“The good people of this wonderful valley are tired of being ignored and fobbed off and being treated as the poor cousins of Australia,” Dr Appleton said.

He said the recent letter from Dr Carol Booth about services, and reported in The Macleay Argus, reflected the informal conversations he hears so often among colleagues in medical nursing and ancillary health fields.

“I applaud those who attempt to maintain the level of service this area of extreme disadvantage requires,” Dr Appleton said.

“I await with interest the fate of Dr Booth because, as an employee of the local health area, she is not supposed to make public comment on ‘official policy’.

“I hope that the emperors in the health system will not be too offended by a local

citizen and doctor pointing out that they have no clothes.”

As an independent medical practitioner, Dr Appleton is not an employee of the North Coast Area Heath Service.

He is free to speak his mind and Dr Appleton said Kempsey District Hospital is slowly being bled to death.

“Despite protests to the contrary from the local level Health bureaucracy, even Blind Freddy can see that our hospital has been downgraded continually over the last decade and earlier and that this decision was made a long time ago by high level bureaucrats on a political and Area Health level,” he said.

Dr Appleton said the 45-year-old hospital needs to be rebuilt.

“The range of services offered has decreased in the over nine years I have lived and worked in the Macleay. Notably the ICU has been downgraded and the surgical ward is open only on occasions ‘as required’.

“I am frustrated as much as any person at the double-speak of the situation where wards are not ‘closed’ but merely not ‘open’.

“The range of surgical services has decreased and the waiting lists are as long as ever if not longer.

“When I came here in 1998, eg, a cholecystectomy (gall bladder removal) could be done within weeks at Kempsey.

“This operation is now only done at Port Base and the waiting list is many months as illustrated well to one of my patients who endured frequent attacks of gallstone pain until her recent operation at Port. This was moved up the list at my repeated request or she would still be waiting.”

And Dr Appleton pointed out that for everyone moved up the list another patient is moved down.

“The move of services to Port particularly affects my patients. Most are on the so-called poverty line and have limited access to transport.

He said Port Macquarie is a 90-minute drive from Bellbrook.

“The costs involved to visit or stay with sick relatives are substantial when they are transferred to Port. It is simply untenable for many.”

Dr Appleton says he has some sympathy for the local Health administration employees who he said are forced to repeat the line that all services are being maintained when they aren’t.

“I’m sure that, like other employees of the hospital, they are constrained in what they are allowed to say lest employment is threatened.”