Latest / 360 with Katie Woolf / The AMA's Dr Robert Parker sheds light on code yellows at RDH and PRH and believes the lifting of an alcohol ban has put extra pressure on emergency departments
Transcript
- 0:00Speaker 1: Now we know that the Code yellow at Royal Darwin
- 0:02Speaker 1: and Palmeston Hospitals remains in place. The internal emergency was
- 0:06Speaker 1: declared on Friday and it was the second code yellow
- 0:09Speaker 1: at top end hospitals in two days, with the spike
- 0:12Speaker 1: and emergency presentations causing a code yellow at the Catherine
- 0:16Speaker 1: Hospital on Thursday. Now yesterday, the Chief Minister explained that
- 0:20Speaker 1: the pressure on a Royal Darwin Hospital and Palmeston Regional
- 0:23Speaker 1: Hospital is due to staff shortages, arise in mental health
- 0:27Speaker 1: patients and long stay patients taking up beds. Now to
- 0:31Speaker 1: shed a bit more light on this situation and let
- 0:33Speaker 1: us know what is going on, is doctor Robert Parker,
- 0:36Speaker 1: who is indeed the head of the AMA, the Australian
- 0:39Speaker 1: Medical Association's Northern Territory branch. Good morning to you, doctor Parker.
- 0:44Speaker 2: Morning kab Now doctor Parker, what.
- 0:47Speaker 1: Do you understand has led to these code yellows?
- 0:51Speaker 2: Well, I think, as I've said in previous interviews, I
- 0:54Speaker 2: mean in two thousand and nine and I recom Minister
- 0:57Speaker 2: haunt pointy hospitals with the business hospitals in Australia often
- 1:02Speaker 2: two or three some of the busiest of the states
- 1:04Speaker 2: and territory and just they have been underfunding for years
- 1:09Speaker 2: by both sides of government, both said the Land States,
- 1:13Speaker 2: and it's now coming to the crunch where we haven't
- 1:17Speaker 2: got enough beds, we haven't got enough star and the
- 1:22Speaker 2: problem is with hecare again, we haven't got enough hcare beds.
- 1:26Speaker 2: So people who are infirm and are significantly disabled who
- 1:29Speaker 2: need to be in an hdre bed are actually sort
- 1:32Speaker 2: of backed up in the hospital are waiting for further care,
- 1:36Speaker 2: all of which is contributing to you this very high
- 1:39Speaker 2: pressure on the hospital and all the code yellow, which
- 1:42Speaker 2: is really justus a statement of the hospital, you know,
- 1:44Speaker 2: is just overwhelmed with a range of factors that some
- 1:49Speaker 2: are some have been long term and some are much
- 1:52Speaker 2: more short term. But it's just continuing pressure. And I
- 1:55Speaker 2: think it just reflects the fact that I mean what's
- 1:58Speaker 2: happening in the territory is it's fairly similar unfortunately to
- 2:01Speaker 2: what's happening in other parts of Australia. And I mean
- 2:04Speaker 2: the AMA has had this block jam campaign nationally because
- 2:08Speaker 2: of similar pressures affecting other hospitals and other states and territories.
- 2:14Speaker 2: And it also to a degree reflects two sort of
- 2:19Speaker 2: patient issues which are an aging population. People are living
- 2:24Speaker 2: longer and we've got the sort of baby boom are effects.
