Rick Wilson (O'Connor, Liberal Party) Share this | Link to this | Hansard source

I rise to draw the attention of the House to the plight of expectant mothers and their families in my home town of Katanning, a regional service hub in the heart of the electorate of O'Connor. The town of Katanning has a population of around 4½ thousand, but it services a hinterland of an additional 10,000 people. In May 2012 the WA Country Health Service withdrew all maternity service offered by the Katanning District Hospital following the departure of one of the town's two GP obstetricians. My wife Tanya and I were blessed to have all of our four children delivered amongst friends and family by the wonderful Katanning hospital maternity staff, some of whom we have known all our lives.

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Those of us who choose to live in small regional towns accept that we may never have the same access to the full range of health services that our metropolitan cousins enjoy, but we do have a right to the basic services such as a maternity facility. In Western Australian government policy, it seems absurd that, despite an allocation of $35 million to upgrade the hospital, scheduled for 2017, it will remain unable to provide the services which will attract and keep young families in our region. While it may seem indulgent to use this grievance debate to discuss an issue critical to my hometown, the reality is that attracting and keeping suitably qualified medical practitioners is a problem for almost all of the towns across my electorate.

However, as Premier Colin Barnett observed at a recent meeting with local mothers to discuss the lack of maternity services, Katanning is not just another wheat belt town. Katanning is a truly multicultural town. Only 78 per cent of the residents speak English as a primary language, with the balance speaking Malay, Mandarin, Korean, Burmese or Dari. It is a town that has witnessed waves of migration, starting with the Malays in the 1970s and followed by Chinese and Filipinos, who were all drawn to the town by employment prospects at the local abattoir and meat-processing plant. More recently, refugees from conflict zones of Africa and Afghanistan and displaced people such as the Karen, have been settled in Katanning through humanitarian relief programs. More than 40 different ethnic community groups are represented in our community. Katanning is also recognised as an area of low socio-economic status, with median individual incomes of $525 per week, and an average household income of less than $950 per week.

Katanning is also a town of young families, with children under the age of 14 making up 25 per cent of our population. So where are all of these babies born? Before May 2012, the town was fortunate to have two GPs with obstetrics training. Between them they provided a 24-hour on-call obstetric service to the Katanning hospital. Midwives would manage the low-risk deliveries with obstetrics back-up available if required. Emergency caesareans, as well as elective caesareans, were performed on a regular basis. On average, more than 110 babies were delivered at the Katanning hospital every year. But the departure of one of the town's two GP obstetricians forced the suspension of not only obstetrics deliveries but all child-birthing services in Katanning.

Since then, expectant mothers have had to plan their pregnancies to allow for birthing at either Narrogin Hospital, 100 kilometres to the north, or at the Albany Health Campus, 200 kilometres to the south. This is despite the fact that the Katanning hospital continues to be staffed by experienced midwives, and one GP obstetrician remains in the town. Consultation with WA Country Health Services confirms that it would be possible to provide midwifery services at the Katanning hospital; they just don't. To re-establish an obstetrics service, it has been determined that it would now require three obstetrics-qualified doctors to provide a safe and reliable service.

The reality for many pregnant women is that you cannot control Mother Nature. Anecdotally, we hear that babies have been born in the back of ambulances en route to hospital. Recently, one woman gave birth within 10 minutes of arrival at the Albany Health Campus, after a 200-kilometre car journey. Some migrant women are having their babies at home. This is a ticking time bomb with a very real risk of a tragedy in the near future and it is not something I want for my community.

Katanning's unique social make-up means that language and communications can be a barrier to making the necessary provisions for birthing elsewhere. Some members of our community, without the support network most of us take for granted, face special difficulties. One newly arrived migrant couple had no drivers licence and no car. They had to take a taxi to Narrogin at a cost of $385. Many low-income women simply cannot afford to relocate two or three weeks prior to their due date, nor can their husbands or partners take the necessary time off work. For women who have had children before, a baby can come much faster than expected. Nine babies have actually been born at the Katanning hospital in recent months to women presenting in advanced stages of labour. Midwives have delivered these babies successfully, but with scant knowledge of the women's medical or antenatal history. That is a big ask—and potentially a big risk.

