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Speaker 1: Now, earlier this week, we spoke to the head of

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Speaker 1: the Nursing and Midwarefree Federation about safety concerns in the

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Speaker 1: emergency department at Royal Darwin Hospital. Heidi Chris but joined

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Speaker 1: us on the show and told us that well, a

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Speaker 1: new graduate nurse had been punched in the face. She

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Speaker 1: also spoke about assaults and the fact that they were

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Speaker 1: going unreported and working in conditions where threats abuse and

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Speaker 1: violence were not isolated incidents, but she said routine. Now,

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Speaker 1: Chris Hosking is the CEO of the Northern Territory Department

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Speaker 1: of Health, and he joins us on the line. Good

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Speaker 1: morning to.

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Speaker 2: You, Chris, get a Cody, and good morning to your listeners.

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Speaker 1: Now, Chris, what was your reaction to claims from the

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Speaker 1: union that members are saying that they're facing daily threats

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Speaker 1: of abuse and real danger in the emergency department.

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Speaker 2: Oh. Look, honestly, Katie, when I hear reports of things

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Speaker 2: like a graduate nurse getting punched in the face, that

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Speaker 2: makes me feel physically ill. I have to say, and

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Speaker 2: I need to say really strongly, that this sort of

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Speaker 2: behavior against our staff, whether they be nurses, doctors, admin, staff, whatever,

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Speaker 2: is completely inappropriate and we just don't stand for it

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Speaker 2: or tolerate it. Look, there is no doubt that working

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Speaker 2: in an emergency department is a difficult and challenging place

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Speaker 2: to work, and I don't think we're that much different

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Speaker 2: to any emergency department in the country. They are challenging

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Speaker 2: work environments. But when people behave badly, and let's call

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Speaker 2: it what it is, this is bad behavior. In fact,

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Speaker 2: it's criminal behavior, we need to call it out and

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Speaker 2: not stand for it. And we certainly don't. You know,

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Speaker 2: when those sorts of things happen, they are reported to

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Speaker 2: the police, and those people should be prosecuted to the

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Speaker 2: full extent of the law. It's simply not good enough,

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Speaker 2: particularly when you take into consideration that people presenting at

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Speaker 2: the ED are there because they're unwell. They need access

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Speaker 2: to health care. And our people are medically trained professionals

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Speaker 2: who come to work every day and front up in

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Speaker 2: very difficult conditions to do their jobs, and they certainly

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Speaker 2: don't deserve to be sworn at and punched and spat on.

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Speaker 2: It completely unacceptable and I guess my message to all

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Speaker 2: territorians here would be, this is a social contract. If

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Speaker 2: you want to come to the hospital for treatment. Then

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Speaker 2: we'll see you where the public health system and we

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Speaker 2: see everybody. But when you're at the hospital, your bloody

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Speaker 2: will behave yourself, and if you're going to behave that way,

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Speaker 2: we'll have you removed.

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Speaker 1: And Crystal guy, I agree with you. I mean, I

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Speaker 1: think it's absolutely disgusting behavior. To think of anybody that

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Speaker 1: is in their workplace being assaulted makes me really angry,

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Speaker 1: And to think of a graduate nurse being punched in

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Speaker 1: the face makes me pretty bloody wild, to be honest,

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Speaker 1: But I guess the fact is. You know, we've now

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Speaker 1: got the nurses and well the nursing and Midway Free

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Speaker 1: Union saying that they need arrangements in place that are

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Speaker 1: more adequate. You know that the ones that are there

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Speaker 1: at the moments of as a decorative purpose. They say

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Speaker 1: that contracted security staff and not able to touch patients,

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Speaker 1: meaning that they're unable to respond effectively to violence, and

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Speaker 1: that nurses will They report delays of up to fifteen

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Speaker 1: minutes after activating juress alarms before a security guard attends.

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Speaker 1: I mean, that is hardly adequate, is it.

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Speaker 2: Look No, it's not, Katie, though, I think to be fair,

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Speaker 2: some of those are isolated incidents more so than systemic problems.

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Speaker 2: And I'll deal with the issue of response times for

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Speaker 2: security guards. And I'm aware of the report of it

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Speaker 2: taking fifteen minutes security to respond. I'm not saying that's

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Speaker 2: never happened. I'm sure it probably has on occasion, but

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Speaker 2: those would be outliers. Generally, the security response is expedient.

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Speaker 2: The security office at rhald Arwen is literally twenty yards

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Speaker 2: down the corridor from the ED, and ED is easily accessible,

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Speaker 2: and so that's not reflective of a broader systemic problem.

