1 00:00:00,200 --> 00:00:03,600 Speaker 1: Joining me live in the studio is doctor John Zorbist, 2 00:00:03,640 --> 00:00:07,480 Speaker 1: because well we know that the latest report into the 3 00:00:07,520 --> 00:00:11,040 Speaker 1: Public Housing report Card or Public Hospital I should say, 4 00:00:11,039 --> 00:00:14,400 Speaker 1: goodness me getting my words wrong there has been released. 5 00:00:14,440 --> 00:00:17,200 Speaker 1: And joining me to talk more about some of the 6 00:00:17,239 --> 00:00:20,440 Speaker 1: areas where we definitely need some improvement in some areas 7 00:00:20,440 --> 00:00:23,360 Speaker 1: where we might be going okay, is doctor john's orbis, 8 00:00:23,440 --> 00:00:25,599 Speaker 1: the head of the AMA. Good morning to you. 9 00:00:25,720 --> 00:00:27,760 Speaker 2: Yeah, good morning Katie. I can't help you with housing, 10 00:00:27,800 --> 00:00:28,560 Speaker 2: but it can help you there. 11 00:00:28,640 --> 00:00:32,760 Speaker 1: Yeah, definitely, you most certainly can now, doctors Orbis. Unfortunately, 12 00:00:32,800 --> 00:00:37,320 Speaker 1: the report card shows well, we've got some modest improvements 13 00:00:37,320 --> 00:00:40,240 Speaker 1: in some areas, including a small reduction in the media 14 00:00:40,280 --> 00:00:45,400 Speaker 1: and wait time for planned surgery, but other areas we're 15 00:00:45,440 --> 00:00:49,640 Speaker 1: significantly worse than we were ten years ago. Talk us through. 16 00:00:49,720 --> 00:00:52,600 Speaker 1: First off, I guess why this report card is undertaken 17 00:00:52,640 --> 00:00:53,080 Speaker 1: each year. 18 00:00:53,360 --> 00:00:55,880 Speaker 2: Yeah, so that these are high level statistics that we 19 00:00:55,920 --> 00:00:58,560 Speaker 2: get from the Australian Institute of Health and Wearfare Welfare, 20 00:00:58,600 --> 00:01:01,600 Speaker 2: so nice independent reporting. We keep track of these to 21 00:01:01,600 --> 00:01:03,440 Speaker 2: paint the picture over time. So you mentioned there's been 22 00:01:03,440 --> 00:01:05,959 Speaker 2: some small improvements in say medium wait time and since 23 00:01:06,000 --> 00:01:07,760 Speaker 2: the last time we did this a year ago, but 24 00:01:07,800 --> 00:01:09,720 Speaker 2: when you look at the bigger picture, there is a 25 00:01:09,720 --> 00:01:13,800 Speaker 2: continual decline there. So you know, Category two surgery wait times, 26 00:01:14,120 --> 00:01:16,000 Speaker 2: we used to see ninety two percent on time in 27 00:01:16,040 --> 00:01:19,480 Speaker 2: twenty eighteen twenty nineteen. That's now down to sixty percent. 28 00:01:20,200 --> 00:01:23,360 Speaker 2: Category three emergency department presentations, so middle of the pack 29 00:01:23,400 --> 00:01:26,120 Speaker 2: in terms of urgency. We're only seeing forty percent or 30 00:01:26,120 --> 00:01:29,039 Speaker 2: two in five in the recommended time frame of thirty minutes. 31 00:01:29,319 --> 00:01:32,040 Speaker 2: As a fifth annual decline in the worst in twenty years. 32 00:01:32,520 --> 00:01:34,640 Speaker 2: It paints a pretty bleak picture, not just in the 33 00:01:34,720 --> 00:01:38,160 Speaker 2: territory but across Australia. And our argument here is that 34 00:01:38,200 --> 00:01:41,920 Speaker 2: this is mostly a result of broken funding models and. 35 00:01:42,080 --> 00:01:44,280 Speaker 1: Took us through if you can. I mean when you 36 00:01:44,319 --> 00:01:47,880 Speaker 1: look at you know, at emergency and that's thirty minutes 37 00:01:48,240 --> 00:01:50,840 Speaker 1: sort of you know, recommended time frame, how long are 38 00:01:50,880 --> 00:01:52,040 Speaker 1: some people actually waiting? 