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Speaker 1: In health news. Well, the Minister yesterday joining us on

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Speaker 1: the show Steve Edgington, to talk about the fact that

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Speaker 1: the Chief Minister Leafanocciairo signed that landmark deal with the

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Speaker 1: Prime Minister and State and territory leaders which is going

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Speaker 1: to deliver an additional twenty five billion dollars for public hospitals,

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Speaker 1: including up to an additional one billion dollars for the

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Speaker 1: Northern Territory. Now, this five year funding agreement locks in

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Speaker 1: a single the single biggest contribution by the federal government

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Speaker 1: to the territory's hospital now obviously well hospitals.

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Speaker 2: I should say we heard from the.

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Speaker 1: Health Ministry guest today, Steve Vegington, he's really welcomed that funding.

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Speaker 1: We also heard from the Federal Member for Solomon, Luke Gosling,

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Speaker 1: who has also welcomed that funding. But I really wanted

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Speaker 1: to hear from those on the ground, those in the hospital,

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Speaker 1: to find out, you know, whether this is welcome, whether

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Speaker 1: it goes far enough, And I'm pleased to say that.

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Speaker 1: Joining me in the studio this morning is doctor John Zorbis,

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Speaker 1: the head of the AMA.

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Speaker 2: Good morning to you morning, Katie listeners.

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Speaker 1: Great to have you in the studio with us this morning. Now, Orbist,

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Speaker 1: what was your reaction to this agreement being signed.

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Speaker 2: Yeah, a mixed bag overall. Welcome.

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Speaker 3: I mean it's been years now, almost two years of

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Speaker 3: back and forth with the Feds and states and territories

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Speaker 3: about who's going to pick up the tab. So the

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Speaker 3: fact that we've now got that certainty going forward is helpful.

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Speaker 3: It means we can actually focus on the work rather

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Speaker 3: than back and forth and arguments. But ultimately, it's just

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Speaker 3: money to tread water. So we're looking at two hundred

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Speaker 3: million a year per year for five years. That's where

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Speaker 3: the billion's coming from. And we've long advocated that that

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Speaker 3: essentially is just the deficit in running our hospitals. That

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Speaker 3: is just operational money that doesn't pay for infrastructure, doesn't

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Speaker 3: pay for new technologies, replacement scans, anything like that. That's

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Speaker 3: going to help us to deliver the services that we

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Speaker 3: need to. So it's not money for the future, it's

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Speaker 3: just bringing us up to where we should have been

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Speaker 3: five years ago.

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Speaker 1: And so the Health Minister had said on the show

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Speaker 1: yesterday that there's going to be further sort of negotiating

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Speaker 1: around things like patient retrieval. Even you know, when we

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Speaker 1: look at our age care because obviously great announcement last

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Speaker 1: week with the provider being announced, but that's still a

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Speaker 1: few years away, so we really still need some additional funding.

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Speaker 1: I would suspect when it comes to age care, will

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Speaker 1: you know, if we can reach an agreement on all

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Speaker 1: of those things, will that.

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Speaker 3: Help, that will make more of an impact. So we've

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Speaker 3: got a hospital that is filled to the brim, a

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Speaker 3: lot of patients who belong in age care facilities, and

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Speaker 3: it's not that they shouldn't get healthcare, it's just they're

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Speaker 3: getting it in the wrong place and so they get

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Speaker 3: the wrong type of care. They need more rehabilitation intensive services,

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Speaker 3: not the types of services that are attached to acute

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Speaker 3: hospital beds. And anytime you've got health money spent in

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Speaker 3: that kind of way, in that kind of inefficient manner,

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Speaker 3: you just end up using it poorly, and that's just

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Speaker 3: not going to help us. So anything that's going to

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Speaker 3: you know, unblock IDH and our other hospitals helpful. Anything

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Speaker 3: that's just money to keep the lights on, that's essentially

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Speaker 3: just robbing Peter to pay Paul. So you know, we

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Speaker 3: can't close the doors. The territory government's been paying this

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Speaker 3: two hundred million dollars for the last few years. Now

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Speaker 3: it's just being paid by the right person.

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Speaker 1: How are things going in our hospitals at the moment?

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Speaker 1: I mean, every time you and I speak, we speak

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Speaker 1: about how busy the hospitals are. Has any of that

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Speaker 1: subsided in any way.

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Speaker 3: No, No, they're still as busy as they've ever been.

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Speaker 3: They're getting busier. We're seeing people who are sicker for longer,

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Speaker 3: and again that's a consequence of a lack of funding

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Speaker 3: in the right places. So you know, if we could

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Speaker 3: put money anywhere, it would be primary care first and foremost.

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Speaker 3: Fifty years ago. You know, we're going to stop people

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Speaker 3: needing hospitals in the first place. And there is a

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Speaker 3: lot of care that's being delivered by necessity rather than

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Speaker 3: it being the best place to deliver care.

