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Speaker 1: Now we know that the Code yellow at Royal Darwin

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Speaker 1: and Palmeston Hospitals remains in place. The internal emergency was

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Speaker 1: declared on Friday and it was the second code yellow

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Speaker 1: at top end hospitals in two days, with the spike

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Speaker 1: and emergency presentations causing a code yellow at the Catherine

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Speaker 1: Hospital on Thursday. Now yesterday, the Chief Minister explained that

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Speaker 1: the pressure on a Royal Darwin Hospital and Palmeston Regional

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Speaker 1: Hospital is due to staff shortages, arise in mental health

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Speaker 1: patients and long stay patients taking up beds. Now to

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Speaker 1: shed a bit more light on this situation and let

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Speaker 1: us know what is going on, is doctor Robert Parker,

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Speaker 1: who is indeed the head of the AMA, the Australian

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Speaker 1: Medical Association's Northern Territory branch. Good morning to you, doctor Parker.

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Speaker 2: Morning kab Now doctor Parker, what.

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Speaker 1: Do you understand has led to these code yellows?

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Speaker 2: Well, I think, as I've said in previous interviews, I

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Speaker 2: mean in two thousand and nine and I recom Minister

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Speaker 2: haunt pointy hospitals with the business hospitals in Australia often

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Speaker 2: two or three some of the busiest of the states

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Speaker 2: and territory and just they have been underfunding for years

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Speaker 2: by both sides of government, both said the Land States,

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Speaker 2: and it's now coming to the crunch where we haven't

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Speaker 2: got enough beds, we haven't got enough star and the

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Speaker 2: problem is with hecare again, we haven't got enough hcare beds.

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Speaker 2: So people who are infirm and are significantly disabled who

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Speaker 2: need to be in an hdre bed are actually sort

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Speaker 2: of backed up in the hospital are waiting for further care,

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Speaker 2: all of which is contributing to you this very high

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Speaker 2: pressure on the hospital and all the code yellow, which

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Speaker 2: is really justus a statement of the hospital, you know,

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Speaker 2: is just overwhelmed with a range of factors that some

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Speaker 2: are some have been long term and some are much

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Speaker 2: more short term. But it's just continuing pressure. And I

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Speaker 2: think it just reflects the fact that I mean what's

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Speaker 2: happening in the territory is it's fairly similar unfortunately to

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Speaker 2: what's happening in other parts of Australia. And I mean

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Speaker 2: the AMA has had this block jam campaign nationally because

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Speaker 2: of similar pressures affecting other hospitals and other states and territories.

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Speaker 2: And it also to a degree reflects two sort of

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Speaker 2: patient issues which are an aging population. People are living

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Speaker 2: longer and we've got the sort of baby boom are effects.

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Speaker 2: So when people are turning up to hospital quite often

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Speaker 2: they've got complex issues. You know, in the old days,

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Speaker 2: you probably turn up with us one or two significant

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Speaker 2: issues that could be meaningfully managed in this charge. But

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Speaker 2: the complexity of people turning up to the hospital these

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Speaker 2: days is more intense, and that means that they tend

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Speaker 2: to tend to have admissions and longer stays doctors. Another

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Speaker 2: factoring assist from the territory is that a third of

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Speaker 2: our population or indigenous, and there's a I mean, the

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Speaker 2: close the gap mortality is just sort of the apex

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Speaker 2: of a pyramids and underneath that bectures all the chronic

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Speaker 2: illness factors that lead to hospitalization. In that letter I

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Speaker 2: wrote to Minister Hunt, I pointed out that we've got

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Speaker 2: we had at that stage half a number of primary

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Speaker 2: care practitions we needed in remote and rural areas, and

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Speaker 2: we had double the number of avoidable admissions. Yeah. I mean,

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Speaker 2: and obviously there's a reflection now, I mean, obviously everyone's

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Speaker 2: very concerned about the GPS, lack of GPS in Australia

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Speaker 2: and falling numbers of GPS, and secondly, the obviously the

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Speaker 2: issue about block willing and being able to access GPS

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Speaker 2: because you know, GP's that because of the under fund

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Speaker 2: their practices and take money over to their families, GPS

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Speaker 2: are often having to abandon while billing because it just

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Speaker 2: isn't it isn't giving them a viable business anymore.

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Speaker 1: Yeah, something we've spoken about.

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Speaker 2: Impacting currently on the current situation.

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Speaker 1: Yeah, it is certainly something we've spoken about before. And

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Speaker 1: that point you make about the fact that you know

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Speaker 1: that you written to the federal Health Minister all the

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Speaker 1: way back in twenty nineteen about these issues and also

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Speaker 1: about the funding. Dr Parker, can you paint a bit

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Speaker 1: of a picture for our listeners at the moment, you know,

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Speaker 1: when we talk about a code yellow in both the

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Speaker 1: Royal Dalwen Hospital and the Palmerston Regional Hospital, what are

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Speaker 1: we talking here? Are we talking about patients being in hallways?

