Note: Where available, the PDF/Word icon below is provided to view the complete and fully formatted document
Disclaimer: The Parliamentary Library does not warrant or accept liability for the accuracy or usefulness of the transcripts.These are copied directly from the broadcaster's website.
Four Corners -

View in ParlView

Program Transcript

Read the full program transcript of Matthew Carney's report on rural health services, "Far From
Health", broadcast 5 June 2006.

Reporter: Matthew Carney

Date: 05/06/2006

MATTHEW CARNEY: In the country, shows like this are a dying tradition. Cobar, in the far west of
NSW, is doing better than most outback towns. Young families are coming into the area. These
mothers love the country lifestyle. But to give birth, they've had to put their babies at risk. The
maternity wing at Cobar Hospital has closed. So, they've had to take long and dangerous journeys to
secure the most basic human right of birth.

Despite the growth in Cobar, the town is losing its services. Banks and businesses have closed, but
this time it's different. It's not about inconvenience, but a case of life or death. Country
hospitals have closed, or have been downgraded. And doctors in the bush are leaving. If you get
seriously sick out here, you're more likely to die than city people.

Tonight on Four Corners, we examine how the health system has failed country people and left them
far from care.

MATTHEW CARNEY: Dr Kevin Coleman is a veteran of 11 years at Cobar, relishing the challenge of the
country practice, and thriving in the complete care of his patients. But he's found he can't
deliver those services any more.

DR KEVIN COLEMAN: Did your baby - I can't remember - we had to ship you out, didn't we?

WOMAN: You had to fly me to Dubbo. Yeah, that's right, and I was pissed off.

DR KEVIN COLEMAN: Yeah, that's right! There were no midwives on.

WOMAN: They were all at 'Cats' in Dubbo, they'd all gone to the musical.

DR KEVIN COLEMAN: I really came here to do obstetrics, and that was my passion. Cradle to grave
stuff - you're looking after the pregnant mums and you deliver their babies and look after newborn
babies and then the kids. I think what's happened to me is it's been a battle the whole way to
maintain procedural services here, and a battle that I've lost.

MATTHEW CARNEY: This is Dr Coleman's last weekend in Cobar. He's the only doctor on call to service
the entire Cobar Shire - a population of 7,000 in an area the size of Tasmania.

DR KEVIN COLEMAN: I just go and see anyone who needs to be seen, and I do periodic clinics during
the day just to pick up people with minor ailments, and if there's any emergencies like a heart
attack or a very rare delivery or an accident or whatever, I get called in and just attend to
people's needs. If I can treat them locally, I do, otherwise we ship them out, usually to Dubbo.
But if it's something more complicated we sometimes overfly and go through to Sydney to one of the
teaching hospitals there.

MATTHEW CARNEY: So, how many hours are you doing a week?

DR KEVIN COLEMAN: Usually between 70 and 80.

MATTHEW CARNEY: Doctors in the country are overworked. They suffer big burnout rates. Coleman is
looking forward to packing up and joining his wife and two kids who have been in Sydney

for the past year.

DR KEVIN COLEMAN: You know, you end up sacrificing your family for your patients, it's just not the
way to go, you know.

MATTHEW CARNEY: You don't feel like you're really making a difference anymore?

DR KEVIN COLEMAN: No, not at all.

MATTHEW CARNEY: In what sense?

DR KEVIN COLEMAN: Well, I think I had a life-saving role previously, I'd deliver the babies and
manage the emergencies. And a lot of stuff now goes out - whether it be fractures that I can no
longer do here because I don't have the insurance, or because of the way obstetrics has basically
whittled down here, I'm not sort of able to do the things I used to be able to do. So, you know,
the meaning's not here, you know? The reason for being here's just...just...gone down the gurgler.

MATTHEW CARNEY: When he first arrived here, Coleman was delivering nearly 40 babies a year. The
maternity ward was the heart of the hospital, and when it closed in 2001, Cobar was stripped of its
skills base.

DR KEVIN COLEMAN: At night here you get the kangaroos sometimes feeding during the drought. It
really is, in summer, is a very idyllic environment, you know?

MATTHEW CARNEY: Any surgical emergency now has to be flown to the regional centres.

