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Thursday, 29 November 1973
Page: 4169

Mr MORRIS (Shortland) - Tonight I speak in support of the recommendation of the Karmel Committee on Medical Education that a medical school be established in Newcastle. In its report brought down in July this year the Committee recommended:

The University of Newcastle should establish a medical school to take its first students in 1977, maintaining a second year enrolment of 60 until 1983 when it should be increased to 100.

Whilst I am aware and apreciative of the needs of other cities that placed submissions before the Committee for the establishment of a medical school, I believe that the claim of the Newcastle-Hunter region is an outstanding one. I am indebted to the honourable member for Hunter (Mr James) for his assistance this evening in the preparation of this speech. The

Hunter region, with a population in excess of 400,000 - that is, a population greater than that of the State of Tasmania - is without a medical school. Royal Newcastle Hospital, through its outpatient clinics, conducts more than 900,000 consultations per year. It has the largest outpatient department in the southern hemisphere.

At the outset, I want to pay tribute to the board of directors, the executive officers and the 2,218 staff of Royal Newcastle Hospital for the exemplary standard of service they provide to the people of Newcastle. The hospital, first established in 1817 in a building intended as a convict gaol, is the second oldest and third largest in the State. It is held in high regard by all persons concerned with the provision of health services. Last year its admissions were approximately 21,470 and its outpatient attendances were more than twice the number at any other hospital in New South Wales. Its specialist medical staff consists of 64 honorary and sessional specialists and 31 full time salaried medical officers. There are also 30 registrars and 47 resident medical officers.

The following visiting specialist medical services in medical care and orthopaedics are provided by Royal Newcastle Hospital to hospitals in the Hunter Valley: Full time physicians undertake care of medical patients in the public wards of Maitland Hospital; the orthopaedic department provides a regular clinic service to Maitland, Kurri Kurri and Cessnock Hospitals; the consultants of the obstetric department co-operate with the Department of Health in providing a consultant service to doctors in the area; and for the past 13 years the hospital has supplied Maitland Hospital with resident medical officers.

The hospital's domiciliary care service provides supportive home care service for almost 2,000 patients. The team consists of specialist geriatricians, with occupational therapists, district nurses and housekeepers working in conjunction with patients' own general practitioners. Clearly this service would provide an excellent basis upon which to build medical student training in community medicine and family practice. A unique feature of the hospital is its outpatient contribution fund which has provided casualty, outpatient, radiology and pathology services for the past 24 years. The hospital runs a blood bank which collects about 10,000 pints of blood a year and supplies all hospitals in the city.

Let me refer briefly to the 6 units administered by the Royal Newcastle Hospital Board. The main unit in the city comprises 509 beds, of which 73 are for obstetric patients. This site could accommodate an additional ward block and extensions for teaching facilities. At Rankin Park the 128 beds are used for chest disease patients and general medical services. Also there are facilities where male patients are given graduated work as part of a rehabilitation and retraining program. The Lodge at Rankin Park provides hostel type accommodation for unmarried mothers. The William Lyne unit is the centre of the domiciliary care service, where about 600 elderly and disabled patients receive treatment each year. This unit also accommodates long term crippled children. Belmont Hospital, with 108 beds, is a new general and maternity hospital with adequate room for expansion. Shortland Clinic, which has 21 beds and is located about a quarter of a mile from the main city unit, provides care for psychiatric patients as inpatients, outpatients and day patients. In addition, accommodation is available for up to 30 students in residence during obstetric and other live in terms.

The Royal Newcastle Hospital has pursued a policy of community involvement and total patient care, insofar as this is possible, for many years. Its training programs cover a broad range. The hospital has 30 specialists in training, all of whose posts are approved by the various postgraduate examination bodies. Resident medical officers are offered appointments over a wide range of terms for a maximum of 3 years, subject to annual reappointment. Since 1972 University of Sydney fifth year medical students have received training in surgery, gynaecology and geriatrics. Nurses' training courses are available for general nurses, obstetric nurces and intensive care nurses. The hospital has a long and proud history in the training of nursing graduates to the highest standards. A postgraduate medical education committee has been established and is developing at all postgraduate levels. An extensive medical library is maintained.

