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Speaker 1: Well, we have been speaking for a considerable amount of

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Speaker 1: time on this show about the concerns within our health

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Speaker 1: system and the shortage of staff. Now, last week Caath Hatcher,

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Speaker 1: the head of the Nursing and Midwiff Reunion, joined us

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Speaker 1: on the show and revealed that we need to bring

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Speaker 1: up to one hundred staff from overseas in an effort

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Speaker 1: to fill some of those shortages. Now joining me on

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Speaker 1: the show to talk more about this and the situation

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Speaker 1: with the health system is the head of the Australian

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

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Speaker 1: to you morning now, Dr Parker. Firstly, are you able

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Speaker 1: to give us a bit of an update as to

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Speaker 1: how the hospital is tracking this morning after I'm assuming

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Speaker 1: what probably what's a busy weekend.

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Speaker 2: No, unfortunately I haven't been in contact leave at the moment.

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Speaker 1: No, that's all right. Well, we will suss that out

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Speaker 1: and see if we can find out how things are going,

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Speaker 1: Dr Parker. We know that there's quite a bit going

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Speaker 1: on though when we do talk about our health system.

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Speaker 1: It was revealed that a letter was said to well

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Speaker 1: sent out by nt Health on Friday afternoon by Royal

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Speaker 1: Darwin and Palmeston Hospitals Medical Services Acting Deputy Director, who

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Speaker 1: said that the resignation of three junior doctors could have

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Speaker 1: a serious impact on patient safety. A twelve months ban

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Speaker 1: from employment with nt Health will now apply to any

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Speaker 1: doctor who resigns before the end of their contract. Do

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Speaker 1: you know why exactly this letter had to be issued, Well, again,

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Speaker 1: it was.

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Speaker 2: The optics skadium. I mean, my understanding is that a

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Speaker 2: number of doctors had resigned and then then opted for

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Speaker 2: locum contracts with the health service, which or attempted to

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Speaker 2: get locum contracts with the health service, which is not

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Speaker 2: a good thing. I mean it basically puts so doctors

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Speaker 2: leaving normal roster systems and not doing the overtime and

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Speaker 2: whatever puts much more pressure on their colleagues. And so

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Speaker 2: it was a general policy that if you're on a

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Speaker 2: normal contract which has all the obligations of working rosters

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Speaker 2: and whatever, than the system wouldn't support you being on

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Speaker 2: a being on a local contract. And that my understanding,

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Speaker 2: was the reason for the letter. It was pretty clunky

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Speaker 2: in the way it was developed and the optics of it, and.

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Speaker 1: What was the reaction from doctors to the letter well again, I.

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Speaker 2: Paid tribute to the all the heroes and their health

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Speaker 2: system and doctors, nurses, ots, physios, cleaners, quok kitchen staff

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Speaker 2: were working really above and beyond their normal their normal

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Speaker 2: expectations at the moment and the current pressure on the

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Speaker 2: health system in the in the level of fours and

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Speaker 2: code yellows. But you know, speaking for the doctors particularly,

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Speaker 2: there's a lot of when you've got reduced medical workforce

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Speaker 2: people leaving, there's much more pressure on the existing medical

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Speaker 2: workforce to fill rosters and vacancies and whatever. So it

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Speaker 2: does put an extra lot of pressure on junior medical

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Speaker 2: staff to keep the system running.

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Speaker 1: And doctor Parker, are our doctors concerned for their safety

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Speaker 1: because they are being put under that extra share at work?

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Speaker 2: Well, CAD there's been a regular theme now in terms

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Speaker 2: of safe working hours. It's recognized if you do work

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Speaker 2: a sixteen hour shift, your body and mind at the

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Speaker 2: end of the shift is not in the same condition

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Speaker 2: was at the beginning, so you know, presumably there's fatigue

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Speaker 2: and has an effect on the work you do, and

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Speaker 2: also you know in terms of your personal and also

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Speaker 2: potentially the patience you're looking after, so that you know

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Speaker 2: the recent industrial would have been very clear there has

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Speaker 2: to be a safe working hours issue and certainly sixteen

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Speaker 2: hour shifts and added shifts go beyond the safe working

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Speaker 2: ours agenda, and so are.

