1 00:00:00,080 --> 00:00:02,840 Speaker 1: The budget estimates process still underway this week and the 2 00:00:02,880 --> 00:00:06,560 Speaker 1: Health Minister Steve Edgington in the hot seat. Yesterday, there 3 00:00:06,559 --> 00:00:10,440 Speaker 1: were questions raised about code yellows at Royal Darwin Hospital. Now, 4 00:00:10,680 --> 00:00:14,320 Speaker 1: when we last caught up with the outgoing NT President 5 00:00:14,520 --> 00:00:17,400 Speaker 1: of the AMA, doctor Robert Parker, he had said to 6 00:00:17,480 --> 00:00:20,119 Speaker 1: us on the show that there had been a directive 7 00:00:20,160 --> 00:00:23,360 Speaker 1: from NT Health not to call them even though they 8 00:00:23,360 --> 00:00:26,880 Speaker 1: were needed. Now the Minister rejected those claims, saying there 9 00:00:26,920 --> 00:00:32,040 Speaker 1: were regular meetings to address any capacity concerns or pressures. Now, 10 00:00:32,080 --> 00:00:34,559 Speaker 1: what we do know is there were eleven code yellows 11 00:00:34,600 --> 00:00:38,000 Speaker 1: called at Royal Darwin and Palmerston Hospitals in the twenty 12 00:00:38,040 --> 00:00:41,120 Speaker 1: three to twenty four financial year, but there have been 13 00:00:41,200 --> 00:00:45,360 Speaker 1: none since the COLP came to government last August. The 14 00:00:45,400 --> 00:00:49,400 Speaker 1: Health Minister and Health Executive remaining firm that there hasn't 15 00:00:49,440 --> 00:00:53,239 Speaker 1: been a need to call code yellows with patient flows 16 00:00:53,240 --> 00:00:57,880 Speaker 1: and capacity issues being managed in other ways. But is 17 00:00:57,920 --> 00:01:00,480 Speaker 1: that the case? Well, joining me on the show is 18 00:01:00,560 --> 00:01:05,280 Speaker 1: the NT branch President of the AMA, the Australian Medical Association, 19 00:01:05,400 --> 00:01:08,280 Speaker 1: doctor John Zorbis. Good morning to you, Doctor. 20 00:01:08,120 --> 00:01:11,480 Speaker 2: Zorbis, Morning Katie. Thanks having us back and buddy. 21 00:01:11,280 --> 00:01:14,119 Speaker 1: Listeners, thank you so much for your time this morning. Now, 22 00:01:14,160 --> 00:01:18,600 Speaker 1: doctor Zorbis, I mean code yellows, capacity issues, whatever you 23 00:01:18,720 --> 00:01:21,640 Speaker 1: call them. Are we still having them at our hospitals. 24 00:01:22,560 --> 00:01:27,120 Speaker 2: Yes, that's clear. We've been like this since roughly twenty sixteen, 25 00:01:27,319 --> 00:01:30,160 Speaker 2: and whatever you call them. And I'm glad you're pointing 26 00:01:30,200 --> 00:01:33,000 Speaker 2: out that you know there's a labels are just labels, 27 00:01:33,040 --> 00:01:35,440 Speaker 2: whatever you call it. We're full, We're more than full. 28 00:01:35,959 --> 00:01:37,360 Speaker 2: And the problem is still there. 29 00:01:37,760 --> 00:01:41,280 Speaker 1: Doctors Orbis, why would there be a need or a 30 00:01:41,280 --> 00:01:44,199 Speaker 1: push to not call them code yellows if that's something 31 00:01:44,200 --> 00:01:47,080 Speaker 1: that gets called around the nation and other hospitals do it. 32 00:01:48,520 --> 00:01:50,480 Speaker 2: I think the problem with a code yellow is it's 33 00:01:50,480 --> 00:01:53,560 Speaker 2: a blurry measure. So a code blue, which is when 34 00:01:53,560 --> 00:01:56,200 Speaker 2: there's a medical emergency in a hospital, is very clear. 35 00:01:56,560 --> 00:02:00,840 Speaker 2: A code blue across the country looks the same everywhere. Okay, yellow. 