Small Tasmanian town loses its only GP

Dr Cyril Latt first visited the small town of St Marys in Tasmania’s Fingal Valley in 2006, working as one of the many locum doctors who would pass through and staff the local hospital and community health centre.
 
The region continued to rely on locum doctors until 2010 when Dr Latt, a dedicated rural generalist, made the decision to move there with his family on a permanent basis. Since then, he has been St Marys’ only doctor, providing the local community with GP services through his clinic, alongside emergency and palliative care services at the local hospital.
 
‘It’s a great place, it’s a great life,’ Dr Latt told newsGP, describing what first drew him to the town – the close-knit community feel and the snow-capped mountaintops he can see from the window of his home. He is often greeted by fresh eggs and vegetables from the local community on his veranda – small gestures of appreciation from his longstanding patients.
 
But despite the beautiful views and deep community ties, Dr Latt has been slowly worn down by the impossible demands of running a busy GP clinic and the on-call requirements of St Marys hospital. He feels he has not been provided with enough government support and his concerns around the excessive workload have been ignored for too long.
 
After continued attempts to re-negotiate the terms of his employment, Dr Latt left the community rattled when he tendered his resignation last week shortly after signing a two-year contract renewal with the Tasmanian Department of Health.
 
‘Everyone thought I got a new contract and signed happily, but that is not the case,’ Dr Latt said.
 
‘You are the only doctor, so you are on call 24/7, 365 days – that’s a problem.
 
‘In the early years there was occasionally a locum, so that wasn’t a problem. But in the last four or five years, especially since COVID, there’s not really many locums at all’.
 
Dr Latt’s clinic provides care for 1800 patients, many of whom travel from out of town to see one of the longest serving doctors on Tasmania’s east coast.
 
At the hospital, Dr Latt services the entire Fingal valley, an area that includes coal mines, mountain passes, farmland and has nearby beaches. Accidents and traumatic injuries are a common occurrence and he fields calls at all hours of the day and cannot remember the last day he had off.
 
His family left St Marys seven years ago so that the children could attend school and university, and due to his on-call demands, he is only able to see them three times a year when they visit during the school holidays.
 
Over the years, Dr Latt says he has repeatedly pleaded with the Department of Health to source another doctor, and that he had been asking for help long before his current contract was due to expire.
 
However, after being assured of changes to his work agreement, a draft contract with meaningful changes that would enable Dr Latt to better manage his unsustainable workload never arrived.
 
The timeline for renegotiations was continually delayed until it was too late and Dr Latt says if he did not extend his current contract, he risked the hospital being closed.
 
The experience left him feeling ‘cornered’, as he worried about his vulnerable patients in the hospital, including those receiving palliative care who may not have survived a transfer.
 
After signing, he tried again to re-negotiate the terms but was offered a new contract that he felt would have made him personally and financially responsible for finding another doctor to staff the hospital if he wanted to take time off.
 
It was the straw that broke the camel’s back, and he decided to resign.
 
Prior efforts to find locum medical officers to join him in St Marys – including even international searches sometimes – had generally proved fruitless. He says those who worked on a short-term basis did not want to return due to the workload, while others cancelled at the last minute after they received better offers elsewhere.
 
The on-call pay rate offered in St Marys is reportedly the lowest in Tasmania; however, even with proper funding Dr Latt believes more needs to be done to bring doctors to rural and regional areas with government support at both the state and federal level.
 
‘Money is not the answer, and I haven’t technically asked for any money – what I ask is for assistance, for the Government to find an extra doctor for the hospital,’ he said.
 
‘We need a change in the system to attract more doctors who will stay in the rural areas.’
 
After resigning Dr Latt says he feels relief, but also a great sense of sadness. Although unsure of what is next for him, the plan is to stay in Tasmania and continue working as a rural generalist after a much needed break.
 
‘I haven’t made any decisions yet as I really need a holiday,’ he said.
 
The Tasmanian Health Minister Guy Barnett has said he is committed to ensuring the St Marys Community Health Centre remains in operation; however, it is believed no replacement has been found.
 
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