- 2:27Speaker 2: So when people are turning up to hospital quite often
- 2:29Speaker 2: they've got complex issues. You know, in the old days,
- 2:32Speaker 2: you probably turn up with us one or two significant
- 2:35Speaker 2: issues that could be meaningfully managed in this charge. But
- 2:38Speaker 2: the complexity of people turning up to the hospital these
- 2:40Speaker 2: days is more intense, and that means that they tend
- 2:44Speaker 2: to tend to have admissions and longer stays doctors. Another
- 2:48Speaker 2: factoring assist from the territory is that a third of
- 2:51Speaker 2: our population or indigenous, and there's a I mean, the
- 2:54Speaker 2: close the gap mortality is just sort of the apex
- 2:57Speaker 2: of a pyramids and underneath that bectures all the chronic
- 3:01Speaker 2: illness factors that lead to hospitalization. In that letter I
- 3:06Speaker 2: wrote to Minister Hunt, I pointed out that we've got
- 3:09Speaker 2: we had at that stage half a number of primary
- 3:11Speaker 2: care practitions we needed in remote and rural areas, and
- 3:15Speaker 2: we had double the number of avoidable admissions. Yeah. I mean,
- 3:19Speaker 2: and obviously there's a reflection now, I mean, obviously everyone's
- 3:22Speaker 2: very concerned about the GPS, lack of GPS in Australia
- 3:28Speaker 2: and falling numbers of GPS, and secondly, the obviously the
- 3:33Speaker 2: issue about block willing and being able to access GPS
- 3:38Speaker 2: because you know, GP's that because of the under fund
- 3:41Speaker 2: their practices and take money over to their families, GPS
- 3:44Speaker 2: are often having to abandon while billing because it just
- 3:48Speaker 2: isn't it isn't giving them a viable business anymore.
- 3:51Speaker 1: Yeah, something we've spoken about.
- 3:53Speaker 2: Impacting currently on the current situation.
- 3:55Speaker 1: Yeah, it is certainly something we've spoken about before. And
- 3:57Speaker 1: that point you make about the fact that you know
- 3:59Speaker 1: that you written to the federal Health Minister all the
- 4:01Speaker 1: way back in twenty nineteen about these issues and also
- 4:04Speaker 1: about the funding. Dr Parker, can you paint a bit
- 4:08Speaker 1: of a picture for our listeners at the moment, you know,
- 4:09Speaker 1: when we talk about a code yellow in both the
- 4:13Speaker 1: Royal Dalwen Hospital and the Palmerston Regional Hospital, what are
- 4:16Speaker 1: we talking here? Are we talking about patients being in hallways?
- 4:20Speaker 1: Are they double bunked? What's going on?
- 4:23Speaker 2: Well, there may be double bunking at times. I think
- 4:25Speaker 2: it's unlikely there are patients in hallways, but I can't
- 4:27Speaker 2: absolutely say that doesn't happen. What that means is that
- 4:30Speaker 2: the hospital has regular meetings, so you know, rather than
- 4:33Speaker 2: doing a daily business, you have to go to meetings
- 4:35Speaker 2: a couple of times a day to look at patient
- 4:37Speaker 2: flow and what's going on in different departments. So the
- 4:41Speaker 2: hospital goes to a sort of much higher level of
- 4:44Speaker 2: acute sort of putting to try and manage the situation.
- 4:47Speaker 2: And I'm quite often unfortunately that leads to cancelation of
- 4:51Speaker 2: I like you're surgical that and again you know, quite
- 4:54Speaker 2: often the people have been on thesese for months and
- 4:55Speaker 2: they've often got crying, disabling and painful conditions. But that's
- 5:00Speaker 2: that's how the hospital managers by diverting resources away from
- 5:05Speaker 2: the services that they can sacrifice the short term to
- 5:09Speaker 2: try and manage the very high bed state.
- 5:12Speaker 1: Now, Dr Parker, the opposition claims that the lifting of
- 5:15Speaker 1: the alcohol ban has added extra pressure on the health system.
- 5:20Speaker 1: From your perspective, is that the.
- 5:21Speaker 2: Case, I would think that's a factor certainly. I mean
- 5:24Speaker 2: I was very concerned and obviously very vocal when the
- 5:28Speaker 2: chievement is that have decided not to pursue the stronger
- 5:31Speaker 2: futures issue with alcohol bands and communities, and we predicted
- 5:35Speaker 2: a that there would be an increasing impact on emergency
- 5:38Speaker 2: departments with alcohol related injuries and other issues and leaders
- 5:43Speaker 2: would have a devastating impact on the families of people,
- 5:46Speaker 2: you know, with domestic violence and children exposed to pretty
- 5:49Speaker 2: awful situations at home, which will have much more of
- 5:52Speaker 2: a long term mental health impact. So I would tend
- 5:55Speaker 2: to agree with the opposition that it's a factor. It's
- 5:57Speaker 2: not the whole situation, but certainly actor in the increasing
- 6:01Speaker 2: pressure on hospitals.
