Maternity staff shortages plugged by FIFO workers

Australian Medical Association (AMA) president professor Steve Robson told ACM many Australian communities were relying on fly-in fly-out staff (FIFO), which had become an expensive "stop gap measure".

FIFO contracts cost government "mind-boggling" amounts of money, and relying on these services meant communities were not finding a long-term solution, Professor Robson said.

ACM spoke to a midwife who works in six-week blocks in rural hospitals with a private agency. The hospitals pay for her flights, accommodation and an allowance for living away from home, on top of her salary.

The FIFO midwife told ACM she was working in a ward where the only full-time hospital employee was the unit manager - who worked overtime to cover shifts.

"It's all very well having numbers on the floor, but at the end of the day FIFO midwives don't know the hospital," she said.

"There is a level of stress that comes from going from place to place and having to try and make things work," she said.

The midwife said because the layout of each hospital was different, she'd often ask the nurse unit manager simple questions - slowing down the work flow and loading extra work on permanent staff.

"It takes a good two weeks just to get your feet under the table, so you're useful for about a month and then you go," she said

"It's a good short-term answer but in the long-term, I do not think this is sustainable," she said.

Professor Robson said "you have to ask yourself why the government is going through a false economy and spending a fortune on FIFO staff when the money could be better spent on establishing services."

"It is, at the very best, a short-term band-aid," he said.

Professor Robson recommended a holistic approach to attracting staff to regional and rural towns, looking at what the town offered. Potential staff wanted respect, to be paid reasonably and to be part of a team where they had adequate breaks.

"Once you start losing these services, it puts a huge strain on regions," he said.

"It makes it hard to have a healthy community when you can't get healthcare services."

Having a baby is a pretty basic healthcare service, Professor Robson said.

"I think the government has that responsibility to make sure everyone has that access to safe maternity care."

A Department of Health spokesperson told ACM the government was committed to improving access to health and hospital services so Australians received appropriate health care.

The spokesperson said the department recognised the challenges and demands in public hospitals and was working in collaboration with states and territories on short and long-term measures to ease pressure.

It will take funding commitments to staff maternity wards appropriately across the country, and the volume of staff needed was large, Professor Robson said.

Nobody can work 24 hours a day, seven days a week, so you needed enough staff so that people could get a break, he said.

"You can't plonk one person there, they need support.," the AMA president said.

And regional and rural communities wanted continuity - they liked working with midwives and doctors who knew them and the area, he said.

Queensland nurses and midwives union secretary Beth Mohle told ACM midwives should be helped to work to their full potential.

Midwifery-led models of care - where midwives work with women throughout their pregnancies, during labour and beyond - had been shown to have high levels of safety and satisfaction, Ms Mohle said.

"FIFO midwives are utilised at time of acute need, but the better long-term option to support quality continuity of care is to invest in the establishment and ongoing support of midwifery group practices in local communities," she said.

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Maternity health care often forms the bedrock for other services in the country including laboratories, operating theatres and anaesthetists, Professor Robson said.

If maternity services fold, there's often not enough work to keep these doctors and specialists in town.

"They either just stop doing that work and lose the skills or they move to somewhere else where they can continue working," he said.

"It's a major, major problem."