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Speaker 1: Yeah, how do you reckon we get past this cycle?

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Speaker 1: Doctor's orbis because I guess the situation is that, you know,

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Speaker 1: you sort of we have these election cycles. You know,

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Speaker 1: money get gets announced. I'm going to call it for

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Speaker 1: things that are sexy, right, like things that win votes,

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Speaker 1: and quite often, you know, hospital funding is not something

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Speaker 1: that wins votes. But if you have a family member

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Speaker 1: that's sick. If you're currently trying to navigate your way

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Speaker 1: through the public hospital system. Well, will actually win votes,

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Speaker 1: But I guess it's a hard win in the sense

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Speaker 1: that if the government comes out and says, all right,

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Speaker 1: we're going to be announcing, you know, ten million dollars

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Speaker 1: towards a radiography or whatever it may be, it may

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Speaker 1: not win them the votes that they're hoping for.

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Speaker 2: How do we get past that? Yeah, look, that's a

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Speaker 2: really good question.

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Speaker 3: The mechanism we used to find our hospitals it's called

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Speaker 3: the National Hospital Reform Agreement. There's no reform in it right,

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Speaker 3: So our pricing models are broken. The way we do

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Speaker 3: business as usual is broken, and that means, like you say,

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Speaker 3: then we need announcements to bail areas out, and your

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Speaker 3: words are spot on. The less sexy it is, the

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Speaker 3: less attention it gets, the less money it gets, and

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Speaker 3: that's not how we should be delivering healthcare. We're very

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Speaker 3: vulnerable to that in the territory. We are a small,

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Speaker 3: far flung jurisdiction. We are a hard place to deliver healthcare.

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Speaker 3: The people working in this system work themselves to the bone.

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Speaker 3: They end up leaving because they work themselves to the bone.

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Speaker 3: It is this endless cycle and without space for reform,

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Speaker 3: we're not going to get out of it.

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Speaker 2: Now. To get that space, we need the money to

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Speaker 2: start with.

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Speaker 1: Yeah, we hear a lot as well, and certainly yesterday

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Speaker 1: when we spoke to the federal member, he'd spoken about

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Speaker 1: those urgent care clinics and and hopefully them helping to

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Speaker 1: ease some of the pressure in our emergency wards.

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Speaker 2: Have they no?

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Speaker 3: So, And you know this is a constant cycle with

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Speaker 3: the AMA and policy announcements in health. But since the

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Speaker 3: dawn of time, urgent care centers make it easier to

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Speaker 3: get in to see a doctor right, especially after hours.

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Speaker 3: They do not help to clog our hospitals. The Australasian

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Speaker 3: College for Emergency Medicine, so the authority on emergency medicine

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Speaker 3: in Australia, has long since said that urgent care centers

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Speaker 3: do not help our eds. Our eds are not full

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Speaker 3: of quote unquote GP type patients. They're full of patients

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Speaker 3: who've already been admitted, who have nowhere to go because

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Speaker 3: there's no space upstairs. So urgent care centers, like you say,

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Speaker 3: they're sexy things. It's a new way and nobody's going

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Speaker 3: to be against being able to see a doctor faster.

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Speaker 3: But if it's not your regular doctor, if it's not

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Speaker 3: someone who's familiar with your conditions and your medications and

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Speaker 3: your situation, that takes a lot of time to get

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Speaker 3: up to speed. So what we see in general is

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Speaker 3: money spent there is not as effective as money that's

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Speaker 3: just put into general practice. But again, if it feds

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Speaker 3: down up and say well, here's more money for general practice,

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Speaker 3: they're not going to get any votes for that.

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Speaker 1: Yeah, John, what would you like? What would you like

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Speaker 1: to see happen over the next few years. I mean,

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Speaker 1: obviously we can see that that we need more funding,

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Speaker 1: there's no doubt about that. I Mean we talk a

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Speaker 1: lot as well in the Northern Territory about the need

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Speaker 1: for a brand new tertiary hospital. The Health Minister had

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Speaker 1: said on the show yesterday that that behind the scenes

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Speaker 1: work is still happening, but they don't want to sort

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Speaker 1: of go to the federal government cap in hand until

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Speaker 1: they've got a really firm plan in place. But what

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Speaker 1: would you like to see happen here in the Northern

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Speaker 1: Territory over the next few years. It could potentially really

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Speaker 1: have an impact on the health of territorians.