39 00:01:52,400 --> 00:01:55,000 Speaker 2: So wait times are blowing out into the hours. We 40 00:01:55,080 --> 00:01:57,800 Speaker 2: have people waiting in our emergency departments for days for 41 00:01:57,840 --> 00:02:00,400 Speaker 2: a bed. So they've been seen by that need to 42 00:02:00,400 --> 00:02:02,720 Speaker 2: see them and they've been admitted, but they'll be waiting 43 00:02:02,800 --> 00:02:05,760 Speaker 2: for several hours sometimes days to move up to the ward. 44 00:02:06,360 --> 00:02:09,440 Speaker 2: You just can't deliver the right type of war care 45 00:02:09,440 --> 00:02:11,800 Speaker 2: in an emergency department in the same way that the 46 00:02:11,800 --> 00:02:13,880 Speaker 2: wards are the wrong place for our aged care patients. 47 00:02:13,919 --> 00:02:16,680 Speaker 2: You know, we design our system to be the best 48 00:02:16,720 --> 00:02:19,400 Speaker 2: infrastructure for that patient at that time. When we can't 49 00:02:19,400 --> 00:02:21,760 Speaker 2: put patients in the location they need to be, that's 50 00:02:21,800 --> 00:02:23,680 Speaker 2: when we see an increase in errors. That's where we 51 00:02:23,680 --> 00:02:25,960 Speaker 2: see delays to care. That's where we see outcomes that 52 00:02:26,040 --> 00:02:27,600 Speaker 2: you know, no doctor wants to see. No. 53 00:02:27,840 --> 00:02:30,480 Speaker 1: And so then with those with the surgery you touched 54 00:02:30,480 --> 00:02:33,320 Speaker 1: on the a category two surgery, what would be you know, 55 00:02:33,360 --> 00:02:35,639 Speaker 1: what would actually be sort of defined as a category 56 00:02:35,639 --> 00:02:36,519 Speaker 1: two surgery. 57 00:02:36,680 --> 00:02:38,960 Speaker 2: So for example, you know, a category one would be 58 00:02:39,880 --> 00:02:42,880 Speaker 2: cancer related. Yeah, right, So the really really urgent stuff. 59 00:02:43,880 --> 00:02:45,680 Speaker 2: There's often you know a lot of these reports will 60 00:02:45,680 --> 00:02:48,800 Speaker 2: talk about elective surgery, and I don't think anybody who's 61 00:02:48,840 --> 00:02:50,959 Speaker 2: waiting for a hip replacement or a knee replacement would 62 00:02:50,960 --> 00:02:54,440 Speaker 2: call it elective. We the AMY calls it planned surgery. 63 00:02:54,480 --> 00:02:58,040 Speaker 2: There's planned and there's emergency surgery. No matter what category 64 00:02:58,080 --> 00:03:01,840 Speaker 2: you look at. Over time, everything has progressively gotten worse, 65 00:03:01,919 --> 00:03:04,680 Speaker 2: and it's particularly bad for us because of the way 66 00:03:04,720 --> 00:03:08,240 Speaker 2: the funding models work. They disadvantage the NT much more 67 00:03:08,280 --> 00:03:10,400 Speaker 2: disproportionately than the rest of the country. 