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Speaker 1: Our doctors regularly completing sixteen hour shifts and longer?

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Speaker 2: I would expect that you're unfortunately with the current situation,

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Speaker 2: particularly gritting, when you're getting vacancies and whatever people are

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Speaker 2: having to fill in, and.

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Speaker 1: So presumably then, like you've said, you know, there has

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Speaker 1: been studies et cetera that have found that that's not

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Speaker 1: the you know, the ideal way for our doctors to

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Speaker 1: be working. So presumingly it is having an impact on them, well.

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Speaker 2: No doubt, no doubt. And it's not good at all

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Speaker 2: for the young doctors having that sort of pressure all

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Speaker 2: the time. No, it's not good at all.

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Speaker 1: Now, we spoke obviously to Kath Hatcher, the head of

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Speaker 1: the Nursing and We're Free Union, just last week about

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Speaker 1: the lack of nursing stuff and the need to bring

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Speaker 1: a nursing stuff from overseas. From your perspective, is this

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Speaker 1: something that we need to do quite soon?

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Speaker 2: Well, I mean I've been aware of the issues of

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Speaker 2: mental health nursing since the early two thousands. I attended

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Speaker 2: a dinner in the early two thousands where there were

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Speaker 2: sixty nurses in the room and there was one only

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Speaker 2: one under thirty years old in that room. So I predicted,

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Speaker 2: I said, you know, we're going to have real problems

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Speaker 2: in about fifteen years time, which we are. What happened

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Speaker 2: before COVID was we were able to compensate to a

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Speaker 2: degree with all the people retiring and whatever the We're

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Speaker 2: able to basically import nursing staff from Ireland, New Zealand, India, Africa.

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Speaker 2: But of course COVID and all the quarantine issues and

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Speaker 2: overseas trouble restricts places significant limits on the available nurses

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Speaker 2: you're able to get to compensate for our lack of

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Speaker 2: locally trained nurses.

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Speaker 1: And so at this point in time, there is obviously

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Speaker 1: a shortage that we are seeing a shortage of nursing staff.

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Speaker 1: From what cath Hatcher had said, she realistically said, between

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Speaker 1: fifty to one hundred is what would be required. I mean,

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Speaker 1: how quickly do you think that we need to try

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Speaker 1: to get some of these staff across and operational within NT.

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Speaker 2: Health within them now? We need them, you know, That's

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Speaker 2: why I so we probably need to if we can

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Speaker 2: get mango pickers over here to pick mango, which is

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Speaker 2: excellent of course for the farmers. We need a similar

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Speaker 2: bubble to get nursing staff from trained nursing staff, you know,

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Speaker 2: who are properly qualified and credentials here as soon as possible.

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Speaker 1: How critical is it if you know, if this doesn't

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Speaker 1: happen quickly, are we're going to continue to see code

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Speaker 1: yellows called? Are we going to continue to see you know,

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Speaker 1: people aren't able to get into to see medical professionals?

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Speaker 1: What will be the ramification if we don't make this happen.

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Speaker 2: It's almost inevitable, Katie, Unfortunately, just you know, there's only

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Speaker 2: a certain reserve within the system. But if we can't

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Speaker 2: keep supporting the staff and supporting staff vacancies, it'll just

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Speaker 2: add a significant pressure of the system.

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Speaker 1: Well, rob do we need to do the same for

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Speaker 1: our medical professionals? I doctors as well? Are we seeing

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Speaker 1: a shortage of our doctors as well? At this point?

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Speaker 2: My understanding is that you know, obviously there some doctors

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Speaker 2: are seeing that it's better to be a loco than

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Speaker 2: there is to be a regular staff because of the

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Speaker 2: pressure in the system. And the advantages that go with

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Speaker 2: being a loco in that sort of situation. So obviously

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Speaker 2: there is a need for more for more doctors along,

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Speaker 2: you know, to help deal with the current pressures on

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Speaker 2: the health system.

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Speaker 1: How many more doctors do you think we need?

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Speaker 2: I don't know, Katie, I can't give you an actual number,

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Speaker 2: but we need more.

