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Speaker 1: Right now, though a bit of a change of pace,

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Speaker 1: because we know Sint John Ambulance is no longer going

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Speaker 1: to be able to perform two life saving, high risk

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Speaker 1: procedures after a directive from NT Health, High acuity lower

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Speaker 1: currence procedures conducted by intensive care paramedics have been immediately

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Speaker 1: suspended due to clinical governance concerns. Now, the AMA's NT President,

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Speaker 1: doctor john's Orbis told News Corp. While the procedure could

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Speaker 1: be life saving, they aren't safe without proper training and oversight.

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Speaker 1: The AMA's NT president joins me on the line right now.

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Speaker 1: Good morning to you, doctor's Orbis.

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Speaker 2: Good morning, Katie, thanks for having us.

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Speaker 1: Yeah, good to have you on the show. Can you

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Speaker 1: explain what these two procedures are.

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Speaker 2: Yeah, So, the two procedures we're talking about. One is

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Speaker 2: called a finger thawer costomy, and that's where we cut

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Speaker 2: into the side of the chest to release a deadly

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Speaker 2: amount of pressure inside the chest that can be pressing

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Speaker 2: against the lungs or the heart and if not treated,

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Speaker 2: will result in death. The second is pre hospital emergency anesthesia,

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Speaker 2: and that's the use of sedation for emergency procedures and

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Speaker 2: that might help to secure an airway, making sure that

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Speaker 2: someone can breathe. There's a few uses for it. These

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Speaker 2: are very high risk procedures. We call them life saving,

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Speaker 2: but they can also be life ending if they're not

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Speaker 2: done properly.

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Speaker 1: Yeah, right, So why are the paramedics no longer going

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Speaker 1: to be able to perform them?

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Speaker 2: So there was a review done by Dr Craig Ellis,

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Speaker 2: commissioned by the government to look into some concerns around

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Speaker 2: practices at Saint John's and what they found was there

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Speaker 2: was a lack of governance around the training and support

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Speaker 2: for paramedics to do these procedures. You can imagine this

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Speaker 2: is the pointing end of the spere in medicine, these

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Speaker 2: types of procedures, and they do need a lot of

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Speaker 2: training around them. Even in expert hands, things can go wrong.

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Speaker 2: So the government report suggested that without that training, these

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Speaker 2: procedures are doing more harm than benefit and they should

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Speaker 2: be suspended until we can get that training back in place.

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Speaker 1: Have there been, as far as you know, have there

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Speaker 1: been instances where these procedures have been used and have

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Speaker 1: had unintended consequences.

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Speaker 2: Members came to us with concerns, which is what led

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Speaker 2: to our original complaints about a year year and a

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Speaker 2: half ago about things they were seeing that raised eyebrows,

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Speaker 2: were asking some questions about whether these procedures should have

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Speaker 2: been done. Now we asked for them to be investigated.

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Speaker 2: My understanding is they have been. You know, we can't

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Speaker 2: talk about specific cases, there's confidentiality around those, but certainly

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Speaker 2: you know, doctors were coming to us with concerns.

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Speaker 1: In terms of, you know, where things are at now

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Speaker 1: or what's going to sort of happen for Saint John

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Speaker 1: in terms of being able to perform these procedures. I

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Speaker 1: understand that the suspension is going to remain in place

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Speaker 1: until a chief medical officer is appointed. My understanding is

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Speaker 1: that they've not had one for a couple of years.

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Speaker 1: Why is that needed?

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Speaker 2: Yeah, And look that's the point of frustration for us

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Speaker 2: because when we identified these issues, what we said to

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Speaker 2: John's at the time was you need a medical director,

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Speaker 2: you need a chief medical officer, just like every other

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Speaker 2: paramedicine service in Australia, and they chose not to do that.

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Speaker 2: Now that's led to the situation wherein now where the

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Speaker 2: ability to do these procedures has been suspended. We welcome

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Speaker 2: that decision obviously for reasons of safety. But now is

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Speaker 2: the time for them to rapidly re establish that position,

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Speaker 2: because that position is the person who has the expertise

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Speaker 2: and the skills to make sure that these procedures are

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Speaker 2: done safely, both in their training and when they're used

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Speaker 2: on the road.

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Speaker 1: All right, So it sounds like there does need to

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Speaker 1: be you know, there is going to be a bit

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Speaker 1: of work there. We are going to catch up with

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Speaker 1: Saint John's this morning after ten o'clock, so we'll see

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Speaker 1: what further detail we can find or what we can

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Speaker 1: get from them. I mean, from your perspective, is this like,

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Speaker 1: is this enough? Do you feel as though you know

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Speaker 1: this is a good move and it is the right

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Speaker 1: move for Territorians.

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Speaker 2: Yeah, we think it's the right mode for Territorians. And

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Speaker 2: you know, I'm somebody who's used this service. I've been

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Speaker 2: injured on the side of the road waiting for an

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Speaker 2: ambulance and I want every Territorian to know that their

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Speaker 2: paramedics are safe to do what they do. And yes,

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Speaker 2: we're the doctors that the paramedics are asking for this

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Speaker 2: as well. The Paramedic Union has made these same requests,

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Speaker 2: so we welcome the decision and now it's up to

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Speaker 2: Saint John's to move swiftly on the second part of

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Speaker 2: his problem, which is get that director back in place,

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Speaker 2: and let's let our paramedics do what they do best.

