But the Bellinger Health Action Group, forged ten years ago when the whole hospital was facing closure, has heard that the Mid North Coast Local Health District is considering closing the emergency department after hours and on weekends, due to a shortage of local doctors to fill the Visiting Medical Officer (VMO) roster.

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The rostered VMO provides medical cover to the ED, and the entire hospital after hours, for a paid 24-hour period.

"Seven years ago, there were ten local VMOs on staff, providing full coverage of the on-call roster," a BHAG spokesperson said.

"Currently there are only five VMOs and they obviously can't cover all of those 24-hour, seven-days-a-week periods.

"The difficulty in filling the rest of the hours with locum doctors who don't live locally - the expense and the administrative costs - is one of the reasons suggested for reducing ED hours."

When asked for a response to these concerns, Coffs Clinical Network Coordinator Dr Theresa Beswick cited major capital projects worth $12 million undertaken at the hospital in recent years and stated that the health district is "committed to maintaining and improving services provided at Bellingen which will ensure this facility can continue to deliver quality health services to our community".

Pressed on the question of whether a reduction in ED hours was being considered, a media spokesperson replied, "The Bellingen ED is open 24 hours a day, seven days a week. No plan has been made to change that."

According to the action group, a reduction in hours has been discussed, and if implemented, people presenting after hours would be transported to Coffs Base Hospital, 30 minutes' drive away.

For patients in outlying areas such as Kalang, Darkwood, Thora and Dorrigo this would mean a travel-related delay of up to an hour and a half.

The shortfall in local doctors willing to serve as VMOs has developed over the last five years and the BHAG spokesperson speculated that both lifestyle choices and money could be involved.

"Maybe they only want to work two or three days a week, maybe they have families or they just prefer not to work full-time. And some believe there's not enough money in it for them - they're sacrificing working hours in their practices to go up to the hospital and feel that the remuneration is not enough."

Locums can come from as far afield as Albury and Lismore, and pre-COVID from Melbourne and Brisbane, and they are paid a loading for their services, unlike the regular VMOs who are on a contract.

"They also sometimes have to have accommodation, because they're not local. And also there's an administrative cost in trying to source all these people and work out a roster with them."

BHAG said the hospital's VMOs are strongly opposed to any reduction in health services within Bellingen Shire, and favour increased efforts to recruit local doctors and attract new doctors to the area.

They are calling on the Mid North Local Health District to establish a permanent vacancy advertisement on the health.nsw.gov.au website so that information about how to apply for a VMO position at Bellingen is always available, whenever a local or regional doctor is interested.

Also, doctors can visit the BHAG website www.savebellingenhospital.com for information on the VMO vacancies.

Full statement from Mid North Local Health District Coffs Clinical Network Coordinator Dr Theresa Beswick:

Bellinger River District Hospital plays an important role in the Coffs Clinical Network of the Mid North Coast Local Health District (MNCLHD), providing services to the Bellingen and surrounding communities.

The hospital provides specialist palliative care and surgical services to the network. Its Emergency Department (ED) is open 24 hours a day, seven days a week, seeing around 5,000 people per year (approximately 14 per day).

Local general practitioners work at the hospital, five of whom are part of the ED roster.

The local health district has been actively advertising for additional doctors to work at the hospital and while this process continues, locum support is provided to the ED by visiting doctors.

The local health district has invested substantially in Bellinger River District Hospital in recent years, undertaking major capital projects worth more than $12 million.

Since 2011, the site has seen the construction of a dedicated Sub-Acute and Palliative Care Unit, renovation of Hartley House and the refurbishment of the hospital's emergency department and day procedure/theatre unit. A project to upgrade and expand car parking at the health campus, worth more than $2 million, is currently underway and scheduled to be completed by the end of this year.

MNCLHD is committed to maintaining and improving services provided at Bellingen which will ensure this facility can continue to deliver quality health services to our community.

Between mid-2012 and mid-2020 the Mid North Coast Local Health District increased its workforce by an additional 867 full time equivalent staff -an increase of 31.8% including 119 more doctors, 391 more nurses and midwives, and 56 more allied health staff.