68 00:03:11,040 --> 00:03:13,040 Speaker 1: Gee, I mean it's hard to hear. And look, I 69 00:03:13,040 --> 00:03:15,160 Speaker 1: think that we all sort of understand that our hospital 70 00:03:15,240 --> 00:03:18,720 Speaker 1: system is absolutely well. Our healthcare system more generally, more 71 00:03:18,760 --> 00:03:21,360 Speaker 1: broadly is under pressure, and it has been for quite 72 00:03:21,360 --> 00:03:23,600 Speaker 1: some time. I mean, anybody that listens to this show 73 00:03:23,840 --> 00:03:26,160 Speaker 1: has heard you and I speaking about this. For goodness 74 00:03:26,200 --> 00:03:28,400 Speaker 1: knows how long. You know, we've been talking about the 75 00:03:28,440 --> 00:03:32,640 Speaker 1: potential of a new hospital for years. But more more seriously, 76 00:03:32,680 --> 00:03:35,200 Speaker 1: I guess over the last six months, everybody seems to 77 00:03:35,320 --> 00:03:38,880 Speaker 1: know what we need in terms of funding, in terms 78 00:03:38,920 --> 00:03:41,920 Speaker 1: of new infrastructure, but we just don't seem to be 79 00:03:42,000 --> 00:03:42,720 Speaker 1: getting at. 80 00:03:43,160 --> 00:03:46,240 Speaker 2: Yeah, and there's competing interests, right, It's not just about health, 81 00:03:46,280 --> 00:03:49,480 Speaker 2: it's about education, transport. We see the flood damage from Catherine. 82 00:03:49,480 --> 00:03:52,160 Speaker 2: Obviously that's going to be a huge burden on us. 83 00:03:52,880 --> 00:03:54,920 Speaker 2: Where we stand in health, you know, our position and 84 00:03:55,240 --> 00:03:57,360 Speaker 2: what do we think is different about health? What do 85 00:03:57,400 --> 00:03:59,640 Speaker 2: we think is different about the NT is that we are, 86 00:03:59,680 --> 00:04:02,240 Speaker 2: as A said before on this show, below the starting line. 87 00:04:02,520 --> 00:04:05,560 Speaker 2: So you know the NHRA funding agreement that is how 88 00:04:05,600 --> 00:04:08,040 Speaker 2: we fund our public hospitals, A billion dollars of a 89 00:04:08,080 --> 00:04:11,440 Speaker 2: five years for the territory. Good headline, right, But that 90 00:04:11,560 --> 00:04:13,080 Speaker 2: just brings us to the level that we should have 91 00:04:13,080 --> 00:04:15,680 Speaker 2: been at this whole time. Back in twenty eleven, we 92 00:04:15,760 --> 00:04:18,160 Speaker 2: used to block fund public hospitals. We should just give 93 00:04:18,160 --> 00:04:21,040 Speaker 2: you a check and say go nuts. Nobody wants that, right, 94 00:04:21,040 --> 00:04:24,159 Speaker 2: that's inefficient. Activity based funding is how we look at 95 00:04:24,200 --> 00:04:26,479 Speaker 2: things now. But if you don't have the activity, you 96 00:04:26,520 --> 00:04:29,440 Speaker 2: can't get paid for it. So in a place where 97 00:04:29,480 --> 00:04:32,280 Speaker 2: we have the highest rates of coronary artery disease desperately 98 00:04:32,320 --> 00:04:35,600 Speaker 2: need a cardiothoracic service, you can't build for cardiothoracics and 99 00:04:35,640 --> 00:04:37,719 Speaker 2: get paid for carthioterracics if you don't have the unit. 100 00:04:38,120 --> 00:04:40,840 Speaker 2: There's nothing in these models that allow us for capacity building. 101 00:04:41,120 --> 00:04:43,440 Speaker 2: And these models don't really direct the money to where 102 00:04:43,440 --> 00:04:45,040 Speaker 2: the need is. They direct the money to where the 103 00:04:45,080 --> 00:04:46,640 Speaker 2: activity is, and that's not the same thing. 104 00:04:47,279 --> 00:04:49,800 Speaker 1: So where too from here? I mean, every year this 105 00:04:49,880 --> 00:04:52,880 Speaker 1: report card comes out, it's not good for the Northern territory. 106 00:04:52,920 --> 00:04:55,080 Speaker 1: Where too from here? With this information? 