36 00:02:01,320 --> 00:02:05,040 Speaker 2: It's finicky, and it's often designed or managed by people 37 00:02:05,040 --> 00:02:08,680 Speaker 2: who aren't working on the front line. It's not clear 38 00:02:08,680 --> 00:02:10,720 Speaker 2: when they should or shouldn't be called. And that's a 39 00:02:10,760 --> 00:02:13,600 Speaker 2: problem because really what we need is a good response 40 00:02:13,680 --> 00:02:16,240 Speaker 2: to a hospital that doesn't have enough beds for the 41 00:02:16,280 --> 00:02:17,760 Speaker 2: patient demand. That it's seeing. 42 00:02:18,760 --> 00:02:21,480 Speaker 1: So doctor Zorbis talk us through some of the capacity 43 00:02:21,520 --> 00:02:25,000 Speaker 1: issues that we are experiencing. I mean, is it at 44 00:02:25,040 --> 00:02:28,680 Speaker 1: both Royal Darwin and also the Palmerston Hospital or is 45 00:02:28,680 --> 00:02:31,639 Speaker 1: it a situation where it is really the emergency ward 46 00:02:31,680 --> 00:02:34,400 Speaker 1: at Royal Darwin Hospital that is copying at most what's 47 00:02:34,440 --> 00:02:34,720 Speaker 1: the go. 48 00:02:36,360 --> 00:02:40,120 Speaker 2: Yeah, so you can treat both hospitals in the same bucket, really, 49 00:02:40,160 --> 00:02:42,920 Speaker 2: because if a patient is seen at Palstan and needs 50 00:02:42,960 --> 00:02:46,080 Speaker 2: to be admitted under surgery or medicine, they need to 51 00:02:46,080 --> 00:02:49,160 Speaker 2: be transferred to Royal Darwin. So ultimately that's still a 52 00:02:49,200 --> 00:02:53,320 Speaker 2: bed that we need. The eds are a symptom of 53 00:02:53,360 --> 00:02:57,040 Speaker 2: a bigger problem. The emergency departments are a beautiful window 54 00:02:57,200 --> 00:02:58,960 Speaker 2: into your health system. If you want to see where 55 00:02:58,960 --> 00:03:01,560 Speaker 2: the problems are and your healths, go go sit in 56 00:03:01,560 --> 00:03:03,799 Speaker 2: your emergency department. And I know any of your listeners 57 00:03:03,840 --> 00:03:08,120 Speaker 2: who've been at Roll Dalnald Palmerston, not even recently, I 58 00:03:08,120 --> 00:03:10,520 Speaker 2: mean in the last few years, will know that the 59 00:03:10,560 --> 00:03:12,480 Speaker 2: weights are getting longer and longer for beds. 60 00:03:13,440 --> 00:03:16,640 Speaker 1: Yeah, so are you able to quantify that a little 61 00:03:16,639 --> 00:03:19,359 Speaker 1: bit for us? I mean, just what kinds of periods 62 00:03:19,360 --> 00:03:22,040 Speaker 1: are people waiting for? Or you know, are we having 63 00:03:22,120 --> 00:03:25,200 Speaker 1: to sort of see people. I don't know whether you 64 00:03:25,240 --> 00:03:27,079 Speaker 1: call it double bunked or what you call it when 65 00:03:27,080 --> 00:03:29,120 Speaker 1: there's a couple of people in the one sort of area, 66 00:03:29,919 --> 00:03:30,720 Speaker 1: talk us through us. 67 00:03:32,000 --> 00:03:35,200 Speaker 2: Yeah, Look, there is a thing called access block, and 68 00:03:35,240 --> 00:03:37,640 Speaker 2: I want to talk about that because that's the national 69 00:03:38,200 --> 00:03:42,560 Speaker 2: objective measure of when you've got a bed pressure problem. 