The editor,

Over the past 10 years we have seen the gradual loss of birthing and surgical services in many small country communities and unfortunately, we know that this trend is likely to continue.

This loss of service was unplanned and is a consequence of individual decisions by doctors and other clinicians who have retired or otherwise moved on.

This comes at a time when there is a recognised shortage of doctors right across Australia, and country communities are struggling to attract general practitioners.

The Country Health Care Plan released recently for consultation is aimed at providing more health services in the country while taking into account the inevitable changes described above.

In other words, we want to make sure that if services go from a small community there is back up available within a reasonable distance.

The plan identifies three tiers of hospitals:

1) Port Lincoln, Whyalla, Mount Gambier and Berri.

2) Clare, Barossa, Ceduna, Kingscote, Millicent, Murray Bridge, Naracoorte, Port Augusta, Port Pirie, Roxby Downs and Wallaroo.

3) And 43 of the smallest hospitals.

Under our plan the first tier of hospitals will have an increased range of medical and surgical services.

Eighty-five per cent of country South Australians live within 60 minutes of one of these centres.

Tier three hospitals will offer emergency services as well as continuing to provide existing services while there is workforce available to provide them safely.

Of these 43 hospitals, we have identified 14 which do not provide either surgical or birthing services.

They are: Elliston, Eudunda, Karoonda, Snowtown, Cowell, Hawker, Kimba, Tailem Bend, Orroroo, Burra, Gumeracha, Pinnaroo, Barmera, and Lameroo.

To look at the future service profile of these centres I have established a taskforce of rural doctors, nurses and others chaired by independent chairman Peter Blacker.

Over the next six months the taskforce will work with these hospitals and the other 29 smaller hospitals where we expect existing services to be maintained.

Let me make one thing plain: no hospital will be forcibly closed and no hospital will lose its emergency services.

I understand that many country residents have been worried by the plan and the government's intentions.

I am sorry for any anxiety that has been caused and I hope that this letter clarifies our intentions.

I have appreciated hearing from many country residents and I can assure you that your voices have been heard.

John Hill

Health Minister