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Speaker 1: I know that. One of the things that we hear

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Speaker 1: about very often on this show is the delays to

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Speaker 1: elective surgeries and longer wait times to see specialists. Are

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Speaker 1: these white times? You know, these types of things sort

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Speaker 1: of decide effect of there being a lack of surgeons

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Speaker 1: and specialists available.

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Speaker 2: Well, no, the surgeons are available, but there are theater

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Speaker 2: Apparently you need to get nurses as well round theaters,

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Speaker 2: and there's a problem with a gather staff in theater

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Speaker 2: nurses at the moment, the problem isn't I mean, one

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Speaker 2: of our AMA Council members mentioned the patient had his

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Speaker 2: elective surgery canceled I think four or five times. So

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Speaker 2: the poor guy, you know, he is told there's a

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Speaker 2: to prepare for surgery, turns up canceled again in a

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Speaker 2: couple of weeks, told is happening, canceled and the effect

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Speaker 2: on you know, apart from the effect on his medical condition,

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Speaker 2: which you know, and again we've been very clear that

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Speaker 2: delaying surgery can lead to potentially a lot more problems

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Speaker 2: later on when those conditions become a lot more problematic,

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Speaker 2: apart from the chronic pain and disability that people have

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Speaker 2: with not having the surgical conditions addressed early leads to

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Speaker 2: a more pressure on the system with much more complex issues,

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Speaker 2: you know, people with much more complex issues arising in

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Speaker 2: the system because they haven't had treatment early. So and

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Speaker 2: that's added to the frustration obviously, if someone having preparing

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Speaker 2: for surgery four times and then having it canceled, and

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Speaker 2: the anger and frustration of dealing with us this system.

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Speaker 1: Goodness me. So is that something that's happened recently, doctor Parker?

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Speaker 2: Yeah, yeah, And this is brought up at our last

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Speaker 2: council meeting about this patient, you know, and I presume

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Speaker 2: he's just one of many ye who've had repeated cancelations

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Speaker 2: of surgery.

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Speaker 1: How big a worry is it really when you talk

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Speaker 1: about that for Territorians who are waiting to have those surgeries.

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Speaker 1: I know that, you know, for some of us listening,

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Speaker 1: we might think, oh, it's an elective surgery. You're not

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Speaker 1: going to you know, you're not going to end up

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Speaker 1: chronically on well if you don't get that elective surgery.

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Speaker 1: But the reality is, like you've said, it is causing

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Speaker 1: a lot of pressure on the individual, but I assume

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Speaker 1: that in the long run it could potentially cause issues

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Speaker 1: for us within our health system as well.

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Speaker 2: Well, that's right. For example, you know, the electro surgery

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Speaker 2: includes colaliscos goes which check for early cancers or pre

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Speaker 2: canceer's conditions, and if they're not done, it can develop

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Speaker 2: under cancer. So you know, a scope isn't done, three

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Speaker 2: months later, the person presents with cancer, which is incredibly

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Speaker 2: unfortunate for that person, but actually much more complex for

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Speaker 2: the system to treat someone with advanced cancer rather than

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Speaker 2: just to get the early treatment of the pre cancerous condition.

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Speaker 1: Wow.

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Speaker 2: Yeah, it's certainly you know, it can have significant implications

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Speaker 2: not doing electric procedures.

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Speaker 1: Early, and that is as you've pointed out, there's the

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Speaker 1: surgeons are actually available, but we just don't have enough

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Speaker 1: theater nurses by the sounds of.

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Speaker 2: It, that's my understanding. Yeah, well, no.

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Speaker 1: Doubt that's something that we'll get onto and that hopefully

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Speaker 1: we are able to see some change there if we're

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Speaker 1: able to bring some of these nurses across from overseas.

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Speaker 1: Dr Parker, you and I have spoken extensively on this

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Speaker 1: show as well about the need for additional funding. I

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Speaker 1: know that it's something you've been lobbying for for quite

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Speaker 1: some time. Is it something that you are continuing to

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Speaker 1: lobby those tiers of government for.