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Speaker 1: Are they double bunked? What's going on?

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Speaker 2: Well, there may be double bunking at times. I think

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Speaker 2: it's unlikely there are patients in hallways, but I can't

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Speaker 2: absolutely say that doesn't happen. What that means is that

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Speaker 2: the hospital has regular meetings, so you know, rather than

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Speaker 2: doing a daily business, you have to go to meetings

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Speaker 2: a couple of times a day to look at patient

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Speaker 2: flow and what's going on in different departments. So the

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Speaker 2: hospital goes to a sort of much higher level of

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Speaker 2: acute sort of putting to try and manage the situation.

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Speaker 2: And I'm quite often unfortunately that leads to cancelation of

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Speaker 2: I like you're surgical that and again you know, quite

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Speaker 2: often the people have been on thesese for months and

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Speaker 2: they've often got crying, disabling and painful conditions. But that's

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Speaker 2: that's how the hospital managers by diverting resources away from

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Speaker 2: the services that they can sacrifice the short term to

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Speaker 2: try and manage the very high bed state.

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Speaker 1: Now, Dr Parker, the opposition claims that the lifting of

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Speaker 1: the alcohol ban has added extra pressure on the health system.

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Speaker 1: From your perspective, is that the.

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Speaker 2: Case, I would think that's a factor certainly. I mean

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Speaker 2: I was very concerned and obviously very vocal when the

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Speaker 2: chievement is that have decided not to pursue the stronger

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Speaker 2: futures issue with alcohol bands and communities, and we predicted

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Speaker 2: a that there would be an increasing impact on emergency

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Speaker 2: departments with alcohol related injuries and other issues and leaders

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Speaker 2: would have a devastating impact on the families of people,

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Speaker 2: you know, with domestic violence and children exposed to pretty

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Speaker 2: awful situations at home, which will have much more of

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Speaker 2: a long term mental health impact. So I would tend

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Speaker 2: to agree with the opposition that it's a factor. It's

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Speaker 2: not the whole situation, but certainly actor in the increasing

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Speaker 2: pressure on hospitals.

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Speaker 1: So since the ending of that legislation, the Stronger Future's legislation,

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Speaker 1: would you say that there has been a difference in

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Speaker 1: terms of, you know, what you're seeing in there at

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Speaker 1: the hospital.

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Speaker 2: Well, again, I've always been concerned that, you know, people,

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Speaker 2: it seems to be related to human rights and the

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Speaker 2: human right to have a drink and then and then

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Speaker 2: use your partner and destroy your family, you know. And certainly,

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Speaker 2: I mean, the Department hasn't been particularly forthcoming with statistics,

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Speaker 2: but I think Bill Yan has probably anecdotally heard from

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Speaker 2: collisions on the floor about increasing rates of alcohol fuel

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Speaker 2: is is presenting do ed. The AMA has got no

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Speaker 2: information about this. It's unlikely we'll get any formal data

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Speaker 2: from the department about this. But certainly, I mean, I

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Speaker 2: think it's almost inevitable, as I predicted at the time

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Speaker 2: that when you abandon alcohol restrictions, people will drink and

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Speaker 2: there will be significant consequences from that.

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Speaker 1: So from what I'm hearing, you would say that that

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Speaker 1: right now, you know that is part of the issue here,

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Speaker 1: the changes to the alcohol legislation, but also you know

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Speaker 1: the fact that that there's not enough funding for our hospitals.

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Speaker 1: We have got one of the sickest populations in Australia

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Speaker 1: and that we realistically need more funding.

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Speaker 2: Well, that's correct, I mean there is I mean I

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Speaker 2: also agree with the Chief Minister about nurses. I mean,

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Speaker 2: unfortunately there has been a significant problem with nurses entering

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Speaker 2: nurse or people entering nurse training in Australia, and I

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Speaker 2: mean we used to supplement obviously with people coming from overseas.

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Speaker 2: COVID had a significant impact on that, as I understand

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Speaker 2: with closing borders, so that had a major impact on

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Speaker 2: being able to obtain a workforce. But obviously I'm understanding

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Speaker 2: is now that there's a backlog of visa applications and

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Speaker 2: they know the Department, to its credit, is working with

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Speaker 2: the federal government to try and fast track visa applications

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Speaker 2: so we can get the stuff we need to run

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Speaker 2: the hospital.

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Speaker 1: So it is an he sure of staff shortage as well.

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Speaker 1: What about when you talk about you know, our doctors

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Speaker 1: and like, have we got a shortage there?