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Speaker 2: Certainly with the alerting the juressalarms, there are juressalarms throughout

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Speaker 2: the ED there under the desk, they're on the wall.

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Speaker 2: If people feel they're at risk, they can enact the

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Speaker 2: juressalarm and it alerts the security staff and the senior management.

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Speaker 2: What we have done recently is we are I don't

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Speaker 2: have these yet, but will be deploying them shortly. Personal

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Speaker 2: juressalarms that staff can carry on their person if they

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Speaker 2: choose to do so, and those will be deployed shortly.

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Speaker 2: And we've also changed the routing of the alerts so

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Speaker 2: that not only security and the senior managers on site

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Speaker 2: getting hour to five, but also senior nursing supervisors, so

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Speaker 2: that is more prevalent.

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Speaker 1: Chris, have you met with the union since they made

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Speaker 1: these claims and came out very publicly with their concerns.

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Speaker 2: I haven't personally. I do have a meeting scheduled with

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Speaker 2: the A and MF in the next week or so,

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Speaker 2: but certainly, our senior hospital staff and our senior nursing

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Speaker 2: staff meet with the A and MF on a very

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Speaker 2: regular basis. In fact, we meet with them as recently

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Speaker 2: as last Thursday to update them on some of the

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Speaker 2: things we're doing to strengthen the arrangements there at Ryal

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Speaker 2: Dal and so we do maintain an open dialogue with

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Speaker 2: the unions. A lot of that happens at the operational

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Speaker 2: level in the hospital, more so than with myself. But certainly,

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Speaker 2: and we've always done that, particularly at times when things

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Speaker 2: are strained as they are at the moment, we will

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Speaker 2: escalate the frequency of those meetings.

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Speaker 1: Look, I know you would agree. I just think it's

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Speaker 1: so incredibly important that anybody working at the hospital that

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Speaker 1: they feel safe. I know that the Nursing and Midway

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Speaker 1: Free Union have said that they wanted to see an

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Speaker 1: immediate investigation by NT WorkSafe. My understanding is that is underway.

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Speaker 1: They also wanted to see an immediate review of security

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Speaker 1: capability and response times, jurors, systems that alert nurse team

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Speaker 1: leaders in real time, and system wide solutions to reduce

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Speaker 1: unsafe pressure on emergency departments. It sounds as though some

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Speaker 1: of that work is happening from what you've just said.

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Speaker 2: Yeah, look, certainly a lot of that is underway, and

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Speaker 2: I can certainly reassure territorians that NT Health meets all

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Speaker 2: of its obligations in terms of reporting to work safe

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Speaker 2: and all notified incidents are reported and investigated where they

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Speaker 2: should be. And I mentioned earlier the changes we're making

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Speaker 2: to JUISS arrangements. Christ Sorry you as security resources are

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Speaker 2: a combination of our own inte health employees, and we

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Speaker 2: supplement that we've contracted some security services. That probably the

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Speaker 2: one area that we're perhaps not aligned at the moment,

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Speaker 2: and I do have strong views on this, Kadie, is

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Speaker 2: that I've had some fairly strong representations made to me

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Speaker 2: that our security staff should have more legal power to

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Speaker 2: use physical force, And look, I really don't think that's

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Speaker 2: the answer here, particularly in a hospital environment when we're

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Speaker 2: confronted with bad behavior, our response is always one of

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Speaker 2: de escalation, and whether it's nurses or our doctors or

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Speaker 2: our security stuff, everyone is trained in de escalating these

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Speaker 2: situations and talking to people and getting them to calm down.

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Speaker 2: And I really don't think a response of giving people

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Speaker 2: more legal authority or know it's been suggested to me

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Speaker 2: that security officers should have powers of arrest, and I

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Speaker 2: don't think physically manhandling them from the building the way

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Speaker 2: that you might see in a licensed premise is appropriate

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Speaker 2: to an emergency medicine setting. And I also can't get

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Speaker 2: past the fact that these people, even when they're behaving

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Speaker 2: really badly, are unwell and they're at hospital because they

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Speaker 2: need to be treated, and I'm not sure bouncing them

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Speaker 2: from the premises, if I can use that colloquial term,

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Speaker 2: is the answer. I think certainly, where people do not

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Speaker 2: respond to de escalation, call the police, and we rely

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Speaker 2: on the police to provide that next level support if

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Speaker 2: people need to be physically removed. But when people are

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Speaker 2: acting up and being troublesome, as security staff will walk

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Speaker 2: them from the premises all the time. Now, whether that's

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Speaker 2: walking them out of the ed or in some cases

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Speaker 2: getting them right off the campus. We do that, but

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Speaker 2: we try our very best to do it in a

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Speaker 2: non violent way.