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Speaker 3: Yeah, there's a couple of things. I think the main, single,

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Speaker 3: most effective thing we could do is reform our price

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Speaker 3: structures so the way we get funded to deliver health

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Speaker 3: care doesn't make sense. So the other states and territories

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Speaker 3: sit in an average of about thirty nine percent of

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Speaker 3: their contribution coming from the Commonwealth, we sit closer to

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Speaker 3: thirty two to thirty three percent. That's that seven percent gap,

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Speaker 3: that's that two hundred million, And we don't have the

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Speaker 3: details of this agreement yet, so we're not even sure

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Speaker 3: if this two hundred mill is actually baked in. Right,

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Speaker 3: it's been announced, so we'll take it on premise, but

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Speaker 3: until we see the agreement, we're not one hundred percent

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Speaker 3: on that. Now, that pricing mechanism does things like treats

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Speaker 3: dialysis as an inpatient service. Now that had been used

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Speaker 3: to the people in Maningrida that they're getting a quote

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Speaker 3: unquote inpatient service. So there's just these perverse pricing structures

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Speaker 3: that don't make sense, especially for somewhere as rural and

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Speaker 3: as regional as the territory. So reform those pricing structures

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Speaker 3: and the money will flow to the right places. And

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Speaker 3: I'm not saying that to say that we deserve more

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Speaker 3: than the rest of Australia. What we deserve is a

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Speaker 3: fair share. And right now those pricing structures are built

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Speaker 3: by people who don't understand the territory, don't see how

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Speaker 3: healthcare has to be delivered here, and so assumptions are

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Speaker 3: made without us in the room. I think it's been

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Speaker 3: great to see our chief Minister in Health Minister be

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Speaker 3: able to petition for this money and secure this agreement.

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Speaker 3: The next step would be proper pricing reform. From that,

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Speaker 3: the money will flow from that, the space for reform

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Speaker 3: will follow. Our front line staff are great at reform.

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Speaker 3: They know what needs to be done, they just don't

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Speaker 3: have the funding and time to do it right now.

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Speaker 1: Now, if you've just joined us in the studio with

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Speaker 1: me this morning, is the head of the AMA here

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Speaker 1: in the Northern Territory, Doctor John Zorbist. Now, John, before

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Speaker 1: I let you go, we've spoken a lot over the

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Speaker 1: last year or so about maternity services in the Northern Territory.

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Speaker 1: From your perspective, how are things tracking as I understand

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Speaker 1: you know, the either at the beginning of this year

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Speaker 1: or the end of last year. Our only sort of

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Speaker 1: private obstetrician that was still delivering babies was going to

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Speaker 1: be finishing up. How are things going from your perspective.

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Speaker 2: Yeah, the clouds are still on the horizon there.

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Speaker 3: So we have the sort of deadline from the administrators

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Speaker 3: on announcing a buyer for dah And Private Hospital was

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Speaker 3: December twenty twenty five. That deadline's come and gone with

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Speaker 3: no announcement, so that still leaves a huge amount of

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Speaker 3: unsert certainty. While the rest of health scopes assets are

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Speaker 3: being cherry picked around the country, du On Private Hospital

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Speaker 3: still doesn't have a buyer. It's a bit confusing to

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Speaker 3: us because DPH is the type of hospital that could

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Speaker 3: provide a decent base for a for profit provider or

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Speaker 3: a not for profit provider. You see these kind of

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Speaker 3: weezer words that explain things away, like oh, you know,

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Speaker 3: we've got to be wary of competition law.

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Speaker 2: Well, there is no competition. It's the only private hospital

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Speaker 2: exactly in the jurisdiction.

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Speaker 3: So look, that's really concerning because without that hospital we

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Speaker 3: be impossible to deliver it inpatient private maternity services. We've

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Speaker 3: seen there's been media around the private practicing MIDWI free model.

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Speaker 3: We had our concerns around that and they've since sort

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Speaker 3: of come to light. We would want to see more

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Speaker 3: money put into the maternity or midw free group practice.

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Speaker 3: You have the same midwife throughout your pregnancy. That's a

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Speaker 3: well functioning program and our obstitutions are calling for more

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Speaker 3: funding and support there, but also exploring public private partnership models,

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Speaker 3: whether it's Healthcope or somebody else. We've got empty facilities,

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Speaker 3: birthing suites, operating theaters, we can get staff. It would

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Speaker 3: be great to have an arrangement where we can provide

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Speaker 3: a private service and an empty building. It's also right

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Speaker 3: next to d right next to all done connected by Coroneld.

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Speaker 3: You couldn't ask for a better sex.

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Speaker 1: So how might that sort of work? If you know,

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Speaker 1: in an ideal world, how do you reckon that would work.

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Speaker 3: Yeah, it's complicated, it's not impossible. There are plenty of

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Speaker 3: private in public services around Australia. Ramsey Healthcare does it

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Speaker 3: on a huge scale with jindal Up Health Campus in Perth.