DR KEVIN COLEMAN: In terms of access to services, it definitely is third-world, there's no question
of that, OK? There aren't many places in Africa where you don't have access to a midwife. I'm
talking about southern Africa, I worked there for 10 years. And I can tell you that in rural South
Africa, there's better access to midwifery services and a caesar than there is in rural NSW at the
moment. There's no question of that. And I think that anyone who's worked in both environments
would agree. 300km is a long way to go for a caesar.

MATTHEW CARNEY: Cobar is not the exception. 130 maternity wards have closed down in rural Australia
in the last 10 years.

DR ROSS MAXWELL, RURAL DOCTORS' ASSOCIATION OF AUSTRALIA: We know that it's a complex issue, why
they do close. We know that if there isn't the adequate workforce there, there's not enough doctors
there or not enough midwives there, then that's a very powerful issue to cause the unit to close.
But the important thing is that a lot of units are being closed because of a lack of commitment
from the local states involved. They're not actually providing the services and they're not
committed to making sure that that service will continue into the future.

MATTHEW CARNEY: Dr Coleman's patients are worried, and they have good reason to be. Country doctors
are getting older, and they're not being replaced with the next generation.

PATIENT 1: Everybody seems to get on very well with him, and they'll be very sorry when he leaves.

PATIENT 2: And his wife who was here was very helpful. She did a lot of things when you come in, or
if anybody was a little bit upset, she'd be there. She was very good, his wife, yeah. We really
missed her when she had to go to Sydney. So, now he's gotta go, so we do need more doctors.

WOMAN IN HOSPITAL: People in any part of the world like a continuity of care. They like somebody to
be there and develop that relationship with their doctor.

MATTHEW CARNEY: Coleman represents a dying breed. If present trends continue, in five years there
won't be a single country GP trained to deliver babies.

DR ROSS MAXWELL, RURAL DOCTORS' ASSOCIATION OF AUSTRALIA: It will be catastrophic for the people,
the women who live in rural and remote Australia. And there will be a group of women who can afford
or who it may suit to come to Sydney to have their babies, but for the majority of women that won't
be the case.

MATTHEW CARNEY: That's something Dominic and Jillian Prince know well. They live on a property 80km
south-west of Cobar. To give birth, they've had no choice but to take the long and potentially
dangerous car trips to where maternity wards are still operating.

JILLIAN PRINCE: I don't think it's acceptable at all. I think, "Why have we been forgotten," you
know? Why has this been let to get to this stage. It's just crazy, it's...

MATTHEW CARNEY: Two-year-old Sarah was born in Dubbo. A week before she was due, the Princes took
the 5-hour car trip and waited in a hotel room for the contractions to start. Then they were
admitted to the hospital.

JILLIAN PRINCE: It was really harrowing, and the midwives were really flat-out, just like they are
in any hospital, but they're not only dealing with Dubbo's community, which they're set up - is
what they're set up to do, they're dealing with five or six other communities from around the area
that are unable to have their babies in their own local hospital.

MATTHEW CARNEY: With their newborn, Alice, they didn't want to repeat the experience or the expense
of Dubbo. They decided to try Bourke, about three hours away. But things didn't go according to

JILLIAN PRINCE: Went into labour 3.5 weeks early. We were here at home and just thought, "My
goodness, let's get our gear together," and we thought, "At least we'll make it - we'll go to town,
we'll go that far, and reassess things then, maybe things might have slowed down."

MATTHEW CARNEY: On the way, the contractions were coming faster and closer together.

JILLIAN PRINCE: I really don't know how to describe it. It's...any woman who's gone into labour
knows what a contraction's like, and their partner who's gone through it with them, but just to be
in the car and every bump that you hit just makes it 10 times worse, can't move around
and you just feel really confined and it just made it worse, it was horrible, it was a really
horrible experience.

MATTHEW CARNEY: Knowing they couldn't deliver at Cobar, they made the dash to Bourke in the dark,
slowed only by the stock and kangaroos on the road. Alice was born soon after they arrived.

