The first white settlers came to the North Coast in the 1840s, a time when few of the things we take for granted today even existed. Medical treatment, such as it was, came in the 1860s and 1870s with the arrival of the first doctors.

In this issue we review (page 6) Dr Neil Thompson’s history of the Richmond Valley doctors from 1866 to 1986. Many people, both medical and lay, are fascinated by this history and have wanted to learn more about their predecessors.

To help get these stories to a wider audience the NRGPN and the Nordocs Group have liaised with Dr Thompson to have the book published in electronic format as an Amazon Kindle ebook. We thank Neil for allowing us this privilege and pay tribute to him for the many hours of devotion to our community that he spent in researching and writing this history.

We also pay tribute to three GPs recently honoured by the Rural Doctors Network (page 13). Ian Falson and Chris Mackenzie of Ballina and Anil Thakur of Maclean were granted the organisation’s Rural Service Medical award in recognition of the special skills they brought to their communities and the years of service they have provided.

Dr Chris Lowry (page 31) has been award the Order of Australia Medal for services to anaesthesia in the Australian Honours list. The award is richly deserved for his years in hospital administration, medical training, overseas volunteering and for his expertise in underwater medicine.

We also mark the end of an era with the recent retirement from the North Coast Primary Health Network of Dr Tony Lembke. On page 16 Dr Lembke reflects on his time leading the local primary health care organisations, first established in the early 1990s as Divisions of General Practice and later morphing into General Practice Networks, Medicare Locals and now the present day Primary Health Networks.

Tony’s work has been a shining example of the Institute for Healthcare Improvement’s fundamental tenets. He has aimed to improve the efficacy of the health care system in addition to improving the health of his own patients while at the same time valuing the skills and input of all those involved in health care delivery.

All members of the team are crucial to achieving this aim and everyone from the most experienced surgeon to the youngest wardsman has their part to play. Most hospital patients, however brief their stay, will marvel at how efficiently things run when everybody is focussed on their job and how smoothly it all works when the team is performing well.

However, they also observe that things do not always go well and can even can go very badly.

On page 15, Dr Charlotte Hall describes the improvements that can be achieved when attention is paid to getting the team to focus on their “team work”. Along with her colleagues she has developed the ADEPT training course that teaches medical personnel the human-factor skills such as leadership, communication, assertion, conflict management, self-awareness, situation awareness, and decision-making that can literally make the difference between life and death in emergency situations.

According to Neil Thompson innovations in medical care such as this have a long-standing tradition on the North Coast. On page 29 Dr Zewlan Moor reviews the book Eggshell Skull that deals with the medical, social and legal costs of sexual assault. Dr Moor has pioneered bibilotherapy for patients on the North Coast. However, this book is recommended as therapy for the medical professionals treating these patients who may suffer the vicarious injury that this work may invoke.

Hep C is now a curable condition and the Australian government is to be congratulated for making the medication affordable for all Australians. However, affordability does not mean accessibility. Through their work with Balund-a residents, which is a diversionary
NSW Corrective Services facility south of Tabulam, Drs Binns and Silberberg have
identified a significant incidence of potentially curable hepatitis C infected patients that can miss being treated in the jails (page 25). They have teamed up with Professor Greg Dore of the Scale-C project that uses innovative techniques to address the issues in this vulnerable group.

The 2012 Reith Lectures The Rule of Law and Its Enemies was given by historian and commentator Professor Niall Ferguson. In this series he argues that modern societies have been successful due to the combination of science and modern medicine, together with competition, consumerism and the work ethic that in turn depend on the inviolability of property rights.

The extent to which efficiencies can be derived from market forces in the delivery of primary care services is currently being tested by the Australian government through its Primary Health Network system. There are potential pitfalls with this approach and the Australian Labor Party has signalled that there may be changes should it win government in the election expected for May.

In his final Reith lecture, Civil and Uncivil Society, Professor Ferguson notes that not all services are best delivered by government. He sees a role for both public and private organisations in education at both the secondary and tertiary levels. While he does not address the issue per se it would be reasonable to make the same argument for medical care at the primary and secondary levels.

However, Professor Ferguson is a strong supporter of local community groups that come together to address a local need or issue. In his own case he has high praise for his local Lions Club in the south of Wales.

Nordocs is the local group of doctors on the Far North Coast of New South Wales. It has its own Facebook page, meets for drinks once a month in a local watering hole and is holding its annual “Unconference” in June this year. All local medical practitioners are invited to come along, have a chat with their colleagues, listen to the talks or better still give one.