy Woy Peninsula, would like to state our position on the employment of nurse practitioners at Woy Woy Hospital.

Firstly, we would like to make it clear that we would welcome any initiative which broadens the care available to the Peninsula.

On the face of it, there could be no objection to working with such highly-trained nurses.

But they say that the devil is in the detail and it is these details, or lack of them, which profoundly concerns us.

There has been no consultation with us on this, unless you count a phone call just before Christmas suggesting nurse practitioners may be coming and an announcement in late February that they had already been employed.

What we have been told is that patients presenting to Woy Woy Hospital will have to choose between seeing a doctor and seeing a nurse practitioner.

The implication is that the nurses will no longer help the doctors and that the cooperation between our two services is to be replaced by competition.

We have also been informed there will be nowhere for us to stay overnight.

This would be tragic.

For more than 30 years, we doctors have had an agreement with Central Coast Health.

In return for the use of their rooms, a bed to stay in overnight and some nursing and logistical support, we provide all the doctor services to the hospital inpatients and a convenient, accessible and affordable after hours service to the people of the Peninsula.

The majority of our services are bulk billed, and those that aren't cost a maximum out of pocket of $25.

We get no direct funding to run our cooperative.

Much of the administrative work is done voluntarily, but we cannot avoid costs like insurances, salaries and stationery.

Up until now, we have just managed, but if Central Coast Health steps back from our agreement, if the nursing support, or the accommodation, or any of the logistical support is withdrawn then we are in trouble.

So will this happen?

We just don't know, even though the nurse practitioners are due to start before the end of April.

The signs so far, however, have not been good.

Our promise to the community is that we will do everything we can to continue to offer our services as we always have.

However, greater forces may be working against us.

It seems particularly curious that in the midst of a government-engineered doctor shortage we see the arrival at Woy Woy Hospital, which is full of doctors, of nurses specifically trained to provide care in outback settings where there aren't any doctors.

Whether this is a bold move towards improving community care or the thin end of the wedge of nurses replacing doctors in our hospitals and beyond is yet to be seen.

We await the future very nervously.

Dr Paul Duff, Woy Woy After Hours GP Cooperative