THE impact on services at Bathurst Base Hospital after it was stripped of its medical registrar training accreditation on Friday night remains unknown, with the chief executive officer of the Western NSW Local Health District (WNSWLHD), Mark Spittal, saying it's too early to speculate on what might happen.
The WNSWLHD was advised on Friday by the Royal Australasian College of Physicians (RACP) that it had withdrawn accreditation for medical registrar training at Bathurst Base Hospital.
Subsequently, four medical registrars will be withdrawn from the medical roster and will leave Bathurst to continue their specialist training at other appropriate facilities.
When asked what services would be affected and when, Mr Spittal was unable to say.
He said the suggestion of services being affected at this stage was "a hypothetical situation" and stressed the LHD is doing all it can to prevent that from occurring.
Mr Spittal said Bathurst Base was at the top of a 38-strong hospital triage system which was doing everything it could to mitigate any reduction to services.
"We have people who are working around the clock to resolve this problem and we are fully committed to doing that," he said.
"What I should make very, very clear, though, is the services that the Royal Australasian College of Physicians has withdrawn, the training accreditation from the general medical service, is only one service within Bathurst Hospital.
"It's the inpatient general medical service that would be most affected because that's where the four registrars work.
"So I'm really clear there are other departments such as paediatrics and ICU, etc, are accredited by different colleges and trainees and none of this affects them."
Having said that, Mr Spittal said he could not gaurantee it would be business as usual for the medical ward.
"I can't guarantee anything in this business," he said.
"I've done it long enough to know that's not a thing to do, but what I can absolutely say is that there is no sense in which the LHD would not see it as absolutely disastrous if the medical services at Bathurst were compromised.
"We have an absolute commitment to the Bathurst community and surrounding communities that we make sure that services are as robust as we possibly can."
However, he can't guarantee that until they have filled all of the slots available.
"We have made some progress towards that, and we still have some progress to go," he said.
But if that progress isn't achieved, what can the Bathurst community expect?
Mr Spittal said it will be medical services, the inpatient services where people need admission, because they have medical issues to be looked at that will be affected.
But he said there are contingency plans in place to ensure that doesn't happen.
"As I say, we have a number of contingencies in place and we are very, very hopeful that all of those will come into play and we will be able to address this in time," Mr Spittal said.
"If we are unable to do that, then our secondary line of approach is we have 38 hospitals across the district; we try and staff them all with medical staff face-to-face because that is our preference.
"Some of our smaller sites, where we do manage to get locums into, we may need to pull some of those locums into Bathurst as a higher priority given its workload."
He said that will be very much be a last resort.
"But it is on our range of contingencies," he said.
Asked when he would be able to guarantee services beyond next week, he again he was unable to say.
"I haven't got an update as off 2pm this afternoon (Saturday)," he said, adding often these things go right down to wire.
"It's not unusual from time to time, across the entire locum market across the state, that there are times when you do come right down to the wire. And, again, that is not unique to Bathurst.
"What we are attempting to do in Bathurst, however, is not just replace the registrars with a different locum doctor everyday.
"What our goal is is to secure people that will stay for a longer period of time because obviously that enables us to give stability and consistency to the health service here.
"I know we already have a couple of doctors who have committed for at least a month and who are considering extending that beyond that period, but we still aren't out of the woods yet.
"This is an extremely difficult situation that no wants to find themselves in. Our goal is obviously to get Bathurst Hospital re-accredited as soon as we can and we are absolutely pulling out every stop.
"This is not a parallel [situation], but in the middle of the pandemic, we almost ended up with no medical staff due to infection and so on with people catching COVID.
"And while its a very different situation, the same principle still applies, the priority of keeping Bathurst running is absolutely up there from a district point of view."
He said achieving re-accreditation will be an onerous task, which could take six to 18 months.
But, he said the health district was "committed to making sure that Bathurst Hospital comes out of this as a better training environment for medical staff than it ever has been".
He said staff at the hospital were obviously concerned by the recent developments.
"The GM advised staff on Friday and I emailed all staff in the district [Friday night]," Mr Spittal said.
"It's one of my commitments to my staff ... we love to celebrate our success and we have many of those. But we also want to be transparent with people and to be open about significant failures we have when they occur, and no doubt this is one of them."
"I haven't had the opportunity yet to be down in Bathurst and talk to staff, and certainly I'll be doing that in the coming days, but the feedback from those working in Bathurst is that while everyone is concerned, and obviously and this is a very significant issue that we have to navigate, the staff are understanding and know there is no shortage of effort going on.
"It's a very challenging and difficult time. No one in the LHD and Bathurst is underestimating this, but we are applying 120 per cent effort around the clock to make sure we mitigate the risks of losing the trainees to the best we possibly can and that commitment will not stop."