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Speaker 1: In what looks like it's some good news, last week,

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Speaker 1: the Northern Territory has employed over two hundred new junior

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Speaker 1: doctors across NT health the hospitals, boosting the medical workforce

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Speaker 1: for the future. The cohort is made up of graduate

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Speaker 1: doctors and resident medical officers or ramos as they're known,

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Speaker 1: who have started rotations at Royal Darwin, Palmerston and Catherine Hospital,

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Speaker 1: as well as go of District Hospital, Alice Springs Hospital

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Speaker 1: and Tenant Creek. Now joining me on the line is

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Speaker 1: the ama NT President, doctor Robert Parker. Good morning to you,

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Speaker 1: Doctor Parker.

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Speaker 2: Good morning Katie. Look before we start, I'd just like

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Speaker 2: to pay a tribute to the Natasha Files in her

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Speaker 2: role as health Minister. I've I really enjoyed working with

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Speaker 2: her and she was probably the best health minister I've

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Speaker 2: had the privilege to work with. Yeah, right at a time,

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Speaker 2: I think it's incredibly sad if she's remembered for what happened,

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Speaker 2: you know, at the end of her current career or

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Speaker 2: you know, the problem that she had. And I just

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Speaker 2: thought she bought energy, enthusiasm, enthusiasm and intelligence to a

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Speaker 2: very difficult portfolio. So I just wanted to say that,

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Speaker 2: you know, and thank her for the role she played

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Speaker 2: her Health minister.

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Speaker 1: Yeah right, I mean, look, I you know what, I think,

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Speaker 1: good on you for coming out and saying that, I

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Speaker 1: know that you know that sometimes when something happens with Polly's,

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Speaker 1: like what happened with the former Chief Minister, that you know,

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Speaker 1: some of that work is forgotten. Is there like is

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Speaker 1: there work in particular doctor Robert Parker that you know

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Speaker 1: that that sort of causes you to say that.

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Speaker 2: Well, she was constantly you know, we're all aware. You know,

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Speaker 2: we've had numerous interviews about the Code Yellows, but she

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Speaker 2: was very much aware of the issues around that and

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Speaker 2: was constantly working to try and reduce the stress on

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Speaker 2: the hospital system, both of the development of new issues

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Speaker 2: such as the new mental health wards, but also you know,

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Speaker 2: approaching the fear to get more funding. And in fact,

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Speaker 2: one of the last conversations I had with when she

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Speaker 2: was your Chief Minister, she'd actually been talking about Prime

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Speaker 2: Ministry of Easy about further funding for anty health and

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Speaker 2: apparently I got some extra money for that.

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Speaker 1: Yeah.

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Speaker 2: So she was constantly working to improve the health of Territorians,

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Speaker 2: and I think it's really important that she's recognized that

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Speaker 2: for that role that she did well, Doctor Parker.

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Speaker 1: We know that there has also been a pretty good announcement.

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Speaker 1: It looks like it's a good announcement on the face

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Speaker 1: of Earth. Last week over two hundred new junior doctors

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Speaker 1: across into hospitals. Is this the boost that we're all

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Speaker 1: hoping for our workforce?

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Speaker 2: Well, it's a really good to have all these extra

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Speaker 2: young doctors in the workforce, Katie. The only problem is

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Speaker 2: medical career progression, and the territory really needs to have

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Speaker 2: the further steps to get these doctors in the territory.

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Speaker 2: The problem is that apart from psychiatry, general practice and physicians,

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Speaker 2: doctors if they want to pursue other specialties such as surgeons, ophthalmology,

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Speaker 2: a gynecology, obstetric we've got to go somewhere else to

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Speaker 2: do through the training. And the key factors for keeping

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Speaker 2: people somewhere are usually a partner and a mortgage, and unfortunately,

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Speaker 2: quite a few of these doctors who go in the

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Speaker 2: state pick up a partner and the mortgage in the state.

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Speaker 2: So that you know, we really need to have the

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Speaker 2: ongoing through the specialist training available for these doctors in

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Speaker 2: the territory, so they pick up their partners and mortgages

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Speaker 2: in the territory and therefore continue to stay on to

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Speaker 2: service territorian.

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Speaker 1: So it sounds like you're a bit worried that even

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Speaker 1: though it's it is sort of a good thing, where

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Speaker 1: it seems like it's a good thing that we're getting

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Speaker 1: these two hundred new junior doctors, it's keeping them here

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Speaker 1: in the NY long term, that's correct.

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Speaker 2: You know, And it's very much the required training so

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Speaker 2: they can complete their specialist training or their career progression

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Speaker 2: within the territory rather than to travel somewhere else to

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Speaker 2: do that and usually pick up a partner and mortgage

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Speaker 2: in the state, which means they don't come back to

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Speaker 2: the territory.

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Speaker 1: So with the two hundred that have started, are there

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Speaker 1: specific areas of medicine where they're going to be placed

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Speaker 1: or are there, you know, are there sort of specific

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Speaker 1: areas Dr. Parker that you think it's going to have

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Speaker 1: a real impact.