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Speaker 3: That's a one thousand plus bed hospital. It's technically a

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Speaker 3: private hospital but provides a huge chunk of the public

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Speaker 3: service for the northern suburbs of Perth. Now, partnerships between

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Speaker 3: the private sector and the public sector are not hard

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Speaker 3: to find around Australia. We would just have to find

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Speaker 3: one that suits us and the owners of dull and

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Speaker 3: private hospital. It would be complicated. I'm not saying it's

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Speaker 3: an easy fix, but it's definitely something that we could scale.

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Speaker 3: We can work on a solution that can potentially restart

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Speaker 3: private maternity. My line here has always been speak to

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Speaker 3: the front line. I think our obstricians and our midwives

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Speaker 3: are in the best position to say, well, this is

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Speaker 3: the kind of model of care we could sustain, this

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Speaker 3: is the kind of money that we'd need, and I

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Speaker 3: think you'd find it to be far cheaper than some

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Speaker 3: of the things are being thrown around at the moment.

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Speaker 1: Well, definitely worth a look at. And I think that

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Speaker 1: the women of the Northern Territory, the families, everybody you know,

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Speaker 1: whether you're a grandparent, no matter who you are, I

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Speaker 1: think that most people would agree that women deserve those

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Speaker 1: choices right and it's absurd to me that we live

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Speaker 1: in a capital city and now one of those major

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Speaker 1: choices has been taken away from women.

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Speaker 3: And I'd throw potential territorians into that mix as well.

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Speaker 3: It's a huge recruitment issue. We know it is, and

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Speaker 3: the sooner we can restore those services, the better it's

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Speaker 3: going to be for the territory.

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Speaker 2: Yeah, Doctor's orbis before I let you go.

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Speaker 1: Are you hearing much about the hydro therapyople at the

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Speaker 1: moment out at the Palmeston Hospital. I know that we

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Speaker 1: heard from disability Advocate Robin Burridge last week who said

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Speaker 1: that despite the Minister saying that people would again be

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Speaker 1: able to access that pool with a referral, they aren't.

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Speaker 1: I know that there are some Territorians out there listening

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Speaker 1: this morning who have previously been able to use that

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Speaker 1: hydro therapy pool and it's a huge part of their

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Speaker 1: rehab who now aren't able to. Is it something that's

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Speaker 1: sort of been raised with you by doctors, specialists, anyone,

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Speaker 1: any members of the IMA.

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Speaker 3: We know that rehab services are difficult to access in

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Speaker 3: the NT and the fact that the only publicly available

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Speaker 3: hydrotherapy pool on the top end has problems with access

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Speaker 3: is really concerning to us. And it doesn't have to

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Speaker 3: be doctors who raises the fact that patients are raising this.

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Speaker 3: That's the most concerning thing we speak on behalf of

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Speaker 3: our patients. There's a disconnect here between the message we're

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Speaker 3: seeing from management saying well, that's not quite how this works,

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Speaker 3: and I know the minister's been on your shows announcing that.

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Speaker 2: It would be access with a GP referral.

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Speaker 3: Either way, it sounds like there's not enough capacity there

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Speaker 3: to service our need. So, regardless of where the money

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Speaker 3: is supposed to come from, how access should work. Hydrotherapy

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Speaker 3: is an essential part of rehab. It instantly makes you lighter,

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Speaker 3: It helps with resistance in a way that's safe for

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Speaker 3: your body. It's not just about patients who've had surgery.

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Speaker 3: It's a really really important part of rehab. Any access

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Speaker 3: restrictions would be of concern to doctors around the territory

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Speaker 3: sure patients as well.

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Speaker 1: Yeah, I really hope that they're able to come to

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Speaker 1: a solution with this, because even last year we'd heard

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Speaker 1: from a grandma I believe, whose grandchild, if I remember correctly,

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Speaker 1: had cerebral palsy and who was accessing that pool and

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Speaker 1: was no longer able to even you know, more senior territorians.

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Speaker 1: And I get it right, Like I get that you

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Speaker 1: absolutely need to have a referral, and that you can't

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Speaker 1: just be having the public going in willy nilly, But

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Speaker 1: I think if you, if you've got people that have

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Speaker 1: a genuine need to use that pool, then surely we

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Speaker 1: can come to some kind of resolution.

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Speaker 3: Absolutely, the older we get, the more frail we get,

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Speaker 3: the more frail we are, the more likely we are

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Speaker 3: to come to harm. Rehab is such a hugely important

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Speaker 3: part of protecting especially our elderly young as well, but

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Speaker 3: especially our elderly, who are incredibly important part of our community.

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Speaker 3: Without those services, people come to harm. It's really important

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Speaker 3: that service gets preserved, scaled up, whatever needs to be

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Speaker 3: done to make sure that people still access when they

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Speaker 3: need it.

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Speaker 1: Well, Doctor John's orbis I always appreciate your time. Thanks,

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Speaker 1: thank you so very much for joining us this morning,

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Speaker 1: and we'll talk to you again soon, no doubt.

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Speaker 2: Thanks appreciate you. Thanks so much,