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Speaker 1: Well, as I said, we will talk to them this

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Speaker 1: morning after ten o'clock. I do want to ask you,

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Speaker 1: doctors orbus Obviously, big announcement yesterday with the Northern Territory

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Speaker 1: government planning to launch this trial of the OC spray

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Speaker 1: to eligible territorians as a tool for self defense, is

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Speaker 1: it a move that Northern Territory doctors support.

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Speaker 2: Look overall. No, If the answer is peppes pray, then

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Speaker 2: wants the question. And if the question is reduction in crime,

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Speaker 2: we're not confident that that's actually going to fix the problem. Now,

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Speaker 2: it's not the AMA's job to tell people what they

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Speaker 2: can and can't do in their own homes. Let me

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Speaker 2: be very clear on that. But if we're talking about

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Speaker 2: the public health of giving pepper spray out more widely

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Speaker 2: than at the moment where it's quite restricted, the outcome

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Speaker 2: and we know this from wa We've done this in

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Speaker 2: w A. People will feel safer, but they won't be safer.

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Speaker 2: We know in w A rates of assaults, both domestic

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Speaker 2: and non domestic, continue to rise faster than rise in population.

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Speaker 2: Same for threatening behavior, deprivation of liberty, sexual assault. And

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Speaker 2: what we see in the emergency departments is you know,

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Speaker 2: victims of misadventure or the pepper spray getting in the

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Speaker 2: wrong hands. It's not that hard to see, you know,

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Speaker 2: pepper spray being bought legitimately and ending up in the

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Speaker 2: hands of a criminal instead. So we've got concerns.

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Speaker 1: Do you anticipate more pressure on the health system as

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Speaker 1: an unintended consequence?

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Speaker 2: Yes, although you know, I don't want to sit here

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Speaker 2: and cry wolf. It's not going to outstrip the resources

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Speaker 2: that we have in the emergency departments. If you compare

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Speaker 2: it to something like the misuse of alcohol, I mean,

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Speaker 2: they're chalk and cheese. That's a much, much, much bigger

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Speaker 2: problem for us. But there are also injuries that don't

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Speaker 2: have to happen. So we're talking about, you know, the

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Speaker 2: three year old found mommy or daddy's pepper spray, or

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Speaker 2: the twenty two year old cop who was just doing

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Speaker 2: his job and got spray trying to apprehend a criminal.

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Speaker 2: A seventy four year old who's marked outdoors and couldn't

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Speaker 2: respond quickly enough to grab his pepper spray. I mean,

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Speaker 2: these are the victims we see.

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Speaker 1: Yeah, it is certainly a broad discussion that we are

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Speaker 1: continuing to have doctors orbis. Just before I let you

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Speaker 1: go this morning, has there been much of an update

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Speaker 1: or much change since c C station of maternity services

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Speaker 1: at Darwin Private Hospital in terms of, you know, additional

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Speaker 1: pressure or anything like that on Royal Darwin.

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Speaker 2: Look too early to tell and you're going to get

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Speaker 2: the most accurate numbers from Royal Darwin. We do know, however,

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Speaker 2: that our obstritions have concerns about changes that are being made.

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Speaker 2: And yesterday on the ABC, you know, we said we

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Speaker 2: made a call to the minister to say, look, the best,

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Speaker 2: the best answers to your questions are going to come

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Speaker 2: from the front line. Speak to your obstricans, speak to

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Speaker 2: your midwives, speak to your patients to make sure you've

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Speaker 2: got your finger on the pulse when it comes to

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Speaker 2: the changes in maternity.

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Speaker 1: So what are the concerns from obstetricians Right now?

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Speaker 2: There's reactionary moves to try and deal with the closure

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Speaker 2: of private maternity services and obviously you know, I don't

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Speaker 2: envy the government. They've got to move quickly. I understand that.

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Speaker 2: But moving quickly and consulting properly they can still be

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Speaker 2: done at the same time. And you know, for example,

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Speaker 2: there's a proposed model for private practicing midwives to be

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Speaker 2: in Rodau and now we've got great relationships with our

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Speaker 2: midwives up here in the territory that are the most jurisdictions.

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Speaker 2: It's a good place to work. But if you launch

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Speaker 2: a model of care in a different way of doing

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Speaker 2: things in a place where they're already doing a pretty

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Speaker 2: good job and expecting the obstritionans to pick up the

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Speaker 2: pieces when things go wrong without talking to them, you

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Speaker 2: can understand where the problem lies. So all we're asking

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Speaker 2: is that the obstritions be part of this conversation. Make

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Speaker 2: sure that things are done properly and safely. Yes, we

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Speaker 2: need to move quickly, but we can't move in a

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Speaker 2: way that's unsafe.

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Speaker 1: Well, Doctor John Zorbust the Australian Medical Associations into president.

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Speaker 1: Good to speak with you, jees, you've had to hit

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Speaker 1: the ground running having your mind you look, I.

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Speaker 2: Mean, it's always fun in the territory. That's why we

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Speaker 2: live here.

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Speaker 1: Yeah, absolutely, doctor's orbis good to have you on the show.

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Speaker 2: Thank you, Thanks Katie, Thanks thanks