- 6:02Speaker 1: So since the ending of that legislation, the Stronger Future's legislation,
- 6:06Speaker 1: would you say that there has been a difference in
- 6:09Speaker 1: terms of, you know, what you're seeing in there at
- 6:12Speaker 1: the hospital.
- 6:14Speaker 2: Well, again, I've always been concerned that, you know, people,
- 6:16Speaker 2: it seems to be related to human rights and the
- 6:18Speaker 2: human right to have a drink and then and then
- 6:21Speaker 2: use your partner and destroy your family, you know. And certainly,
- 6:24Speaker 2: I mean, the Department hasn't been particularly forthcoming with statistics,
- 6:29Speaker 2: but I think Bill Yan has probably anecdotally heard from
- 6:32Speaker 2: collisions on the floor about increasing rates of alcohol fuel
- 6:36Speaker 2: is is presenting do ed. The AMA has got no
- 6:38Speaker 2: information about this. It's unlikely we'll get any formal data
- 6:43Speaker 2: from the department about this. But certainly, I mean, I
- 6:46Speaker 2: think it's almost inevitable, as I predicted at the time
- 6:49Speaker 2: that when you abandon alcohol restrictions, people will drink and
- 6:53Speaker 2: there will be significant consequences from that.
- 6:55Speaker 1: So from what I'm hearing, you would say that that
- 6:59Speaker 1: right now, you know that is part of the issue here,
- 7:02Speaker 1: the changes to the alcohol legislation, but also you know
- 7:05Speaker 1: the fact that that there's not enough funding for our hospitals.
- 7:09Speaker 1: We have got one of the sickest populations in Australia
- 7:13Speaker 1: and that we realistically need more funding.
- 7:16Speaker 2: Well, that's correct, I mean there is I mean I
- 7:17Speaker 2: also agree with the Chief Minister about nurses. I mean,
- 7:21Speaker 2: unfortunately there has been a significant problem with nurses entering
- 7:26Speaker 2: nurse or people entering nurse training in Australia, and I
- 7:29Speaker 2: mean we used to supplement obviously with people coming from overseas.
- 7:35Speaker 2: COVID had a significant impact on that, as I understand
- 7:39Speaker 2: with closing borders, so that had a major impact on
- 7:42Speaker 2: being able to obtain a workforce. But obviously I'm understanding
- 7:46Speaker 2: is now that there's a backlog of visa applications and
- 7:50Speaker 2: they know the Department, to its credit, is working with
- 7:52Speaker 2: the federal government to try and fast track visa applications
- 7:56Speaker 2: so we can get the stuff we need to run
- 7:58Speaker 2: the hospital.
- 7:59Speaker 1: So it is an he sure of staff shortage as well.
- 8:02Speaker 1: What about when you talk about you know, our doctors
- 8:04Speaker 1: and like, have we got a shortage there?
- 8:08Speaker 2: Well, again, I mean we're still waiting for the EBA
- 8:10Speaker 2: to go through, and I mean we're a where the
- 8:12Speaker 2: ninety percent of territory doctors decided that what the government
- 8:15Speaker 2: offered was not it was not appropriate. The issue is
- 8:20Speaker 2: that people can view this as agreedy doctor issue, But
- 8:23Speaker 2: the problem is we have to be competitive in the market,
- 8:27Speaker 2: and we're competing against other states and territories and if
- 8:30Speaker 2: their awards are better, people tend to go and work
- 8:33Speaker 2: in other places. So the territory has to have a
- 8:36Speaker 2: competitive medical officers award to get the staff we need
- 8:40Speaker 2: to keep the place running. And we have and ASMOV
- 8:43Speaker 2: have been in communication with the government about that. And
- 8:46Speaker 2: I mean the government, to its credit, has changed as
- 8:49Speaker 2: wages policy now and ASTHMA are continue to work with
- 8:53Speaker 2: the government to achieve a workable wages policy so we
- 8:57Speaker 2: can recruit medical staff because at the moment, again, you know,
- 9:00Speaker 2: we are unable to recruit up and against the awards
- 9:03Speaker 2: and we've got, you know, we get locums, and locums
- 9:07Speaker 2: at the moment can charge up to three thousand dollars
- 9:10Speaker 2: a day to work and that's you know, that's what
- 9:12Speaker 2: the market. That's what the market says, you know, and
- 9:15Speaker 2: we have to pay to keep the service going. And
- 9:17Speaker 2: I've often said to the department, work out how much
- 9:20Speaker 2: a measure, you know, work out how much you're paying
- 9:23Speaker 2: them locans as opposed to how much it's going to
- 9:25Speaker 2: cost to get an award through. And the Department hasn't
- 9:28Speaker 2: decided to do that, but I mean, you know, it's
- 9:30Speaker 2: a bit of a false economy where you haven't got
- 9:32Speaker 2: a viable of wards, you can't recruit medical staff, and
- 9:35Speaker 2: you're having to pay locums a large amount of money
- 9:37Speaker 2: to keep the health service going.