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Speaker 2: Well, again, I mean we're still waiting for the EBA

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Speaker 2: to go through, and I mean we're a where the

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Speaker 2: ninety percent of territory doctors decided that what the government

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Speaker 2: offered was not it was not appropriate. The issue is

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Speaker 2: that people can view this as agreedy doctor issue, But

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Speaker 2: the problem is we have to be competitive in the market,

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Speaker 2: and we're competing against other states and territories and if

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Speaker 2: their awards are better, people tend to go and work

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Speaker 2: in other places. So the territory has to have a

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Speaker 2: competitive medical officers award to get the staff we need

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Speaker 2: to keep the place running. And we have and ASMOV

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Speaker 2: have been in communication with the government about that. And

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Speaker 2: I mean the government, to its credit, has changed as

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Speaker 2: wages policy now and ASTHMA are continue to work with

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Speaker 2: the government to achieve a workable wages policy so we

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Speaker 2: can recruit medical staff because at the moment, again, you know,

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Speaker 2: we are unable to recruit up and against the awards

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Speaker 2: and we've got, you know, we get locums, and locums

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Speaker 2: at the moment can charge up to three thousand dollars

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Speaker 2: a day to work and that's you know, that's what

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Speaker 2: the market. That's what the market says, you know, and

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Speaker 2: we have to pay to keep the service going. And

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Speaker 2: I've often said to the department, work out how much

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Speaker 2: a measure, you know, work out how much you're paying

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Speaker 2: them locans as opposed to how much it's going to

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Speaker 2: cost to get an award through. And the Department hasn't

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Speaker 2: decided to do that, but I mean, you know, it's

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Speaker 2: a bit of a false economy where you haven't got

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Speaker 2: a viable of wards, you can't recruit medical staff, and

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Speaker 2: you're having to pay locums a large amount of money

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Speaker 2: to keep the health service going.

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Speaker 1: Dr Parker, do you think that what the government is

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Speaker 1: doing right now in the Northern Territory is working or

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Speaker 1: what do you think needs to happen to try to

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Speaker 1: ease these issues that we are seeing with the code yellows,

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Speaker 1: because it seems as though we have seen more of

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Speaker 1: them in the recent year than what we had than

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Speaker 1: what I ever recall being called previously.

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Speaker 2: Well, look, I think you know, and the credit to

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Speaker 2: the to the Chief Minister and the Health Ministry. I

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Speaker 2: think she is working. I mean a lot of these

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Speaker 2: issues and the years in development, you know, and I said,

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Speaker 2: both sides of politics have been have been equally involved

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Speaker 2: in the underfunding of health, and I think the Chief Minister,

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Speaker 2: to a credit is trying to just trying to communicate

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Speaker 2: with the federal colleagues about issues and trying to develop

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Speaker 2: some funding and also develop some future planning for the

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Speaker 2: Health department. I mean, the the these these situations can

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Speaker 2: be a it seasonal. I mean, for example, you know,

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Speaker 2: with with with COVID and with the flu, you can

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Speaker 2: put increasing pressures and the pressure goes away for a while,

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Speaker 2: comes back again. But I think the the you know,

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Speaker 2: the the continuing code yellow is just to mean that

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Speaker 2: obviously there's a level of illness in the community for

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Speaker 2: a range of factors that are putting significant pressure and

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Speaker 2: we're more likely to see how yellows in the future

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Speaker 2: because there's sort of like a catch up with any

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Speaker 2: of these issues. Starving shortages, underfunding, age fare have been

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Speaker 2: years in the making and can't be undone quickly and

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Speaker 2: have to look at a sustainable coming option. Yesterday, you know,

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Speaker 2: with the current economic climate and with the dead both

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Speaker 2: federally and with the MC I can't see rivers and

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Speaker 2: money's do the opening up nice for the starving situations

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Speaker 2: in the short term.

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Speaker 1: Now I know that the Australian Salary Medical Officers Federation

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Speaker 1: had described the situation in the Northern Territory right now

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Speaker 1: as at crisis point. Would you say the same, Well, again,

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Speaker 1: it is.

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Speaker 2: A crisis point, but I mean the crisis both. You

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Speaker 2: know the Chinese character for crisis the calligraphy apparently those

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Speaker 2: elements of danger and opportunities. So there are danger, but

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Speaker 2: there's also an opportunity to look at ways we can

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Speaker 2: build the situation, maybe attract attract more funding, look at

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Speaker 2: different ways of doing things a case.

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Speaker 1: Well, Doctor Robert Parker, the head of the a m

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Speaker 1: A here in the Northern Territory, always appreciate your time.

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Speaker 1: Thank you very much for having a chat with us.

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Speaker 2: Good to talk to you, Katie.

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Speaker 1: Thank you