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Speaker 2: Well, these are resident hospital residents, Katie. So hospital residents

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Speaker 2: rotate through various terms, so they might start off in medicine,

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Speaker 2: they then go to eat the surgery, maybe finish with

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Speaker 2: psychiatry or pediatrics, so they usually do four terms a

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Speaker 2: year and rotate through those various terms sort of to

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Speaker 2: provide service to territorians but also to get the required

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Speaker 2: training they need for their further career progression. So you know,

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Speaker 2: it's really good that we've got this enthusiastic in talas

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Speaker 2: the young workforce to do that work, but we need

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Speaker 2: to also support them by developing their further opportunities.

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Speaker 1: Is that difficult, Like, is it difficult having all those

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Speaker 1: new doctors in terms of that training and ensuring that

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Speaker 1: there are those senior staff there to mentor them.

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Speaker 2: Well, that's right, that's right, and it is it is

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Speaker 2: the issue of the various colleges with their training requirement.

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Speaker 2: So I said, currently you can fully train as as

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Speaker 2: psychiatrists in the Northern Territory, and I gathered the College

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Speaker 2: Physicians is working towards that and you can certainly do

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Speaker 2: your GP training, but otherwise you've usually got to go

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Speaker 2: and do required terms and experience outside the NC. And

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Speaker 2: there's been and so I know, there's been a number

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Speaker 2: of initiatives to try and develop Northern training regions and

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Speaker 2: to approach the colleges to think about more flexibly, flexibly

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Speaker 2: about their training requirements so that training can occur in

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Speaker 2: the territory.

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Speaker 1: How are things going at the moment in terms of

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Speaker 1: staffing levels when you when you look at doctors, have

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Speaker 1: we got enough at the moment? I mean, how is that?

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Speaker 2: Well, obviously there's two hundred. These two hundred young people

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Speaker 2: certainly add to the staffing whenever. I mean, we've always

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Speaker 2: got shortages. Unfortunately, you know my own specially psciatary, we've

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Speaker 2: still got a number of consultant shortages we're trying to

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Speaker 2: trying to fill. And I know some other areas have

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Speaker 2: still got the same issue and having to use locals

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Speaker 2: rather than stuff. I'm in the logans employs aspose the

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Speaker 2: governance and training issues within the specialty. So that's what's

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Speaker 2: much more preferable to getting a locum. Yeah, so that's

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Speaker 2: just another issue. So, I mean, I think the health

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Speaker 2: system is coping, yeah, but there are shortages in the

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Speaker 2: process at the moment, Doctor Parker.

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Speaker 1: We have spoken quite a few times this year on

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Speaker 1: air about assaults on staff in the emergency department, you know,

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Speaker 1: security staff, nurses, doctors, some pretty serious incidents we've been

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Speaker 1: told about by listeners. But also yesterday, you know, we

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Speaker 1: were talking about we're talking to Saint John Ambulance about

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Speaker 1: the situation where they've got those frontline paramedics that are

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Speaker 1: being assaulted almost on a daily basis. Is what Craig

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Speaker 1: Garaway told us on the show. How are things going

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Speaker 1: from your perspective when you talk about staff in the hospitals,

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Speaker 1: particularly the lights of Royal Darwin when it comes to

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Speaker 1: those assaults and some of that.

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Speaker 2: Bad h Well, of course, Katie, unfortunately with the large

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Speaker 2: numbers of you know, a lot of this stuff is

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Speaker 2: substance related, with alcohol being the main substance, and unfortunately,

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Speaker 2: usually the theeds are the only light on in town,

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Speaker 2: so when the people are behaving badly in the community,

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Speaker 2: they've dropped off on the ED and quite often there's

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Speaker 2: a high level of intoxication which can lead to significant aggression.

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Speaker 2: So unfortunately, the yeah, unfortunately this you know, it's not

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Speaker 2: excusable at all, but the hospital has to work in

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Speaker 2: ways to look at safety in them part of a

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Speaker 2: hospital committee called the bow Cup Committee, which is constantly

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Speaker 2: monitoring these issues and trying to develop processes and responses

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Speaker 2: that can address safety issues in the hospital. So yeah,

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Speaker 2: I mean, I totally agree to the major concern, and

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Speaker 2: while people continue to get drunk and also use substances

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Speaker 2: like amphetamines and cannabis, you will have these high levels

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Speaker 2: of aggression unfortunately, and the hospital has to and particularly

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Speaker 2: amphetamines and eyes of course significant increase in aggression. So

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Speaker 2: it's yeah, we've just got to try and adapt a

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Speaker 2: system because people will continue to be dropped to the

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Speaker 2: front door of VD with these issues and we've got

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Speaker 2: to have to work away around it.

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Speaker 1: I mean, what else can you do? Because from the

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Speaker 1: response that the health department had given us, they'd said that,

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Speaker 1: you know, they've taken things out of emergency rooms that

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Speaker 1: can be used to throw and that kind of thing, Like,

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Speaker 1: what else can happen here to try to keep all

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Speaker 1: the staff safe?