Surprisingly, despite the availability of excellent birthing services in Albany and Narrogin, the most distant option—birthing in Perth, 285 kilometres away—is the option many of the more affluent women choose. A survey of local mothers was recently conducted by a resident GP, with findings submitted to the WA health department. That survey suggested that most middle-class women choose to deliver their babies in Perth because they have accommodation and childcare options such as staying with family for an indeterminate period of time. But the expense of travelling for up to eight antenatal visits, the disruption to their children's routine, the exhaustion of their husband's leave entitlements and the impost on their extended family were all cited as issues they experienced with birthing out of town. Given the choice, every woman surveyed indicated they would have chosen to give birth in Katanning, were it possible, even if there were no specialist obstetrician or anaesthetist available.

Earlier this year, research teams of health professionals from the University of Sydney, the University of Queensland, the University of British Columbia, the Northern Rivers University Centre for Rural Health in Lismore, the University of Wollongong and Southern Cross University visited Katanning to assess whether the town fits an internationally conceived model which identifies areas in need of birthing facilities. This model, the Australian Rural Birth Index, suggests that Katanning has the combination of factors that necessitate local birthing services. Those factors are a large reproductive-age population, high actual birth numbers and a combination of indices of social disadvantage affecting access to distant birthing services.

The outcomes of this study are not yet published but outcomes from studies in Far North Queensland and rural Victoria suggest that Katanning Hospital is, at the very least, eminently suitable for a midwife-driven delivery service with professional backup from the excellent regional facilities in Albany and Narrogin. The Katanning Hospital should be able to provide a low-risk, or level 2, birthing option with its existing staff of midwives and the local GP. Of course, offering a full maternity service at Katanning would require further obstetric capability. For the past 2½ years there has been a recruitment drive to secure suitably qualified doctors, as well as incentives to encourage upskilling of the local GP workforce; unfortunately, all to no avail. Meanwhile, Narrogin Hospital enjoys the luxury of three GP obstetricians, plus a general surgeon with Caesarean capabilities, just an hour and a quarter's drive away. So could the two hospitals collaborate to enable a full service to operate at both locations?

Premier Colin Barnett recently attended a community meeting to hear the views of the Katanning mothers. I thank him for the time he spent respectfully hearing the views of every woman present on that day. Women came to share their own experiences or to tell the story of migrant women who could not speak for themselves. The message Mr Barnett relates to his health minister will, hopefully, be that Katanning is a community in need of a birthing service—for the refugee women, for the Indigenous mothers, for the displaced, for the underprivileged, for the ordinary and for the affluent—because every local woman deserves the opportunity to birth in a purpose-built facility such as the maternity ward of the Katanning Hospital, supported by a group of skilled and dedicated professionals and surrounded by the familiar faces of their loving family and friends.

I started this fight well before I came to this place. In every community there are strong leaders who make a real difference and Katanning is lucky to have one of them in Paula Bolto. Paula gave birth to her first three children in Katanning, then had to go to Albany for the birth of her fourth, Lucy, because by that time Katanning's maternity facility was not available. Paula was one of the fortunate ones. Her circumstances meant she was able to relocate to Albany for three weeks before Lucy's birth. But she knew that it was not easy for many others in our community.

Paula and I decided to do something about it. She established the 'Save Our Maternity Hospital' lobby group and within three weeks we had a petition with nearly 5,000 signatures calling for the reinstatement of a maternity facility. We presented that petition to the WA state parliament 12 months ago—unfortunately, to no avail. Paula has not stopped since, working tirelessly with her team of dedicated volunteers and lobbying anyone who will listen, in an effort to bring this issue to a successful resolution. I bring their endeavours to the attention of this place in the hope it will facilitate a favourable outcome for the women of my home town.