- 9:39Speaker 1: Dr Parker, do you think that what the government is
- 9:42Speaker 1: doing right now in the Northern Territory is working or
- 9:45Speaker 1: what do you think needs to happen to try to
- 9:48Speaker 1: ease these issues that we are seeing with the code yellows,
- 9:51Speaker 1: because it seems as though we have seen more of
- 9:54Speaker 1: them in the recent year than what we had than
- 9:57Speaker 1: what I ever recall being called previously.
- 10:00Speaker 2: Well, look, I think you know, and the credit to
- 10:02Speaker 2: the to the Chief Minister and the Health Ministry. I
- 10:04Speaker 2: think she is working. I mean a lot of these
- 10:06Speaker 2: issues and the years in development, you know, and I said,
- 10:09Speaker 2: both sides of politics have been have been equally involved
- 10:14Speaker 2: in the underfunding of health, and I think the Chief Minister,
- 10:17Speaker 2: to a credit is trying to just trying to communicate
- 10:21Speaker 2: with the federal colleagues about issues and trying to develop
- 10:23Speaker 2: some funding and also develop some future planning for the
- 10:26Speaker 2: Health department. I mean, the the these these situations can
- 10:32Speaker 2: be a it seasonal. I mean, for example, you know,
- 10:35Speaker 2: with with with COVID and with the flu, you can
- 10:38Speaker 2: put increasing pressures and the pressure goes away for a while,
- 10:40Speaker 2: comes back again. But I think the the you know,
- 10:44Speaker 2: the the continuing code yellow is just to mean that
- 10:48Speaker 2: obviously there's a level of illness in the community for
- 10:51Speaker 2: a range of factors that are putting significant pressure and
- 10:54Speaker 2: we're more likely to see how yellows in the future
- 10:57Speaker 2: because there's sort of like a catch up with any
- 11:00Speaker 2: of these issues. Starving shortages, underfunding, age fare have been
- 11:05Speaker 2: years in the making and can't be undone quickly and
- 11:09Speaker 2: have to look at a sustainable coming option. Yesterday, you know,
- 11:13Speaker 2: with the current economic climate and with the dead both
- 11:16Speaker 2: federally and with the MC I can't see rivers and
- 11:19Speaker 2: money's do the opening up nice for the starving situations
- 11:21Speaker 2: in the short term.
- 11:22Speaker 1: Now I know that the Australian Salary Medical Officers Federation
- 11:26Speaker 1: had described the situation in the Northern Territory right now
- 11:30Speaker 1: as at crisis point. Would you say the same, Well, again,
- 11:34Speaker 1: it is.
- 11:35Speaker 2: A crisis point, but I mean the crisis both. You
- 11:38Speaker 2: know the Chinese character for crisis the calligraphy apparently those
- 11:42Speaker 2: elements of danger and opportunities. So there are danger, but
- 11:45Speaker 2: there's also an opportunity to look at ways we can
- 11:48Speaker 2: build the situation, maybe attract attract more funding, look at
- 11:53Speaker 2: different ways of doing things a case.
- 11:55Speaker 1: Well, Doctor Robert Parker, the head of the a m
- 11:57Speaker 1: A here in the Northern Territory, always appreciate your time.
- 12:00Speaker 1: Thank you very much for having a chat with us.
- 12:03Speaker 2: Good to talk to you, Katie.
- 12:04Speaker 1: Thank you