LOCAL DOCTORS think amputation from the Hunter New England Health (HNEH) district might be the best option to save resources and services for the region.
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It comes as the New England Joint Organisation voted unanimously to explore breaking-up what eight mayors have described as a "Newcastle-centric" system.
New England nephrologist and general physician Dr Stephen May said he's been concerned rural interests would come a distant second to metropolitan areas since the districts combined in 2005.
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"I think the system is big and cumbersome and it's not particularly reactive," he said.
"It's very slow to our needs, it serves the people of the Hunter region fairly well, but I don't think it's good for the rural sector."
Dr May said a painfully slow administrative system has seen anaesthetists and neurologists who wanted to live and work in the New England move to other areas because contracts took too long to process in Newcastle.
He said a lack of services in the region has forced sick cancer patients to drive 3.5 hours to Newcastle for something as simple as a PET scan, or to sign a consent form.
And, he said despite the region's desperate need for medical staff - more nurse practitioners were dished out to the Hunter region, while the New England struggles to attract healthcare workers.
"I think the mayors have got it right and we should be administratively separate systems while maintaining our close clinical networks that are based on mutual understanding and trust," he said.
A Hunter New England Health spokeswoman said untangling the system would come at a hefty cost.
"There would be significant costs to replicate services and management positions that were merged in the amalgamation," she said.
"The amalgamation of HNEH in 2005 led to a reinvestment into improving frontline clinical care, particularly in rural and regional areas."
She argued regional and rural patients have access to major hospitals in Newcastle, which provide specialist care and outreach support to hospitals across the New England.
"Many staff regularly visit rural centres to provide outreach clinics, giving patients local access to specialist care which they would previously have had to travel long distances to obtain," she said.
"Our staff also regularly take secondments to rural and regional areas to help fill short-term vacancies to ensure we can continue to provide high quality services in those regional communities."
Retired GP Dr Lyn Allen worked as a practitioner in Tamworth when the health districts were separate, and said they never should have amalgamated in the first place.
"It was a bad idea to do what they did," she said.
"Amalgamation happened in a hurry, but breaking stuff up takes so long - I guess they thought they would save on admin, but really all I think they did was neglect the rural areas.
"The problem will be funding now that it's in a big pot, but maybe if we stood on our own two feet we would have a better chance of attracting specialists."
HNEH is the only organisation in the state that serves a large metropolitan base in Newcastle and an extensive rural area.
Discussions continue between NEJO, which consists of the Armidale, Glen Innes Severn, Inverell, Tenterfield, Uralla, Moree Plains and Narrabri councils and Namoi Unlimited, which represents Tamworth and other councils in the north-west.
Namoi Unlimited chair Jamie Chaffey said he felt the two groups could negotiate on behalf of the region to get the best health outcomes.
However, Minister for Regional Health and Mental Health Bronnie Taylor has made it clear she has no plans to change the current district structure.
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