JILLIAN PRINCE: If we had gone to Cobar Hospital and they couldn't get an air ambulance for me, I'd
have had to go by road. Which is a 4-hour ambulance journey, because they swap ambulances at
Nyngan, so, four hours, I wouldn't have made it. Wouldn't have made it to Dubbo, so...

MATTHEW CARNEY: You would have had the baby in the car.

JILLIAN PRINCE: More than likely, that's right.

MATTHEW CARNEY: The Bradfords were happy to come and live in Cobar when they moved from Newcastle
almost a year ago. They're the kind of family Cobar needs if the town wants to keep growing. Daniel
came to work as a mine geologist in the local copper mine.

DANIEL BRADFORD: I get up every morning and I'm pumped to go to work, it's not often that you get
to go and work underground, especially that far, and see some pretty awesome rocks and see some
pretty awesome formations. Yeah, it's just a big buzz, really.

NIKKI BRADFORD: I'm totally proud of my husband, I think he's great. I think what he does is very
clever, he's very interesting. Yeah, he's a gem.

MATTHEW CARNEY: They thought country living would be good for the family, until Nikki fell
pregnant. She was shocked to learn that she wouldn't be allowed to give birth in Cobar. Nikki says
she has no option but to go back to Newcastle to have the baby. So, at 38 weeks, she'll pack up the
house, get in the car and drive to her parents' place. Daniel will join her a week later.

NIKKI BRADFORD: It takes me about eight hours. Probably take me a little bit longer this time
because I'll have to have a couple of rest stops.

MATTHEW CARNEY: By yourself with the kids?

NIKKI BRADFORD: Yeah, I'll be having the two kids with me and doing the trip all by myself. So,
yeah, very scary, very daunting. I'll leave early in the morning and hopefully be there by four
o'clock in the afternoon.

MATTHEW CARNEY: She just hopes she won't go into labour during the trip. Once there, she'll ask the
doctor to induce her a week early, so her son can get back in time for the start of the school

NIKKI BRADFORD: If I had have realised that this was the situation, I probably would have waited at
home until the baby had been born and then moved out here.

JILLIAN PRINCE: I was induced eventually, like, after a fair while, with my first, Sarah, they
induced me. And it hit like a freight train.

MATTHEW CARNEY: At this mothers' group, they're swapping horror stories about being forced from
Cobar to give birth.

NIKKI BRADFORD: What happens if you go into labour, they say if you're over 4cm dilated, they won't
fly you?

MEREDITH COYLE: Yeah. Or five, they told me.

NIKKI BRADFORD: Right. So, then, you just have to go in the car.

MEREDITH COYLE: Surely they would not just put you in a car and say, "You'd better drive."

MATTHEW CARNEY: What's worrying here is the stories of complicated births, and until now it's only
been chance that has averted tragedy.

For both of her births, Meredith Coyle was airlifted by the flying doctors from Cobar to Dubbo to
deliver. But if she had driven, her eldest son, Zach, may not be here now. He was born with his
umbilical cord around his neck.

If Zach was born in the air or in a road ambulance or in your car outside Dubbo with the cord
around his neck...

MEREDITH COYLE: Yeah. Well, yeah, I'd just hate to think of the consequences. Yeah.

MATTHEW CARNEY: And do you think that's what it's going to take - is a death?

MEREDITH COYLE: Well, you'd hate to think so, the death of a baby. Yeah, you'd hate to think it
would come to that.

MATTHEW CARNEY: Nikki Bradford is fast learning there is a different standard of care for people in
the bush. She had a serious bleed at 30 weeks and went to Cobar hospital.

NIKKI BRADFORD: It's the scariest thing to think that, what happens if I did go into labour and
we're not quick enough and the baby comes early and I'm only, you know, 30 weeks. And is there
someone here to deliver the baby? If there's not, how long does it take? It is scary. It's just,
yeah, especially when you're an emotional pregnant woman.

MATTHEW CARNEY: Meanwhile, Dr Coleman is closing down his old surgery. To leave Cobar wasn't an
easy decision - he has lots of friends and memories here.

DR KEVIN COLEMAN: There was a really pleasant sort of family atmosphere here, you know? People
would sit around and chat and...