70 00:03:42,880 --> 00:03:45,840 Speaker 2: So access block. If you rock up to an e D, 71 00:03:46,320 --> 00:03:48,520 Speaker 2: you get seen and the doctors say, look, you need 72 00:03:48,560 --> 00:03:52,000 Speaker 2: to come into hospital, you start a timer. And if 73 00:03:52,040 --> 00:03:54,480 Speaker 2: eight hours later you still haven't gone to where you 74 00:03:54,520 --> 00:03:56,000 Speaker 2: need to go, if you still haven't gone to your 75 00:03:56,080 --> 00:03:58,320 Speaker 2: ward bed, if you still haven't gone to the operating theater, 76 00:03:58,360 --> 00:04:01,360 Speaker 2: if you still haven't gone to the ICU, your hospital 77 00:04:01,480 --> 00:04:04,080 Speaker 2: where your emergency department is in access block, and that 78 00:04:04,320 --> 00:04:08,480 Speaker 2: is the clearest sign that you don't have the available 79 00:04:08,480 --> 00:04:11,520 Speaker 2: beds that you need to support the patients that you're seeing. 80 00:04:11,600 --> 00:04:13,800 Speaker 2: And we can talk about how long people wait, and 81 00:04:13,880 --> 00:04:16,920 Speaker 2: everybody's got a story because this is the reality. You know, 82 00:04:16,960 --> 00:04:21,560 Speaker 2: we've had there's a ABC investigation recently on mental health 83 00:04:21,600 --> 00:04:23,719 Speaker 2: and we have patients in New South Wales waiting for 84 00:04:24,240 --> 00:04:26,560 Speaker 2: longer than eighty or ninety hours in ed now we 85 00:04:26,880 --> 00:04:29,560 Speaker 2: definitely have seen that in the territory before. Everybody's got 86 00:04:29,600 --> 00:04:32,599 Speaker 2: long waits. What I want to focus on is longer 87 00:04:32,600 --> 00:04:35,359 Speaker 2: than eight hours to get to your bed. That's a problem. 88 00:04:35,640 --> 00:04:38,919 Speaker 2: And past that it's just it's just more more hours. 89 00:04:38,960 --> 00:04:40,640 Speaker 2: But that the trigger should be eight hours. 90 00:04:40,920 --> 00:04:43,320 Speaker 1: Well, and I can't even begin to imagine the strain 91 00:04:43,400 --> 00:04:45,640 Speaker 1: and the stress then that that puts all the staff 92 00:04:45,680 --> 00:04:49,720 Speaker 1: that are in the emergency department under you know, when 93 00:04:49,760 --> 00:04:52,880 Speaker 1: you've then got additional people turning up needing that emergency 94 00:04:52,920 --> 00:04:56,000 Speaker 1: care and then you're already full and you're trying to 95 00:04:56,040 --> 00:04:59,600 Speaker 1: get people on towards it must be really difficult for staff. 96 00:05:00,600 --> 00:05:03,520 Speaker 2: Yeah, absolutely, because when you are blocks like that, it 97 00:05:03,600 --> 00:05:05,440 Speaker 2: means you have less space to do what you need 98 00:05:05,520 --> 00:05:07,760 Speaker 2: to do. So in the emergency department, that's less room 99 00:05:07,839 --> 00:05:10,520 Speaker 2: to take care of the emergencies. But I will say 100 00:05:10,520 --> 00:05:13,600 Speaker 2: this isn't just the emergency department. So the ward staff, 101 00:05:13,800 --> 00:05:16,960 Speaker 2: you know, they're always under pressure to discharge people the emergency. 102 00:05:17,200 --> 00:05:19,520 Speaker 2: The operating theaters are always under pressure to get through 103 00:05:19,520 --> 00:05:23,400 Speaker 2: more cases. This is across all of health, even outside 104 00:05:23,400 --> 00:05:26,640 Speaker 2: general practice, where you know people people are not able 105 00:05:26,640 --> 00:05:29,280 Speaker 2: to get into general practice or the general practitioners are 106 00:05:29,320 --> 00:05:32,960 Speaker 2: forced to deal with more and more, more and more complexity, 107 00:05:33,200 --> 00:05:35,640 Speaker 2: and more and more patients presenting to their clinics. So 108 00:05:35,640 --> 00:05:36,960 Speaker 2: it's just across the whole system. 