AMA president Michael Bonning visits Tamworth, lays out $50 million fix to stop New England health system from 'collapsing'

That's the view of the state head of the powerful national doctors' group, the Australian Medical Association NSW president Dr Michael Bonning.

The Leader sat down with Dr Bonning on Wednesday, where he laid out the beginnings of a plan to invest in local services to help close gaps in chronic care, which have proven the main concern for the region's doctors.

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"Moving $50 or $60 million in that budget from Newcastle to out here would make a world of difference for out here," he said, as part of a visit to the region this week to talk health needs with local clinicians.

"And what we're talking about is thinking about how you use the services here, in Tamworth, Armidale, especially, as our biggest referral hospitals more effectively."

Dr Bonning said there was an economic argument and a clinical case for decentralising health services, as well as simply convenience for patients.

He said the state health system could find some of the tens of millions of dollars of additional investment needed by slashing spending on patient transport and other costs associated with treating bush patients in Newcastle hospitals.

"That cost is borne both in dollars and also in outcomes. It is harder to fix something 24 hours later once the patient gets to John Hunter [Hospital] than it is to fix it here and now," he said.

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The association chief spent Tuesday and Wednesday meeting with doctors at Tamworth and Armidale hospitals, private practices, and representatives from the local health bureaucracy and medical education system.

His visit comes in the aftermath of the release of the rural health inquiry, which slammed the health system as in crisis, which had caused "premature deaths" among people in rural areas.

He said the chief shortages were in primary care - like GPs - and in specialties to treat chronic disorders like diabetes, rheumatoid arthritis or dementia.

"There are so many patients, in primary care, who fall in this chasm, they are too complex for general practice, they are not sick enough for the emergency department, and they can't afford a private specialist," he said.

"The public system will say 'we can see you in 12 months'.

"And the takeaway with that is that those patients then become sicker but also harder to manage and take up more time.

"If you intervene in that spiral for the individual patient and actually bring them out of that, get a bit of help ... done."

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While he didn't take a clear side on the proposal to break up the Hunter New England health district, Dr Bonner said a divorce wouldn't solve everything.

He pointed out that small rural districts are heavily dependent on a fly-in, fly-out workforce and lack a "critical mass" to provide a range of services.

"It's never going to get any face time at the ministry," he said.

Dr Bonning said whatever change happens, he said it needs to take place quickly, before the old generation of rural doctors leaves the industry, either by retiring or moving away from a health system facing a death spiral.

"Because if you're going to say, well, we'll just keep doing it the same way we've always done it, how are you going to expect anything other than the same results?" he said.

"And those same results have been a continued loss of workforce, and a continued kind of degradation in the ability to provide the care that's needed for locals in town."

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