MATTHEW CARNEY: The bush urgently needs 800 doctors like him. His biggest regret is that he can't
see the system changing.

DR KEVIN COLEMAN: What's gonna happen? There must be a rise in morbidity, mortality at some stage,
OK? How long that takes, I don't know, but I think there will be.

MATTHEW CARNEY: If giving birth in the bush is perilous, the situation is just as bad if you get a
life-threatening disease. Studies around the country show that if you get cancer in the bush,
you're less likely to survive. The most recent study in NSW concludes you're 35 per cent more
likely to die within five years of diagnosis. And the more remote you are, the worse it gets - in
some cases increasing to 300 per cent.

Chrissey and Lindsay Newton are survivors in this harsh land. They live, literally, out the back of
Bourke. The drought nearly cost them their farm but it's Chrissey's battle with cancer that showed
them a whole new level of hardship. They've had to struggle with the lack of rural cancer services.

Chrissey Newton was first diagnosed with breast cancer 23 years ago. Her only chance of survival
was to go immediately to Sydney, a place they'd never been to before.

CHRISSEY NEWTON: It was like a big nightmare. It really was. We didn't know how to catch a bus. We
didn't know about public transport. We didn't know who to get if we needed help. We didn't know how
to get from point A to B. So, everything was done in a taxi and you just hoped that he knew what he
was doing. Very bewildering.

MATTHEW CARNEY: Chrissey Newton's cancer was so advanced that her specialist only gave her months
to live. Her only hope was to be part of a radical chemotherapy trial.

CHRISSEY NEWTON: 12 months of chemo and 8 weeks radiotherapy on that first breast, yeah.

MATTHEW CARNEY: And you were told, what, later, that, out of the 60...?

CHRISSEY NEWTON: 60, only 3 of us got through.

MATTHEW CARNEY: So you're one of the three?

CHRISSEY NEWTON: Yeah, one of those three, yeah.

Pretty greedy sort of a person, actually. I wanted to see my kids through primary school. Then I
wanted to see my kids through high school. Then I wanted to see them married. Then I wanted
grandkids. And now I'm just hanging on to see those grandkids go through school.

MATTHEW CARNEY: In 2000, Chrissey Newton's cancer returned and she had her remaining breast
removed. But now she's bracing herself for her biggest challenge. She's been diagnosed with ovarian

CHRISSEY NEWTON: Very aggressive, yeah, and I don't hold great hopes of beating it. Like, with the
breast cancer, I had a definite thing, "I'm going to beat you." But with the ovarian, I seem to be
at loss with it. It's just so aggressive and we can't keep it quiet very long - that I do fear I
will lose the battle.

MATTHEW CARNEY: To see a specialist and get treatment, the Newtons have to close down the farm and
travel 370km to Dubbo. They don't know how long they'll be gone for.

CHRISSEY NEWTON: Four hours to Dubbo today, yep. And if it were Sydney, it'd be 10. So, you sort of
got to be prepared for a day or two weeks, depending on what they decide.

MATTHEW CARNEY: If you get cancer out here, the tyranny of distance means that you're a long way
from diagnosis and treatment. Many country people don't want to leave their family and choose not
take the long trips to the city. Chrissey's mother didn't and she died soon after she was diagnosed
with breast cancer.

CHRISSEY NEWTON: She wouldn't go through to Sydney because it was too much time away from the
family and she just had the basic sort of operation to remove her breast and then took the chemo.
And I still feel that if she'd have gone through and had much closer surgery and more scanning and
more detailed surgery, she would have probably made it, you know.

MATTHEW CARNEY: This long road trip is crucial. And tomorrow, she'll get a good indication of just
how long she has to live. A blood test will provide the answer.

CHRISSEY NEWTON: If that count is down, I think he'll review it again, whether we have more chemo,
whether we go to Sydney for an operation again, which I've had two on that area - whether he'll
operate again and then start more chemo, it'll all be depending on the decision of what he reads
from these counts tomorrow.