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Speaker 1: All right, Chris, asking, let's move along, because I do

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Speaker 1: want to ask you about a couple of other things.

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Speaker 1: And one of the things that you and I have

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Speaker 1: spoken about quite extensively in the past is that additional

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Speaker 1: maternity funding. Now, you and I had spoken about this

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Speaker 1: towards the end of last year, also again earlier this year.

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Speaker 1: I know that you'd been in certainly in negotiations or

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Speaker 1: discussions with the federal government about that additional funding. I

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Speaker 1: thought it was about about eleven million dollars. But where

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Speaker 1: are things ash And you know, when are we expecting

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Speaker 1: this funding to flow through and some work to happen

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Speaker 1: there on the maternity ward.

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Speaker 2: Yeah, no, good, good question, Katie. And you're dead right.

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Speaker 2: It was around that ten or eleven million dollar mark.

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Speaker 2: And we've been doing and throwing with our federal counterparts

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Speaker 2: on that. And in the meantime, we've been doing all

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Speaker 2: the work to finalize our designs, and we've been working

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Speaker 2: with our stakeholder groups to make sure we've got all

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Speaker 2: of that work framed up and scoped and ready to

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Speaker 2: go once we get air hot little hands on the dough.

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Speaker 2: What I would say, without giving too much away, is

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Speaker 2: that the federal budget gets handed down a few weeks

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Speaker 2: from now, and I would keep your eye on that

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Speaker 2: for an announcement.

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Speaker 1: Yeah right, So they're keeping it in their pockets potentially

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Speaker 1: until then.

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Speaker 2: I suspect we're probably going to see it as a

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Speaker 2: budget announcement well in about a month's time.

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Speaker 1: Yeah right, my bloody hopes so, Chris, and I know

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Speaker 1: that every little family around the territory will be hoping

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Speaker 1: so as well, because that eleven million dollars is absolutely needed.

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Speaker 1: I mean, I think we probably need more, but you know,

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Speaker 1: you don't need to say it, but I can. It

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Speaker 1: sort of annoys me that they're hanging on to it

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Speaker 1: actually until the budget because we need it now.

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Speaker 2: Yeah, it is a bit. We would have liked to

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Speaker 2: get our hands on it now so we could get

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Speaker 2: tenders out the door and trade is engaged. But I

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Speaker 2: I'm very conscious when I make those remarks, Katie, I'm

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Speaker 2: making them on public radio, so you can probably sense

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Speaker 2: my confidence levels pretty good.

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Speaker 1: Yeah, exactly. Well, how we we.

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Speaker 2: Just really annoyed someone in the Commonwealth. I'm sure, I'll

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Speaker 2: hear about it.

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Speaker 1: Exactly. We don't want to do that because we want

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Speaker 1: to make sure that you're able to get that funding

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Speaker 1: another one before I let you go. Saint John. They

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Speaker 1: are under extreme pressure at the moment when it comes

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Speaker 1: to those demands that they have, you know, the last

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Speaker 1: couple of weekends, they've been under enormous strain from where

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Speaker 1: are things app from the department's perspective in terms of

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Speaker 1: their funding agreement? Does it go through the department or

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Speaker 1: is it the Minister that makes a decision in terms

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Speaker 1: of that long term funding?

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Speaker 2: No, Well, the contract is Saint John's deliver that triple

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Speaker 2: zero ambulance service under a contract, and it's nt Health

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Speaker 2: Are Department who manages that contract, and it's up for renewal,

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Speaker 2: and we're well progressed on negotiating a new one, and

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Speaker 2: we are negotiating that direct with Saint John's because we

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Speaker 2: don't have a competitive market for those services here in

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Speaker 2: the territory. It's not like there's several different emergency ambulance services.

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Speaker 2: If there were, we'd go to public tender for it.

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Speaker 2: But we're direct negotiating that arrangement with Saint John's and

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Speaker 2: we are looking at addressing to the extent we possibly

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Speaker 2: can those capacity constraints that are there because of the

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Speaker 2: available funding envelope. And I can't say too much, Katie,

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Speaker 2: because I know I've just been a little bit loose

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Speaker 2: with my reference to the Commonwealth budget, but we are

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Speaker 2: certainly seeking some improvement to that overall arrangement, and the

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Speaker 2: Northern Territory budget gets handed down in the second week

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Speaker 2: of May. What I would say to you and your

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Speaker 2: listeners now is that I'm quietly optimistic we'll see some

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Speaker 2: improvements there. We're still working through the finer detail of that,

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Speaker 2: but there's absolutely no doubt that Saint John's undercooked from

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Speaker 2: a resourcing perspective, and that has been slowly but surely

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Speaker 2: eroding the quality of the service over years, and we

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Speaker 2: need to do something about it, and we're committed to

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Speaker 2: doing that.

