Local politicians have used a horror incident at a small town hospital to argue for an end to an over-reliance on locum doctors.
A woman died in Tamworth on August 29 after attending the Glen Innes hospital on a weekend when it did not have a doctor booked.
Member for Northern Tablelands Adam Marshall told NSW Parliament it was time for a permanent solution for what he said was an "unreliable" system that "relies on outside medical recruitment agencies" to fill gaps.
Glen Innes Mayor Carol Sparks has spent years campaigning alongside the MP for a commitment for a permanent resident medical officer at the hospital.
The tragic incident wasn't the first and won't be the last, but Hunter New England Health (HNEH) has never solved the problem, she said.
"It comes down to money and [patient] numbers and that means the community suffers," she said.
Cr Sparks, a former nurse, said emergency room staff working with the assistance of telehealth could not provide the level of care community members were entitled to.
"I don't believe for emergency situations, no. How can you tell somebody how to stop a bleed, for example, on television? It's just impractical."
Ambulance officers often bypass Glen Innes or Inverell hospitals and continue on to the larger Armidale hospital so patients see a doctor quicker, she said.
"Our community needs a doctor at the hospital.
"Why is the hospital being neglected? This is our health service. We have to travel for renal dialysis, we've got no CT scanner in place. This is serious. We really need to have this situation looked at and reviewed as an urgent matter."
In a statement to the Leader this week HNEH Executive Director for Rural and Regional Health Services Susan Heyman said telehealth is not replacing doctors when doctors are available. The service always does its best to book locum doctors, she said.
Glen Innes hospital is categorised as a local hospital, designed to provide first line treatment, resuscitation and transfer to specialist trauma services for a higher level of care.
If presented with a more complex presentation, requiring a higher level of care, HNEH's smaller rural and regional hospitals have a Business Continuity Plan in place to provide care by using telehealth.
"In this particular case, the Business Continuity Plan was enacted appropriately," Ms Heyman said.
"Glen Innes hospital nursing staff are highly skilled and are appropriately qualified to manage emergency presentations."
Cr Sparks revealed the New England Joint Organisation of councils, which covers Glen Innes Severn council, wrote to Ms Heyman on October 20 asking her to a meeting in November in light of the locum shortage.
"We're asking her to outline how we can increase the levels of resident and visiting medical officers, including doctors, to improve the health outcomes for residents in New England," she said.
"And we're asking her to explain this in detail."
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A patient at Tenterfield hospital died last year while the hospital did not have a doctor rostered on.
Asked what they had done since then, Ms Heyman pointed to the doubling of recruitment to 145 interns through the Rural Preferential Recruitment Program.
Funding of $1.6 million is provided to the Rural Doctors Network to run programs to attract doctors to rural areas, she said. Some 15 scholarships are offered every year for NSW medical students interested in a career in rural NSW. And 50 training positions are provided across NSW under the NSW Rural Generalist Training Program.
In a statement HNEH said their locum hired for the weekend of August 29 had become ill and they had not been able to replace them. The woman's critical condition would have required transfer to a larger hospital for specialist care, even if a medical officer was on site, they said.
"I want to assure the community that a locum medical officer is currently working at Glen Innes Hospital and rosters are covered for several weeks in advance," Ms Heyman said.