MATTHEW CARNEY: When the Newtons took their first cancer trip, they had to close the farm for three
months. It almost sent them broke and they had to put themselves into more debt so Chrissey could
finish her treatment. But what she found more traumatic was leaving her three young children

CHRISSEY NEWTON: Very difficult, because I'd never ever left them, even with a babysitter. The
youngest child, actually, when I come back after the three months and I'd lost my hair, she ran
away from me. She said it wasn't her mother. We had told her I'd lost my hair and everything but it
was just such a shock to her. There was lots of problems come out of that.

MATTHEW CARNEY: Did you ever think that you'd lose Chrissey at all?

LINDSAY NEWTON: It's always in the back of your mind, yeah, yeah.

MATTHEW CARNEY: So, this is really the kids and the grandchildren that have really given her her
drive and her will?

LINDSAY NEWTON: They've been her inspiration to keep going, I think, yeah, and, plus, we get on
well together, the two of us.

MATTHEW CARNEY: Through it all, Lindsay Newton has been by his wife's side. They've been married
for almost 36 years.

CHRISSEY NEWTON: I wouldn't be here if it wasn't for him and his support. He's been absolutely
wonderful. He's the one that lived with me for three months in a flat in Sydney, bathed me and
showered me, got me back for more appointments. My old rock hasn't moved one little bit. He's very
good. Very good. These long trips, he is what you'd call a full-time carer.

MATTHEW CARNEY: Today is the big day. And it's an anxious wait.

Dubbo's oncology unit is always full of patients when the specialist is in town. Dr Philip Beale
tries to make it to Dubbo once a week if his hectic schedule in Sydney allows it.

The service survives on the goodwill of the visiting specialist. There is no formal arrangement to
provide cancer services in Dubbo.

DR PHILIP BEALE: So, your blood count has come down.


DR PHILIP BEALE: But not a lot.



CHRISSEY NEWTON: Well, that's alright, yeah.

DR PHILIP BEALE: So, 130, down to 80, down to 63, down to 57. So, it is going in the right

CHRISSEY NEWTON: Thank you very much. Thank you, Philip.

MATTHEW CARNEY: The news is good.

CHRISSEY NEWTON: Well, I won't ever beat it. But I will give it a good run for its money. Yep. I
won't ever beat it but I will keep it quiet for as long as I can.

MATTHEW CARNEY: The result means that, in the short term, she won't have to go to Sydney for an
operation. She will still have to have another course of chemotherapy. And then she can go back to
the farm.

CHRISSEY NEWTON: Yeah, you don't look forward to the jab, but you get it. And when you get the
dexamethasone, it sort of rushes through you with the heat and you feel it down in the groin area.
Yeah, 'ants in your pants' as Mark says, yeah. But you learn to go with those feelings with it and
you get - you don't ever get used to them, but you do cope with them. Yeah, you become used to
having them.

MATTHEW CARNEY: With caseloads increasing in the city, oncology services at Dubbo are being
squeezed. In recent months the services here have been cut back, forcing the visiting doctors to
work longer hours and leaving patients to wonder if they're going backwards.

CHRISSEY NEWTON: Yeah, it's as if it's slipping back to what it was before. And we can't afford for
that to happen. I mean people have raised this money, got a beautiful oncology unit there. And it's
going to be half-used if they keep cutting the services back.

MATTHEW CARNEY: In Sydney, Chrissey Newton's good friend from Bourke, Heather Delaney, is
recovering from a massive operation. She just had a cancerous growth removed from her face.

When country people have to come to the big cities, they're hit with the extra burden of travel and
accommodation costs. Heather Delaney has been living in this room for three weeks, with her husband
Bruce. They're heading back to Bourke but are struggling to get packed.

HEATHER DELANEY: You have to strip the linen off the beds. And I'm starting to feel giddy. Yeah,
just have a...I'm very, very sweaty again. Yeah, not much good.

BRUCE DELANEY: Do you think we should stay here?

HEATHER DELANEY: No. No, I want to go.

MATTHEW CARNEY: They're both pensioners and have had to dip into their savings to fund this
life-saving trip.

BRUCE DELANEY: It's impossible to do it on a pension. You've got no chance of doing it on a

MATTHEW CARNEY: So, what happens to people that can't do that, do you think?

BRUCE DELANEY: I've got no idea. I think a lot of them don't have the treatment.