109 00:05:37,480 --> 00:05:40,839 Speaker 1: Doctor's orbis in terms of you know, that access block 110 00:05:40,920 --> 00:05:45,039 Speaker 1: and people waiting more than eight hours to then get 111 00:05:45,080 --> 00:05:47,560 Speaker 1: into a ward or to go to where they need 112 00:05:47,560 --> 00:05:50,159 Speaker 1: to go. How often would you say that we're dealing 113 00:05:50,200 --> 00:05:53,280 Speaker 1: with that in the NT daily basis. 114 00:05:53,560 --> 00:05:55,039 Speaker 2: So you know, every now and then we'll have a 115 00:05:55,120 --> 00:05:58,279 Speaker 2: day where we're lucky or things have worked well for 116 00:05:58,320 --> 00:06:03,760 Speaker 2: whatever reason. You know, every everybody's out camping, But for 117 00:06:03,800 --> 00:06:05,960 Speaker 2: the most part, it's a daily occurrence. 118 00:06:06,880 --> 00:06:09,599 Speaker 1: So from your perspective, and I mean since taking on 119 00:06:09,960 --> 00:06:12,120 Speaker 1: the role, because it is something that we've spoken to 120 00:06:12,720 --> 00:06:15,840 Speaker 1: doctor Robert Parker about. I mean, had there been a 121 00:06:15,960 --> 00:06:19,360 Speaker 1: directive to not call code yellows or to not sort 122 00:06:19,400 --> 00:06:22,760 Speaker 1: of call when there is these concerns. 123 00:06:24,279 --> 00:06:27,000 Speaker 2: Yeah, so the Health Department have said that they haven't 124 00:06:27,320 --> 00:06:31,880 Speaker 2: suppressed code yellows and I haven't seen anything to say 125 00:06:31,920 --> 00:06:35,120 Speaker 2: that that's not the case. But look, a lot of 126 00:06:35,120 --> 00:06:38,200 Speaker 2: this comes down to bureaucracy. I suppose if you're full, 127 00:06:38,279 --> 00:06:40,920 Speaker 2: you're full, Whether you call a code yellow or not. 128 00:06:41,000 --> 00:06:44,000 Speaker 2: You know, now we're talking semantics and rearranging deck chairs 129 00:06:44,000 --> 00:06:46,240 Speaker 2: on the Titanic. You know, full hospital is a full 130 00:06:46,240 --> 00:06:49,080 Speaker 2: hospital and we just we want to focus on that. 131 00:06:49,279 --> 00:06:51,400 Speaker 2: You know, there were eleven code yellows under the last 132 00:06:52,440 --> 00:06:56,200 Speaker 2: management and zero. Now, anybody who's been into our hospitals 133 00:06:56,200 --> 00:06:58,360 Speaker 2: will know that doesn't mean we've suddenly found a lot 134 00:06:58,360 --> 00:07:00,680 Speaker 2: of space for our patients. We're still and that's the 135 00:07:00,680 --> 00:07:01,280 Speaker 2: real problem. 136 00:07:01,360 --> 00:07:04,400 Speaker 1: Well, it's more managing a pr issue rather than a 137 00:07:04,440 --> 00:07:08,680 Speaker 1: capacity issue, i think, which really doesn't treat the issue. 138 00:07:09,400 --> 00:07:12,320 Speaker 2: Yeah, and it's important that this government have committed to 139 00:07:12,400 --> 00:07:15,600 Speaker 2: funding the operations of the new mental health ward. We've 140 00:07:15,640 --> 00:07:19,360 Speaker 2: got a new general ward being built above the cafe 141 00:07:19,440 --> 00:07:22,040 Speaker 2: area in Roaldo and it's important that that's funded as well. 142 00:07:22,360 --> 00:07:25,320 Speaker 2: But these are things we've been calling for for many 143 00:07:25,360 --> 00:07:28,080 Speaker 2: many years now. Roll DA has been full for a 144 00:07:28,080 --> 00:07:31,480 Speaker 2: long time. Part of the issue is that when you 145 00:07:31,520 --> 00:07:34,520 Speaker 2: look at how we're funded on a federal level, we 146 00:07:34,560 --> 00:07:37,600 Speaker 2: