CARDIOLOGIST Dr Sesh Narasimhan is angry.
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He is stepping out of the operating theatre to declare cardiac patient care in the Manning Valley as "second-class citizen treatment" and brands as "bulls..t" the Hunter New England Local Health District (HNELHD) statement that "the majority of Manning patients receive transfer and timely care within the agreed 48 hour timeframe".
The catalyst for his decision to speak publicly is the HNELHD decision to not enter into a public-private partnership agreement with Mayo Private Hospital in Taree to allow public patients to access its Cardiac Catheter Laboratory.
Manning Hospital Medical Staff Council chair Dr Murray Hyde Page recently exposed the HNELHD backdown from the in-principle support for the agreement as given by NSW Health Minister, Jillian Skinner during a meeting in Taree two years ago. Dr Hyde Page, Dr Narasimhan, HNELHD chief executive officer Michael DiRienzo and member for Myall Lakes Stephen Bromhead attended the meeting.
Dr Narasimhan is the only cardiologist in the Manning Valley and the genesis of his fight for public patient access to the Mayo's Cardiac Catheter Laboratory is the experiences of his patients in John Hunter Hospital in Newcastle.
"The audacity of these people to say that the majority will receive transfer and timely care within the agreed 48 hours that is bulls..t. It never happens. It never happens," Dr Narasimhan said.
Emerging to stand with him are patients Albert Longworth and Dennis Roe. It is their experiences of Manning Hospital and John Hunter Hospital in Newcastle that reveal the trauma and realities of public patient cardiac care. (See stories page 2 and 3).
"I write letters of complaint to them (HNELHD) and they say, 'yes, thank you' and they do nothing about it. Here is the proof in the pudding. I'm not making up any stories," Dr Narasimhan said.
"All of you are used to second class citizen treatment - you think that is the norm - you are not second class citizens.
"The disease that affects Mr Longworth and Mr Roe is the same thing that is in the eastern suburbs of Sydney. It's just that we have to carry the cross of the desert up and down to get what is rightfully needed for you."
Dr Narasimhan identifies the unavailability of timely access to important lifesaving cardiac procedures as a critical issue.
He also believes HNELHD must consider the impacts of emotional stress, cost and inconvenience on patients and their families in its decision-making process.
He also cites evidence of improved patients outcomes for Aboriginal patients when all treatment facilities are in one location.
Dr David Keegan passionately supports the revelations of Dr Narasimhan adding that he knows "a legion of patients who have waited weeks and weeks and weeks" for treatment.
It is one of the issues Dr Keegan is championing as the Country Labor candidate for Myall Lakes in the NSW election on March 28.
"Now before Sesh came along, they (patients) would be bounced between different physicians - they wouldn't listen to us - but Sesh has got a lot more weight and we can get him to go into bat and get things done. But it shouldn't have to be a battle for each case to get done," Dr Keegan said.
"If you have full private health cover then the system will work for you, but if you don't, and you don't have a terrier like Sesh going into bat for you, well you can languish in the system.
"We have a facility at the Mayo Hospital and public patients should have the right to access it but they (HNELHD) just won't give approval.
"Their first argument was John Hunter Hospital had surplus capacity and therefore it would be cost inefficient to not use that. If there is surplus capacity, why are they going to build a new facility in Port Macquarie and two in Maitland when we have one that is operational?
"They keep threatening everyone who speaks out, threatening their jobs, threatening defamation suits, all sorts of things to shut us all up. If we shut up we will wither on the vine. Port Macquarie will keep on thriving and now Maitland and others."
Dr Narasimhan contends HNELHD chief executive officer Michael DiRienzo is supportive of a public-private agreement for the Maitland Hospital development and argues that "what applies to Peter must apply to Paul."