MATTHEW CARNEY: They just stay...

BRUCE DELANEY: I think so.

MATTHEW CARNEY: Stay at home and die, basically?

BRUCE DELANEY: I think so, yeah.

MATTHEW CARNEY: So, what is this stuff?

BRUCE DELANEY: It's called [gevity]. It contains all the minerals and just a liquid form of
nourishment. It's got everything in it that you need to live on.

E: Bruce feeds Heather like this three times a day. He is her full-time carer.

BRUCE DELANEY: I'm an expert at this now, mate.

MATTHEW CARNEY: How long have you been doing this?

BRUCE DELANEY: This is the second whack. I did it for eight months last time. She lived on this
without taking anything by mouth for eight months. I might go on it myself.

MATTHEW CARNEY: State governments do offer a small subsidy for petrol and accommodation if country
people have to travel for treatment. But it doesn't cover costs.

BRUCE DELANEY: Like if they think they can get away without paying me, they will. And sometimes
they say that Heather doesn't need a carer. Well, I don't know how this can be because how's she
gonna drive herself down here and how's she gonna drive herself back? And how's she gonna feed
herself and look after herself? And I've gotta help bathe her when she's really bad. And I've just
got to do it.


MATTHEW CARNEY: The Delaneys have been staying at this lodge which houses cancer patients from
rural areas. Before he goes, Bruce helps another husband find his way out of the city.

MAN: When I come down here always...other fella give me another way but I think yours is the simplest
way. That's Hawkesbury Road.

BRUCE DELANEY: Yep, when you turn onto the Great Western Highway you keep in the left-hand lane.

MAN: Right.

BRUCE DELANEY: When you turn onto the Cumberland Highway, you turn into the right-hand lane,
because you've gotta turn down there.

MAN: And go down here and then get on the right side of the road.


MAN: That'll do.

BRUCE DELANEY: When are don't know when you're going?

MAN: No, no. Not yet. It could be a week.

BRUCE DELANEY: Well, we're gonna beat you home, I'll tell you that.

MATTHEW CARNEY: So, this is the bit you don't like, all the traffic and the...?

BRUCE DELANEY: Hate it. Hate it with a passion. I'm not used to it, mate. That's why we get away in
the times where this traffic density is not so bad.

MATTHEW CARNEY: It's a 10-hour car trip to Bourke. But for the Delaneys it will take two days.
Heather's decided not to come back if she needs any more radical treatment.

Many country patients opt for local cancer care. But, in doing so, they can put themselves at risk.

Dr Craig Underhill is one of the very few oncologists based in regional Australia. He's come to
Sydney to discuss some research he's been working on - a nationwide review of cancer services.
Alarmingly, it shows that unqualified medical personnel are treating country cancer patients.

per cent, or a bit over one-third of hospitals that administer chemotherapy, it's done so by
someone who doesn't have a formal qualification in chemotherapy delivery.

There's a risk that the patient would either be under-dosed, so they have a non-effective
treatment. So, if you're trying to cure someone, obviously that's a problem. Or, conversely, if the
wrong, if too much dose is given then the patient would suffer unnecessarily with side effects. So
there's a risk that their quality of experience and outcomes is gonna be inferior.

MATTHEW CARNEY: Is it acceptable that, as your report has found - that if you are a country person
with cancer that your care, because of the nurses aren't trained, is going to get worse...?

DR CRAIG UNDERHILL: Yeah, no. I don't think that is acceptable. I think that it's not acceptable,
that the quality of standards are different.

MATTHEW CARNEY: Dr Underhill and his colleagues say the inequality in services cannot be allowed to
go on. They've drawn up a reform plan and sent it to all health ministers. What they want now is

DR CRAIG UNDERHILL: If we just gave people access to the best treatments as the current body of
evidence is in 2006, there would be substantial improvements in the survival rates.

MATTHEW CARNEY: In the cotton town of Narrabri, it's ANZAC Day. The people here have sacrificed
more than their fair share of sons in battle. Their roll call has included about 30 Gallipoli
veterans. They're proud of their service to the nation but the state of their local hospital has
them outraged.

MAN: I'm about the fifth generation of Narrabri.