107 00:04:55,440 --> 00:04:58,240 Speaker 2: Yeah, two paths forward we think, I mean, one is 108 00:04:58,320 --> 00:05:01,279 Speaker 2: the funding models, and we're working quite closely with you know, AMA, 109 00:05:01,320 --> 00:05:04,279 Speaker 2: Federal and AMA and T part of the same organization. Obviously, 110 00:05:04,720 --> 00:05:08,599 Speaker 2: we work with the federal minister, our local minister, our 111 00:05:08,600 --> 00:05:11,320 Speaker 2: health department to say, look, this doesn't work for the territory, 112 00:05:11,360 --> 00:05:13,839 Speaker 2: and here's why on a needs basis, not just because 113 00:05:13,880 --> 00:05:16,000 Speaker 2: we want more money, but here is why, and here's 114 00:05:16,000 --> 00:05:18,839 Speaker 2: the evidence for why. The second thing is the inefficiencies. 115 00:05:18,839 --> 00:05:21,480 Speaker 2: You know, there's no point filling a leaky bucket. Obviously, 116 00:05:21,520 --> 00:05:23,800 Speaker 2: we have to fill this bucket. We need health care 117 00:05:23,880 --> 00:05:26,760 Speaker 2: without a healthy economy. Without a healthy healthcare system, you 118 00:05:26,800 --> 00:05:30,440 Speaker 2: don't have a healthy economy. But we also need to 119 00:05:30,480 --> 00:05:32,839 Speaker 2: intelligently fill this bucket and start patching some of these holes. 120 00:05:33,040 --> 00:05:36,040 Speaker 2: So we would work hand in hand with ant health, 121 00:05:36,080 --> 00:05:39,680 Speaker 2: with government, both territory and federal, to focus on areas 122 00:05:39,680 --> 00:05:43,320 Speaker 2: we think need particular attention. Aged care is an obvious one. 123 00:05:43,680 --> 00:05:45,840 Speaker 2: We've been asking for a workforce agency to look at 124 00:05:45,880 --> 00:05:50,200 Speaker 2: workforce retention and recruitment, particularly important for the territory. You know, 125 00:05:50,279 --> 00:05:53,400 Speaker 2: as an example, the EBA is under discussion at the moment. 126 00:05:53,440 --> 00:05:56,520 Speaker 2: Offer on the table is a below inflation increase that's 127 00:05:56,560 --> 00:05:58,320 Speaker 2: not going to get us the staff that we need 128 00:05:58,360 --> 00:06:00,560 Speaker 2: and keep us in the NT let's focus on the 129 00:06:00,600 --> 00:06:02,720 Speaker 2: areas of care that we need to fix, and let's 130 00:06:02,760 --> 00:06:05,560 Speaker 2: stop applying band aids. Let's fund models that we know 131 00:06:05,640 --> 00:06:08,000 Speaker 2: that work, We've got the evidence for it, Let's fund 132 00:06:08,000 --> 00:06:08,520 Speaker 2: them properly. 133 00:06:08,839 --> 00:06:10,640 Speaker 1: It just seems at the moment like there's so many 134 00:06:10,680 --> 00:06:13,680 Speaker 1: areas across our health system where there are concerns. I mean, 135 00:06:13,720 --> 00:06:15,919 Speaker 1: even earlier in the week Kosha, the Council of the 136 00:06:15,960 --> 00:06:18,880 Speaker 1: Aging here in the Northern Territory had issued a statement 137 00:06:19,120 --> 00:06:23,120 Speaker 1: urging the government to intervene urgently to prevent cuts to 138 00:06:23,600 --> 00:06:28,800 Speaker 1: critical dementia support service and they're really worried about, you know, 139 00:06:28,880 --> 00:06:33,120 Speaker 1: some changes when it comes to dementia care and you know, 140 00:06:33,200 --> 00:06:36,040 Speaker 1: not to mention then the age care beds and the 141 00:06:36,080 --> 00:06:37,240 Speaker 1: maternity services. 