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Speaker 2: Well. My understanding was that last Thursday there was a

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Speaker 2: national ring around of all state health ministers who were

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Speaker 2: very concerned. They're all facing similar situations to what's happening

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Speaker 2: in Darwen at the moment with their hospital systems. There

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Speaker 2: was a framework for advancing health issues within the old

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Speaker 2: government system, the Council of Australian Government, so it was

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Speaker 2: called the Australian Armac Australian Health Minister's Advisory Council, and

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Speaker 2: that was abolished and so there's currently no proper advisory

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Speaker 2: system through the national Cabinet about how desperate things are.

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Speaker 2: My understanding is all information comes from Brendan Murphy, who

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Speaker 2: may be a bit partial to the truth about advising

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Speaker 2: national Cabinet about what the real situation situation is that

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Speaker 2: the coal phase and my understanding is so I think

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Speaker 2: the state, the state healthness is are very frustrated that

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Speaker 2: they're not able to address national Cabinet about the real

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Speaker 2: situation effecting their hospitals. However, in Saturday's Week in Australian

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Speaker 2: Premier Pala Shape from Queensland made a point that they're

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Speaker 2: not going to open their borders without additional hospital funding.

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Speaker 2: So she's now taken this argument directly to the Prime Minister,

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Speaker 2: who apparently ignored it. But it is a desperate situation.

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Speaker 2: Part of the problem is that the five year health

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Speaker 2: funding agreements were signed off last year and after that

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Speaker 2: the Commonwealth breathe aside of the releases, we've done it,

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Speaker 2: we can another five years, will think about it. The

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Speaker 2: problem is this situation isn't going to last wait for

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Speaker 2: five years. There are real problems affecting hospitals all over

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Speaker 2: Australia and it's a significant situation.

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Speaker 1: Well, and then of course you add COVID to the

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Speaker 1: mix and we've I guess seen it exasperated. How concerned

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Speaker 1: are you about the state of the health system right

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Speaker 1: now when we do talk about that delta strain of

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Speaker 1: COVID potentially coming to the territory.

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Speaker 2: Very concerned, I mean to, given my understanding, is currently

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Speaker 2: half of the beds in Royal Melbourne Hospital, which is

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Speaker 2: one of Melbourne's major health institutions, that devoted to COVID,

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Speaker 2: and that gives you some idea of the pressure that

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Speaker 2: COVID can put on a health system. So obviously, if

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Speaker 2: we do get an outbreak of COVID in the territory,

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Speaker 2: and particularly if it affects individuals in the indigenous communities

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Speaker 2: they've got poor vaccination rates, it's probably can have massive

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Speaker 2: implications both for very serious health complications and mortality in

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Speaker 2: those individuals.

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Speaker 1: Oh and you and I spoke, I think it was

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Speaker 1: last Monday actually about the number of beds that we've

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Speaker 1: got when it comes to when it comes to having

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Speaker 1: those respirators and various things that you potentially need. If

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Speaker 1: there is somebody who becomes chronically I'm well or critically

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Speaker 1: I'm well with COVID, it just doesn't seem as though

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Speaker 1: we've really got what we require. No.

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Speaker 2: Well, I've argued for much better funding for the health system,

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Speaker 2: you know, for a long time, and that letter I

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Speaker 2: wrote to Minister Hunt three years ago argued for a

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Speaker 2: lot more funding for the nt SO I agree we

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Speaker 2: need a lot more beds to deal with the current

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Speaker 2: pressure on the health system and potentially, you know, anticipating

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Speaker 2: we'll get a more pressure with COVID as well.

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Speaker 1: Doctor Parker, I have just got one question from a listener.

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Speaker 1: Our healthcare workers need to be mandatory vaxed if they

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Speaker 1: don't want the vax and this causes staffing issues, isn't

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Speaker 1: this a bad thing? I don't know if you've got

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Speaker 1: any comment on that.

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Speaker 2: Look, I think a vaccination is a contribution to the

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Speaker 2: community and to your the patient care and really that's

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Speaker 2: why it's essential or health care workers have vaccinated.

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Speaker 1: Doctor Robert Parker, the head of the Australian Medical Association's

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Speaker 1: Northern Territory branch, thank you very much for your time

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Speaker 1: this morning. Twice in a row that you've been on

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Speaker 1: leave and still joined us on the show. We really

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Speaker 1: appreciate you chatting this morning.

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Speaker 2: My pleasure, Katy.

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Speaker 1: Thank you