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Speaker 2: Well, again, I suppose there are processes we go through,

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Speaker 2: and it can we bow. We've got their processes what

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Speaker 2: they call cod blacks and co grays, which are situations

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Speaker 2: of imminent threat and we just need to work on

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Speaker 2: ways of approaching so we've got sufficient staff and people

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Speaker 2: aren't left isolated to be attacked with. There's sufficient support.

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Speaker 2: So then individuals with high levels of agitation or aggression,

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Speaker 2: and there's appropriate care levels such as a number of

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Speaker 2: security staff rather than one who are with them, so

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Speaker 2: that you know that it's not one security staff member

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Speaker 2: there's been dealing, but a number of security stuff are

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Speaker 2: potentially could help. There are ways you can work around,

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Speaker 2: but certainly removing objects that are potentially dangerous or lethal

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Speaker 2: the people who are agitated can use is a very

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Speaker 2: important step.

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Speaker 1: Do you have those code blacks or code gris very often?

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Speaker 2: Oh, there are pretty Unfortunately, there are reasonably regular occurrence

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Speaker 2: within the hospital and they're reported on daily, so we're

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Speaker 2: aware of situations that have occurred. I mean, one of

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Speaker 2: the really good things about World Darwin is we have

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Speaker 2: the daily huddle which happens at the quarter of nine

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Speaker 2: ech morning where hospital administrators the colinicians all get together

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Speaker 2: and report and certainly code blacks are reported on in

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Speaker 2: that forum, and if necessary there are further discussions. And

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Speaker 2: it's a particularly difficult patience, then there's discussion held afterwards

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Speaker 2: about ways of managing those. So the hospital is constantly

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Speaker 2: where those in reporting on them, and there's input from managers.

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Speaker 2: So the managers aren't just sitting in ivory towers, they're

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Speaker 2: actually part of that discussion and involved with it. So

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Speaker 2: and I know that roll Down has been complimented for

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Speaker 2: that process, the fact we have this daily review, so

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Speaker 2: good on them. And you know, I mean, you can

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Speaker 2: never develop a totally effective solution for these because again, unfortunately,

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Speaker 2: the EED doors the only ones that are open at

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Speaker 2: o'clock in the morning, you know, Unfortunately, and I mean

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Speaker 2: individuals who are aggressive or agitated are usually dropped off

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Speaker 2: at d So we're never going to stop this process,

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Speaker 2: but we can certainly adapt around it. And I mean

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Speaker 2: there are also the populations. I mean, obviously what happened

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Speaker 2: in our Springs with the with the alcoholic in town camps,

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Speaker 2: massive rise in domestic violence and they had a massive

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Speaker 2: impact on ED. And obviously then the intervention by Prominstraul

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Speaker 2: Benezi and the intervention which stopped that. So there's also

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Speaker 2: population effects which can affect the levels of violence and

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Speaker 2: ED as well.

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Speaker 1: Yeah, look, it is a you know, it's a it's

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Speaker 1: a terrible situation. I think that start find themselves in

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Speaker 1: where like you've said, people are coming in then they're

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Speaker 1: impacted by drugs and alcohol and they're taking out aggression

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Speaker 1: on people that are there trying to help them. It's

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Speaker 1: woeful and I don't know that you're ever going to

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Speaker 1: be able to completely stop it from happening, but gee,

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Speaker 1: you want to try and minimize it as much as possible.

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Speaker 2: That's right, Katie. And you've just got to constantly work

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Speaker 2: on solutions and sometimes you know, one solution works one

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Speaker 2: day and you've got to use another solution the next day.

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Speaker 2: So that you know there are processes and I mean

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Speaker 2: the committee I'm on you're looking at processes because the

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Speaker 2: processes that are more permanent, but also you're just going

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Speaker 2: to adapt from day to day to kneel what's happening.

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Speaker 1: Yeah, and look, I tell you, you know, even like

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Speaker 1: with those code blacks and those code grays, it, you know,

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Speaker 1: it does sound as though there's systems in place there

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Speaker 1: within NT Health or within the within the hospital, I

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Speaker 1: should say, all hospitals to try and deal with those scenarios.

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Speaker 1: But yeah, to be incredibly frightening if you if you're

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Speaker 1: trying to help someone and then you're faced with a

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Speaker 1: very confronting situation.

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Speaker 2: Totally agree, And we can want to pay tribute to

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Speaker 2: all the heroes and the health system, doctors, nurses, ots, physios, cleaners, cooks,

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Speaker 2: all of whom are constantly working to make the system

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Speaker 2: work better, and the managers obviously working with the collisions

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Speaker 2: try and improve things.

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Speaker 1: Well, Doctor Robert Parker, I always appreciate your time. Thank

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Speaker 1: you very much for having a chat with us this morning,

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Speaker 1: and we will talk to you again soon.

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Speaker 2: No doubt my pleasure cated. Thank you,