MATTHEW CARNEY: And what do you think of the health services here? Do you think they're OK?

MAN: No, they're not. The hospital is a disgrace. Absolute disgrace. We badly need a new hospital.
The theatre's completely out of date. And the hospital's out of date. It's very hard to get staff
and the staff need our congratulations for putting up with it.

MATTHEW CARNEY: More than half of Australia's 760 public hospitals are in rural or remote areas.
Many of them are being closed or downgraded, further contracting services in the bush.

Four Corners sought access to a dozen rural hospitals in several states. We were refused permission
or directed to model projects. Here in Narrabri the residents find their local hospital a dangerous
place to be.

MAN: I was in there a couple of years ago for a week. And it was absolutely terrible. The plumbing
worked sometimes. Mostly not. The oxygen and cylinders like that have to be carried bodily into
there, instead of being, like in your modern system, straight in through piping into the wards. You
just... It's long overdue.

MATTHEW CARNEY: So you wouldn't want to get sick there?

MAN: No.

MATTHEW CARNEY: So, what are your options, if you've got a serious problem?

MAN: Well, you have to go away. You have to go away.

MATTHEW CARNEY: Narrabri Hospital was built in 1944. And the operating theatre hasn't been updated
since then. We were refused permission to film inside. We've been told the equipment in there is
old or faulty. As a result, operations are cancelled or delayed. Even the NSW Health Department
declared the emergency ward dysfunctional.

ROSS GLEESON, NARRABRI HOSPITAL ACTION COMMITTEE: Every study into this hospital is damning - and I
mean damning. It's not, "Oh dear, this is - this is not good". It's damning. And each time we get a
report from the government, it says the same thing, but the government just doesn't grasp, or
doesn't seem to want to grasp, the fact that they have to build a new hospital, and it has to be
done soon.

MATTHEW CARNEY: The community is taking matters into its own hands and they've formed a hospital
action group. They've just collected 2000 signatures to present to the state government.

ROSS GLEESON: The fact that our community has been agitating for so long is the thing that's
pushing people to sign these letters. And the fact that they have used the hospital, if they
haven't used it personally, then family members have, and they know the standard of it.

MATTHEW CARNEY: So everyone's got a story about it or knows something about it?

ROSS GLEESON: Absolutely.

MATTHEW CARNEY: First-hand experience?

ROSS GLEESON: Absolutely.

Now, this is the culmination of a 2-month campaign.

MATTHEW CARNEY: The committee says, back in 2001, they were promised a new hospital but, so far,
there's been no action. They say every week, they hear of an alarming incident at the hospital.

ROSS GLEESON: Everyone that visits the hospital knows it has to be done. What does it take for it
to be done? Now, if it takes a death, and one would really, really hope that that's not the case -
if it takes a death, then whose head is that know? And, and I don't want it to be my
mother or my brother or my wife or my children. I don't want it to be anyone in our community.

MATTHEW CARNEY: Meanwhile, the residents are putting up with sub-standard treatment, or none at

Di Eggins is recovering from cancer. She went to the hospital, to get help with a serious
temperature and the nurses told her to go home.

DI EGGINS: They just said, "We'll get the doctor." And the doctor-on-duty came in. And he, sort of,
wanted to put me into hospital and probably run some tests, and then put me on a drip of
antibiotics. And, um, then the nurses, sort of, advised the doctor that they didn't have a room
clean enough to put me in, because I had no immunity. Like, it would be safer for me to come home
and sleep in my own bed and look after myself, basically.

MATTHEW CARNEY: It's difficult to identify any individual or level of government responsible for
the mess in rural health.

The Federal Government has put money into addressing the critical shortage of country doctors and
increased its spending on cancer care. And the states have to juggle their competing health
priorities. But it's all piecemeal. Health care in the country is uncoordinated and fragmented.

DR ROSS MAXWELL, RURAL DOCTORS' ASSOCIATION OF AUSTRALIA: I think there is two systems. I think we
are accepting a lower standard of care in the bush, and I think that's...that's wrong. It's not
fair to the people who live in the bush. The people who live in the bush...they pay their taxes.
They're actually subsidising the services of those people who live in urban Australia.