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Speaker 1: Yeah, absolutely, And you know they do a tremendous job

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Speaker 1: under difficult circumstances, and to be in a situation where

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Speaker 1: you know they're literally were not able to get to

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Speaker 1: people when they are in their moment of need or

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Speaker 1: it takes longer than what it should is difficult for everybody.

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Speaker 1: But then we also know that even as the paramedics

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Speaker 1: center turning up to the emergency department at different times,

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Speaker 1: they're having to wait because ED is absolutely overflowing as well.

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Speaker 1: And it again points to the fact that our our

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Speaker 1: health service, our health services more generally are under a

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Speaker 1: lot of strain.

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Speaker 2: Yeah, you look, you make a really good point there,

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Speaker 2: Cody and I must have met, certainly. I know things

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Speaker 2: with Saint John's was strained on the Easter weekend, particularly

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Speaker 2: on the Thursday night Friday. The weekend prior to that

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Speaker 2: was much worse and you would have seen that play

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Speaker 2: out in the mainstream media. Very very Fortunately the situation

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Speaker 2: at Royal Darwen had stabilized. We were out of Code

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Speaker 2: yellow and we had available beds. But had that crisis

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Speaker 2: in the ambulance has happened a couple of weeks prior,

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Speaker 2: when we were way over at capacity numbers and operating

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Speaker 2: in Code yellow, we would have been in dire straits.

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Speaker 2: And it, as you say, it just really underlines the

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Speaker 2: fact that we are operating a health system under all

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Speaker 2: sorts of strain and we really need to step it

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Speaker 2: up another level if we're going to provide a good

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Speaker 2: service to territorium.

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Speaker 1: Well, this is the thing. And look, I get it

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Speaker 1: that it comes down to how you know when to

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Speaker 1: health are managing things and obviously all of our healthcare

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Speaker 1: professionals juggling everything. But it also to me points to

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Speaker 1: the fact that we do not have enough money for

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Speaker 1: what is required. You know, and I know that we

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Speaker 1: got a boost from the federal government. I'm not expecting

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Speaker 1: you to go into a political debate about this grease,

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Speaker 1: but you know, to me it indicates that we actually

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Speaker 1: do need more, like we are under underfunded.

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Speaker 2: Well, look we are, and now we've had some really

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Speaker 2: significant wins in the last twelve months and which we're

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Speaker 2: very grateful for. We've an extra billion from the Commonwealth

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Speaker 2: over the next five years, which will mean at least

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Speaker 2: our public hospitals are now fully funded for the first

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Speaker 2: time in about fifteen years. We still have some fundamental

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Speaker 2: shortfalls and our funding arrangements around primary care, not non

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Speaker 2: hospital components of the health service, and we are continuing

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Speaker 2: to advocate for the Commonwealth on that and we're anticipating

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Speaker 2: some outcomes in the May twenty twenty six budget where

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Speaker 2: the Northern Territory government is certainly doing its fair share

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Speaker 2: of the heavy lifting and stumping up. I mean I

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Speaker 2: joined the Health Department in August twenty four KD after

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Speaker 2: the last general election, and you know, we were in

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Speaker 2: a dire predicament with our budget, so you know, budget

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Speaker 2: repair was one of my non negotiable sort of deliverables.

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Speaker 2: I think we're probably two thirds of the way there,

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Speaker 2: but as you say, we've still got a way to

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Speaker 2: go to be able to operate in the black and

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Speaker 2: have our nostrils above the waterline and not struggling to

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Speaker 2: stay afloat. We've made good progress, but we're not there yet.

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Speaker 2: And the one area that is really going to need

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Speaker 2: a really intense focus over the next little while is

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Speaker 2: going to be working with the Commonwealth around a new

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Speaker 2: tertiary hospital because that's not something the territory can afford

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Speaker 2: off its own back. And a bigger, more sophisticated tertiary

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Speaker 2: hospital will be more expensive overhead to run, so we'll

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Speaker 2: have to tackle that too.

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Speaker 1: Yeah, but it is absolutely needed. Chris Hosking, the Health

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Speaker 1: Department CEO, always appreciate your time. Thank you very much

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Speaker 1: for having a chat with us this morning.

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Speaker 2: Thank you, Katie, it's always a pleasure and wish you

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Speaker 2: and your listeners a terrific day.

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Speaker 1: Thank you, you two