142 00:06:37,320 --> 00:06:37,960 Speaker 2: Like, there are so. 143 00:06:38,040 --> 00:06:40,359 Speaker 1: Many areas at the moment where it feels like we 144 00:06:40,480 --> 00:06:43,599 Speaker 1: are bleeding, for want of a better word, and where. 145 00:06:43,400 --> 00:06:45,760 Speaker 2: The canary and the coal mine, you know, the changes 146 00:06:45,800 --> 00:06:48,599 Speaker 2: that are proposed to the NDIS and the Thriving Kids program. 147 00:06:48,680 --> 00:06:52,440 Speaker 2: They put more of an impost on the territories in 148 00:06:52,480 --> 00:06:57,360 Speaker 2: the States to deliver rehabilitation and support services. Now, if 149 00:06:57,400 --> 00:06:59,960 Speaker 2: you're New South Wales and you've just spent fifty eight 150 00:07:00,120 --> 00:07:03,240 Speaker 2: billion and counting on metros and urrails. You've got some 151 00:07:03,279 --> 00:07:05,760 Speaker 2: money to move around. We don't have that free cash. 152 00:07:06,160 --> 00:07:09,720 Speaker 2: Queensland has got a thirty one billion dollar health budget 153 00:07:09,720 --> 00:07:12,760 Speaker 2: repair package that they're looking at and talking about. Now, 154 00:07:13,040 --> 00:07:15,080 Speaker 2: we can't do that. We don't have thirty one billion 155 00:07:15,160 --> 00:07:17,560 Speaker 2: laying around now. I'm not saying we should just get 156 00:07:17,600 --> 00:07:19,640 Speaker 2: money and that will fix everything. As I said, leave 157 00:07:19,680 --> 00:07:22,280 Speaker 2: the bucket. There's things to do. We just want what's 158 00:07:22,280 --> 00:07:24,679 Speaker 2: fair and right now. I think the evidence it's pretty 159 00:07:24,680 --> 00:07:26,520 Speaker 2: clear if you look at the markers that we measure, 160 00:07:26,560 --> 00:07:28,640 Speaker 2: if you look at the way funding works out, the 161 00:07:28,760 --> 00:07:31,200 Speaker 2: territory is not getting its fair share of Commonwealth funding. 162 00:07:31,280 --> 00:07:32,320 Speaker 2: Plain and simple. 163 00:07:32,200 --> 00:07:36,119 Speaker 1: Doctor's orbis when it comes to things like cancer diagnoses 164 00:07:36,320 --> 00:07:39,120 Speaker 1: in the Northern Territory and you know, and other sort 165 00:07:39,160 --> 00:07:41,840 Speaker 1: of chronic illnesses. Are you concerned that, you know, when 166 00:07:41,920 --> 00:07:43,880 Speaker 1: you look at this report card and you look at 167 00:07:44,040 --> 00:07:46,000 Speaker 1: the way times you look at the time it takes 168 00:07:46,040 --> 00:07:48,440 Speaker 1: for somebody to be able to see a specialist, are 169 00:07:48,480 --> 00:07:52,600 Speaker 1: you concerned that things could be going undiagnosed or worse, 170 00:07:52,880 --> 00:07:56,560 Speaker 1: you know, still ending up being diagnosed sort of at 171 00:07:56,680 --> 00:08:00,480 Speaker 1: quite a late stage where it becomes very hard to treat. Thanks. 