MATTHEW CARNEY: Back at Bourke, it's a week into Chrissey Newton's chemotherapy and she's feeling
pretty crook.

CHRISSEY NEWTON: With this course, I'm getting a lot of peeling on my hands and feet, and numbness
in the ends of my fingers and toes. And, other times, I've had peeling in the groin area, bleeding
easy, if you bump yourself. Sore mouth, ulcers, cracked tongue - all the lovely little things that
- you've got to really say, "They're making me better."

MATTHEW CARNEY: She calls chemotherapy her 'quiet time', and doing needlework keeps her mind off
the pain. Family is everything to her and she worries how they'll cope when she's gone.

CHRISSEY NEWTON: I know the, um - the girls and Rob and Marg, they have such good partners, they'll
be fine, but Lindsay worries me. He's such a...just an...individual quiet soul, and I think he'll
find it very hard. But, hopefully, we'll train him too before we go, and get him used to the idea.

MATTHEW CARNEY: The Newton family has had to deal with the emotional scars of separation, a
hardship that's been heightened because they live in the bush. The eldest daughter, Theresa, who
also lives in Bourke, may have to deal with the same problems. Her mother's cancer has a genetic
component. Theresa has just decided to be tested for the cancer gene. She's put off having a family
until she knows the results.

THERESA NEWTON: I've decided to have the genetic testing done in a couple of months. I feel really
anxious about it. Um, I haven't...I guess - - -

MATTHEW CARNEY: How does it manifest? I mean, apart from the obvious ways, I mean, about fears
about having a family, or fears...

THERESA NEWTON: I guess, yeah, having a family. And having children go through what we went
through, I guess.

CHRISSEY NEWTON: If it's positive, they've said that she can have breast reconstruction. She'll
have to have both breasts off and a full hysterectomy. And that's a big - a big, big thing to offer
someone at - in their late 30s.

MATTHEW CARNEY: What Chrissey Newton's experience has taught her is that country people have to
look after their own emotional wellbeing. There are very few counselling services in the bush, so
people like her have to step in and fill the gap. She's become a de facto counsellor, and now is
turning to advocacy work, to try and get more support for country people.

CHRISSEY NEWTON: I've just, um, got involved in all the little fights, and, um - yeah, let's make
this better for someone else. We mightn't get it in our time, but we'll get it for someone else,
coming behind us, and I think that's where - where the advocacy work really works.

MATTHEW CARNEY: Heather and Bruce Delaney have arrived back home in Bourke. Heather is feeling
better now. She credits her friend Chrissey with giving her the strength to travel to Sydney for
her life-saving operation.

HEATHER DELANEY: She's always there to support anyone else that's having problems with - cancer
patients, because she counsels people, on the phone, from all over New South Wales.

MATTHEW CARNEY: And did she help you?

HEATHER DELANEY: My word, she was my inspiration. If...when they told me I had it, like, I just
went to water and then I thought, "Well, what I've got is nothing to what Chris had, and if she can
go through it and fight, so can I."

MATTHEW CARNEY: This morning in Bourke they're doing a roaring trade in cakes and scones. Chrissey
Newton and her friends have been baking up a storm for the last 10 days. The whole town has pitched
in to help.

JOYCE O'SHANNESSY, ORGANISER, BIGGEST MORNING TEA: They're just great, absolutely great. You would
not get another town like Bourke. If you're in trouble, they're there. No, it's a wonderful,
wonderful effort by everyone today.

MATTHEW CARNEY: All around the country, people are turning out for the annual Big Morning Tea, to
raise money for cancer research.

Chrissey's cancer journey will continue.

CHRISSEY NEWTON: I start a new course of chemo on Monday, so that's exciting isn't it? Could be a
different cocktail, that'd be wonderful.

MATTHEW CARNEY: What country people want is equality of care - an equal chance of surviving deadly
diseases and to be born with the same rights as any city baby.

CHRISSEY NEWTON: No, I feel it's not acceptable to have a two-tiered system, just because of
numbers in one area are more dense than others, I feel that it's wrong. We give out to other
countries, we try to make them whole, why not our own country, and make everybody equal with their
health and treatments?