Mr Speaker,there is need in Newcastle for a new medical school which should be developed at the University of Newcastle in association with the hospitals in the area and centred on the Royal Newcastle Hospital for the following reasons: The supply of potential teaching beds; the size of the existing medical schools in Sydney; the population distribution; the general desirability of decentralisation and the orientation towards social medicine and family practice. Over a period of many years the residents of the Newcastle-Hunter region have waged a continuing campaign to have a medical school established there. I have the complete support of my colleagues, the Minister for Transport and Civil Aviation (Mr Charles Jones), the honourable member for Hunter (Mr James); the State members, Mr Face, Mr Jones, Mr Hunter, Mr Wade and Mr Booth, all members of the New South Wales Legislative Assembly in this project; also the Newcastle City Council, the Newcastle Chamber of Commerce, the Central Northern Medical Association, all of the hospitals in the region, many other citizen organisations and, most importantly, the citizens themselves and on this occasion, the support also of the honourable member for Paterson (Mr O'Keefe) and the honourable member for Lyne (Mr Lucock).

It is only 2 years ago that the then New South Wales Minister for Health, Mr Jago, foreshadowed a medical school for Newcastle within 5 years, that is, by 1976. However, the New South Wales Government's submission to the Karmel Committee proposed that foreseeable future needs for medical education could be met by extending the capacity of existing schools in Sydney.

Following the Karmel Committee's report, Mr Jago in a letter to the Newcastle City Council said:

The New South Wales Government's submission to the Committee clearly indicated foreseeable future needs for medical education could be met by extending the capacity of existing schools. While not opposed to establishment of an additional school in Newcastle, the State Government would insist on a satisfactory financial arrangement with the Australian Government for all increased costs.

Does Mr Jago's statement mean the establishment of a medical school at Newcastle is to be inhibited by the economies of scale available by simply expanding existing schools in Sydney? If this is all that is withholding New South Wales support for Newcastle, then his successor and the Australian Government should consider the bad features of further enlarging medical schools which are already too large by the international standards accepted by most authorities. When medical schools become too large they become too impersonal, and it becomes increasingly difficult to experiment and diversify with new teaching methods. This is particularly serious in an age when medical and teaching techniques are changing with an increasing rapidity.

With the dynamic new concept which this Government has implemented of making the national Government responsible for tertiary education and searching for quality of life and a bare quality of opportunity rather than economies of providing minimum of essential education, we should not delay any longer doing what is necessary to prevent further growth of Sydney's already overgrown medical schools. If extra finances are needed to start a new medical school, this Government ought to declare itself in favour of this principle. Likewise, Mr Jago's successor ought to spell out his support for this same principle. Mr Jago has said that his Government wanted further development in Sydney only and throws the onus entirely onto Canberra for a different initiative and new financial arrangements. If the New South Wales Government has any intention of decentralising and improving medical training, it ought to say so clearly and stop hedging.

I strongly request the Minister for Education (Mr Beazley), supported by the Minister for Health (Dr Everingham) to give the green light to the Australian Universities Commission to implement the recommendations of the Karmel Committee on medical education which gave Newcastle top priority for the next medical school in New South Wales. It has better developed facilities than any of the other applicant centres, which would mean early operation of the school, a point which the Australian Minister for Health has conceded is one of the strongest arguments in favour of Newcastle. I hope that the Minister for Education will act promptly to initiate implementation of the Karmel Committee's recommendation on the Newcastle medical school. I hope that the New South Wales Government will show the same spirit of co-operation with the Australian Government as has been exhibited with respect to the Albury-Wodonga proposals and act quickly, as barely 3 years remain to prepare the school for the intake of its first students in 1977.

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