172 00:08:00,640 --> 00:08:03,000 Speaker 2: Yeah, I don't know where that tipping point is. I 173 00:08:03,040 --> 00:08:04,720 Speaker 2: do know that you can't keep putting pressure on the 174 00:08:04,720 --> 00:08:07,840 Speaker 2: system and expect that those things won't happen. We've already 175 00:08:08,120 --> 00:08:10,440 Speaker 2: everybody has stories of a family member or a friend 176 00:08:10,480 --> 00:08:13,400 Speaker 2: who's had their care delayed for whatever reason. Now, we 177 00:08:13,440 --> 00:08:15,760 Speaker 2: don't cancel things in the public health sector just because 178 00:08:15,840 --> 00:08:18,360 Speaker 2: you know, it's probably because of a code yellow, code brown, 179 00:08:18,360 --> 00:08:20,440 Speaker 2: because of the flooding. You know, these things happen. There's 180 00:08:20,440 --> 00:08:24,320 Speaker 2: always variations to care, and there's lots of backstops. There's 181 00:08:24,360 --> 00:08:27,360 Speaker 2: lots of safety checks where you have multiple layers in 182 00:08:27,440 --> 00:08:30,840 Speaker 2: position to stop things from just disappearing, right, But they 183 00:08:30,880 --> 00:08:34,120 Speaker 2: only work so well and eventually they stop working. You know, 184 00:08:34,160 --> 00:08:36,840 Speaker 2: we're still seeing our Cat one patients in a reasonable 185 00:08:36,840 --> 00:08:40,880 Speaker 2: time frame, both surgery, both in emergency department, but that 186 00:08:40,960 --> 00:08:44,400 Speaker 2: doesn't The longer the tail gets, the more harm we 187 00:08:44,440 --> 00:08:46,960 Speaker 2: see and the more burden of disease. There is the 188 00:08:46,960 --> 00:08:49,480 Speaker 2: problem with risk in health care is you go from 189 00:08:49,800 --> 00:08:52,640 Speaker 2: near misses to front page headlights. There's not a lot 190 00:08:52,640 --> 00:08:53,120 Speaker 2: of in between. 191 00:08:53,240 --> 00:08:55,680 Speaker 1: That's exactly right, your spot on there. Hey, before I 192 00:08:55,760 --> 00:08:57,320 Speaker 1: let you go, just on all the flooding that we're 193 00:08:57,320 --> 00:08:59,760 Speaker 1: seeing across the top end. Has it seen some additional 194 00:08:59,800 --> 00:09:01,640 Speaker 1: pre on Royal Darwin Hospital. 195 00:09:01,840 --> 00:09:04,400 Speaker 2: Definitely, but you look a huge shout out to all 196 00:09:04,400 --> 00:09:07,199 Speaker 2: the public agencies that have been involved, both health education 197 00:09:07,600 --> 00:09:10,800 Speaker 2: across the board. Big shout out to the public service 198 00:09:10,960 --> 00:09:13,959 Speaker 2: agencies for the response and to the public for heeding 199 00:09:13,960 --> 00:09:16,559 Speaker 2: the warnings, for heitting the concerns following the boil water 200 00:09:16,640 --> 00:09:18,680 Speaker 2: and reduce water instructions like we do these things for 201 00:09:18,720 --> 00:09:22,199 Speaker 2: a reason, and that response means that so far we've 202 00:09:22,200 --> 00:09:24,160 Speaker 2: been able to cope with the patients we've had to 203 00:09:24,200 --> 00:09:27,360 Speaker 2: medically evacuate out of Catherine. It's important for us to 204 00:09:27,360 --> 00:09:29,520 Speaker 2: remember there's a long tail to these things. Let's not 205 00:09:29,520 --> 00:09:31,800 Speaker 2: forget about Catherine. When the floodwaters received, there's going to 206 00:09:31,800 --> 00:09:34,160 Speaker 2: be a lot of work to do. Let's support everybody 207 00:09:34,160 --> 00:09:35,839 Speaker 2: across the territory the same way we would anybody in 208 00:09:35,880 --> 00:09:36,400 Speaker 2: duwe Well. 209 00:09:36,520 --> 00:09:38,880 Speaker 1: Dr John's orbis the head of the AMA here in 210 00:09:38,920 --> 00:09:41,000 Speaker 1: the Northern Territory. Good to speak with you today. 211 00:09:41,040 --> 00:09:42,040 Speaker 2: Thank you, thank you.