A Canberra woman whose mother bled to death at a doctorless hospital is calling out "systemic failures" in the regional health system.
Dawn Trevitt died unexpectedly on Tuesday, September 15 from a gastrointestinal bleed when she presented to Gulgong Hospital - also know as a Multi-Purpose Service or MPS - in the NSW central tablelands. She was treated by a doctor over teleconference because there were no doctors available after hours.
Her daughter, Canberra woman Hayley Olivares said they family had been mortified at the level of health care being provided in regional NSW.
"This can't be acceptable," she said, while emphasising her concerns were about systemic issues rather than the care her mother received from staff at the hospital.
"...I feel like I've lost a beautiful, generous, caring mother. I'm devastated that my three girls are not going to grow up and have the same memories of her that I have."
She described the shock of the afternoon that her mother died. It began with a phone call from her aunt.
"My aunt who was visiting my mum and dad at the time called me late that afternoon and said mum had been picked up by an ambulance and was on the way to hospital," Ms Olivares, who grew up in Gulgong, said.
Ms Olivares called the hospital who told her that her mum was conscious but they were concerned by her low blood pressure. She initially expected to be told she would be transported elsewhere.
"They told me that she had presented and they were treating her there, that anybody that worked at the MPS was currently working on her and that she was gravely ill, but was conscious and talking to them," Ms Olivares said.
"Mum was only 66. I wasn't tracking that she was unwell.
"They said, give them 20-30 minutes and call back and hopefully they'd have something to tell me at that point."
But before Ms Olivares could call back, her mother had died.
"My father, myself and my brother - we were shocked. My brother and I both reside in cities, so when we understood that this is the level of health care that the communities are provided we were mortified. This can't be acceptable," she said.
"I'm not sure who in the decision making process thinks that replacing physical doctors with video facilities is appropriate. I'm not quite sure on what information they're forming those decisions."
Ms Olivares said she could not stress enough that she saw this as a systemic failure and did not want to single out any MPS staff who went above and beyond to serve the community.
"I don't want them at all to think that this is targeted at mum's specific treatment at the MPS. That's absolutely not what it's about," Ms Olivares said.
"I'm not suggesting that they did anything wrong, or that even having a doctor there would have made a difference to my mum. It's more about asking 'Is this an acceptable level of health care for rural and regional Australia?' In my view, no.
"So what are we going to do about it?
"There was no follow up with us as a family from the MPS. I haven't spoken to anybody from that service or facility or from NSW Health since mum has passed away."
NSW Health Minister Brad Hazzard has called for a full report on the situation at Gulgong Hospital after the incident.
Gulgong MPS has been without a doctor since June after Western NSW Health did not renew a visiting medical officer contract, leaving the facility doctorless and forcing patients into telehealth consults - sometimes with a doctor overseas.
Ms Olivares said her mum - who had been a teacher at Gulgong Public School - was the type of person to put people before herself.
"For her entire professional life she dedicated a lot of time, effort and energy to providing opportunities for me. She was a very devoted wife. My dad had a stroke in 2012 - and since that time she has cared for him selflessly and retired effective immediately when he got sick," she said.
"From the time she was a school teacher she was always trying to help those that were struggling in the system, just to give them better opportunities.
"And that was reinforced to us as a family, which was so heartwarming - that we had all of these beautiful tributes flowing in about how much of a difference she made to individuals lives who are now adults, and how she was the one that believed in them when they felt like nobody else did."
Ms Olivares described her mum as a dedicated teacher, mother and carer and passed on a handwritten letter she received from a former student of her mother's during her time at Gulgong Public School.
"Our deepest condolences on the loss of your loved one," the letter read.
"Dawn was truly one in a million with her ambitious attitude, helping everyone that stepped foot into her classroom succeed no matter their ability. She was always there with her compassionate, hard-working attitude.
"It's safe to say throughout our primary school years that Mrs T was a mother to us. Always there to lend a helping hand when you're struggling. She helped shape our futures with tutoring lessons that will never be forgotten.
"Throughout all our adventures, we will forever cherish the times spent with Mrs T. We send loving thoughts to you as you say goodbye and move forward."
In September, Gulgong resident Sharelle Fellows, along with another Gulgong resident Kathryn Pearson decided to distribute both a digital and then a paper petition calling the NSW Health Minister to appoint a doctor as a matter of urgency.
The petition now has more than 3000 signatures.
"We hope to get the petition finalised and to Parliament within the next two weeks while parliament is still sitting," Ms Fellows said.
"People in the community are shocked and saddened as they had not realised the circumstances of Dawn's death. Many people were still unaware that there was no physical doctor present at the MPS in emergency situations. The situation needs immediate resolution."
'Cuts not acceptable'
The Mudgee Guardian reported earlier in the year on the issues arising in Coolah and Gulgong communities when VMO contracts were not being renewed, leaving towns without adequate medical services.
Western NSW has come under fire for the way these contracts are being offered with reduced compensation. Former Coolah GP Dr Abbas Haghshenas confirmed that his decision to leave the area after five years came after a new contract offered less pay.
"It was disrespectful I thought, after five years and training two more doctors. I didn't expect a pay rise but not pay cut either," he said.
In September, a Western NSW Health spokesperson told the Mudgee Guardian that it was a challenge attracting doctors to regional areas.
"The Western NSW Local Health District has been, and continues to, actively recruit for Visiting Medical Officer roles at Gulgong Multi-Purpose Service," the spokesperson said.
"Recruiting health professionals to regional, rural and remote areas is a challenge nationwide and not just confined to our region, regardless of financial incentives."