get short changed. So territorians are not getting as much 147 00:07:37,600 --> 00:07:40,120 Speaker 2: money as they should be. So the sickness that we 148 00:07:40,160 --> 00:07:42,320 Speaker 2: have here for the number of people that we have here, 149 00:07:42,680 --> 00:07:45,080 Speaker 2: and we've had conversations with the Health Minister about this, 150 00:07:45,200 --> 00:07:48,360 Speaker 2: and we're in lockstep on making sure that the federal 151 00:07:48,400 --> 00:07:51,320 Speaker 2: government funds US to the level that we need. 152 00:07:51,920 --> 00:07:55,480 Speaker 1: Doctor's orb us in terms of what can be done 153 00:07:55,640 --> 00:07:58,440 Speaker 1: or you know, how we can change things, you know 154 00:07:58,520 --> 00:08:00,680 Speaker 1: what needs to be changed to try t'sryan have an 155 00:08:00,680 --> 00:08:04,200 Speaker 1: impact here. Obviously that additional federal funding is something I 156 00:08:04,240 --> 00:08:06,600 Speaker 1: know the AMA has been calling for for a very 157 00:08:06,720 --> 00:08:11,960 Speaker 1: long time. What else can be done at this point, Yeah, the. 158 00:08:11,920 --> 00:08:14,200 Speaker 2: Low hanging fruit have been picked, that's for sure. I 159 00:08:14,200 --> 00:08:17,080 Speaker 2: don't think there are magical efficiencies we're going to suddenly 160 00:08:17,120 --> 00:08:19,680 Speaker 2: find that we haven't thought of. I think there are 161 00:08:19,720 --> 00:08:22,080 Speaker 2: two main things we need to focus on. One is 162 00:08:22,120 --> 00:08:26,440 Speaker 2: the resourcing, and that's making sure that we're funding our 163 00:08:26,480 --> 00:08:28,440 Speaker 2: health service to the level that it needs to be 164 00:08:28,480 --> 00:08:32,080 Speaker 2: funded at to deliver what we need for territorians. And 165 00:08:32,120 --> 00:08:35,240 Speaker 2: the second is talk to the front line. So if 166 00:08:35,240 --> 00:08:37,320 Speaker 2: you want to make solutions for the healthcare problems that 167 00:08:37,360 --> 00:08:39,600 Speaker 2: we have, there's no point talking to the layers in 168 00:08:39,600 --> 00:08:42,560 Speaker 2: the middle. Come to the frontline. Come to your emergency departments, 169 00:08:42,559 --> 00:08:44,320 Speaker 2: come to your wards, come to your theaters, come to 170 00:08:44,360 --> 00:08:47,400 Speaker 2: your general practices, come to your remote clinics and talk 171 00:08:47,440 --> 00:08:49,520 Speaker 2: to the people delivering the services. Because those doctors and 172 00:08:49,600 --> 00:08:51,880 Speaker 2: nurses have been doing this job for a long time, 173 00:08:51,960 --> 00:08:54,440 Speaker 2: they know where the problems are and often, you know, 174 00:08:54,440 --> 00:08:56,960 Speaker 2: a solution come up the well, yeah, obviously that's what 175 00:08:57,000 --> 00:09:00,200 Speaker 2: we need to fix. The more we can focus on 176 00:09:00,280 --> 00:09:04,679 Speaker 2: those problems at that level frontline to management, the more 177 00:09:04,720 --> 00:09:05,880 Speaker 2: we can do with what we've got. 178 00:09:06,640 --> 00:09:10,720 Speaker 1: So, I mean, we're too from here for those doctors, nurses, 179 00:09:10,840 --> 00:09:12,960 Speaker 1: all of the healthcare stuff that are really working in 180 00:09:12,960 --> 00:09:15,199 Speaker 1: our hospitals at the moment. As we're you know, as 181 00:09:15,200 --> 00:09:18,880 Speaker 1: we're dealing with these capacity issues. We're not calling code yellows, 182 00:09:18,880 --> 00:09:21,439 Speaker 1: but we're still having to deal with those capacity issues. 183 00:09:21,960 --> 00:09:24,200 Speaker 1: You know, we're too for them. Man, What is the 184 00:09:24,240 --> 00:09:26,880 Speaker 1: message really for the government. 185 00:09:28,720 --> 00:09:31,679 Speaker 2: The message is exactly what we've said this morning, is 186 00:09:32,480 --> 00:09:36,560 Speaker 2: to talk to those stuff, hear their concerns, hear their problems, 187 00:09:36,559 --> 00:09:40,320 Speaker 2: hear their solutions, and let's make earnest efforts to work 188 00:09:40,360 --> 00:09:43,720 Speaker 2: towards them. I don't think this is an unfixable problem, right. 189 00:09:43,920 --> 00:09:46,040 Speaker 2: It's a very very hard problem and it's a problem 190 00:09:46,080 --> 00:09:49,000 Speaker 2: we're seeing across Australia, not just here. But there are 191 00:09:49,000 --> 00:09:50,880 Speaker 2: certainly things we could be doing better in the NT 192 00:09:51,320 --> 00:09:53,679 Speaker 2: and that's what we'll keep doing, and we want your 193 00:09:53,720 --> 00:09:57,240 Speaker 2: listeners to make sure that they advocate for that through 194 00:09:57,280 --> 00:09:59,800 Speaker 2: their own members of Parliament and their own interactions with 195 00:10:00,480 --> 00:10:03,720 Speaker 2: people they might know in healthcare and you know, let's 196 00:10:04,160 --> 00:10:05,080 Speaker 2: get this sorted. 197 00:10:04,880 --> 00:10:06,800 Speaker 1: And doctors orbis. I know there has been you know, 198 00:10:06,840 --> 00:10:10,160 Speaker 1: there's been some like you touched on the new mental 199 00:10:10,200 --> 00:10:14,520 Speaker 1: health ward that is obviously going to help, I would imagine, 200 00:10:14,640 --> 00:10:17,200 Speaker 1: I know they've been the announcement with the federal government 201 00:10:17,800 --> 00:10:22,480 Speaker 1: prior to the federal election for additional aged care beds. 202 00:10:22,520 --> 00:10:24,920 Speaker 1: I mean, we know all of these things will help, 203 00:10:24,960 --> 00:10:26,880 Speaker 1: but I guess it's just how quickly they can get 204 00:10:26,920 --> 00:10:27,640 Speaker 1: online too. 205 00:10:28,640 --> 00:10:31,520 Speaker 2: Yeah. Yeah, a lot of this stuff needed to have 206 00:10:31,520 --> 00:10:34,600 Speaker 2: been built yesterday. And if we know that that's been 207 00:10:34,600 --> 00:10:36,680 Speaker 2: our message for a long time. It's good to see 208 00:10:36,720 --> 00:10:39,520 Speaker 2: that there's some money starting to flow. But we're going 209 00:10:39,559 --> 00:10:41,040 Speaker 2: to have to move a lot faster than this, and 210 00:10:41,200 --> 00:10:44,920 Speaker 2: especially in aged care. So we're now you know, two 211 00:10:44,920 --> 00:10:48,920 Speaker 2: federal governments in on promises for funding in age care 212 00:10:49,280 --> 00:10:51,840 Speaker 2: and age care facilities. We've got a huge number of 213 00:10:51,840 --> 00:10:55,080 Speaker 2: acute hospital beds that are being occupied by patients who 214 00:10:55,120 --> 00:10:57,960 Speaker 2: belong in care facilities and that's a big one, really 215 00:10:57,960 --> 00:10:58,319 Speaker 2: big one. 216 00:10:59,400 --> 00:11:03,120 Speaker 1: Well on Zorbis always appreciate your time. Thanks so much 217 00:11:03,120 --> 00:11:03,959 Speaker 1: for having a chat. 218 00:11:03,760 --> 00:11:05,960 Speaker 2: With us this morning, anytime, Katie. 219 00:11:06,000 --> 00:11:06,920 Speaker 1: Thanks, thank you, thank you.