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Speaker 1: It is just on a quarter past nine. We are

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Speaker 1: due to catch up in a few minutes time with

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Speaker 1: Craig Garaway from Saint John's. Following on from that incident

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Speaker 1: in the CBD last night, we know that a restaurant

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Speaker 1: is boarded up, is what's being reported now after that

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Speaker 1: explosion which did injure five diners at a popular venue

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Speaker 1: in the CBD. So we are due to catch up

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Speaker 1: with Saint john Operations manager Craig Garaway in the next

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Speaker 1: few minutes or so and finding out exactly, you know,

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Speaker 1: how those five patrons are going at this point in time.

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Speaker 1: But what we do know right now is that around Australia,

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Speaker 1: the shortage of general practitioners could soon force clinics to

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Speaker 1: cut back on services and in some cases may see

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Speaker 1: them turn away patients unless the government intervenes. Well, that

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Speaker 1: is what doctors and peak medical bodies are warning in

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Speaker 1: some of our other states around the nation now, the

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Speaker 1: concerns of seeing calls for restrictions on overseas trained gps

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Speaker 1: to be eased. While rural practices have been dealing with

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Speaker 1: you know the impact of the shortage for years now,

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Speaker 1: the problem is increasingly being felt in Metro areas and

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Speaker 1: even areas like the Northern Territory and indeed Darwin. So

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Speaker 1: how are things tracking in the Northern Territory at the moment? Well,

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Speaker 1: joining me on the line is Robin Karl, the CEO

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Speaker 1: of the Palmerston GP Superclinic.

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Speaker 2: Good morning to you, Robin.

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Speaker 3: Good morning Kating, Good morning to your listeners.

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Speaker 1: Robin, how are things tracking from your perspective when it

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Speaker 1: comes to the national GP shortage? I guess is what

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Speaker 1: it's been dubbed at this point.

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Speaker 3: Well, general practice in a word, is in crisis and

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Speaker 3: has been brewing for quite some time, and I think

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Speaker 3: the experience of COVID over the last three years has

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Speaker 3: brought it to your head. And the government's both state

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Speaker 3: and federal, really need to take a step back and

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Speaker 3: have a really good look at how they're treating general

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Speaker 3: practice and how they're supporting general practice.

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Speaker 1: Wow, Robin, that's a big call. So you believe at

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Speaker 1: this point it is at crisis point? What makes you

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Speaker 1: feel as though we're at that level?

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Speaker 3: So across the nation now only fifteen percent of all

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Speaker 3: of our medical graduates are electing to pursue general practice

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Speaker 3: as their specialty. Fifteen percent. It used to be around

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Speaker 3: forty five to fifty percent, which was the time where

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Speaker 3: we were always concerned that we didn't have enough GPS,

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Speaker 3: and it was for that reason we had a very

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Speaker 3: large push into recruitment of overseas medical graduates. And if

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Speaker 3: we thought forty five percent was bad, imagine how it's

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Speaker 3: going to be with only fifteen percent of graduates taking

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Speaker 3: up general practice training. Yeah.

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Speaker 2: Right, it's going to be down the track. Well.

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Speaker 1: Already we're feeling that shortage, but in the years to come,

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Speaker 1: it's going to.

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Speaker 3: Get worse, oh, without question. And I think one of

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Speaker 3: the main factors is having worked in both the acute

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Speaker 3: care and the primary health care sector, there's no question

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Speaker 3: that the view and the approach of governments towards primary

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Speaker 3: health care is very much it's a special that can

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Speaker 3: deal with its own problems. So it's the only specialty

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Speaker 3: where training is not fully funded by the public system.

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Speaker 3: It's where private practitioners are expected to carry the burden

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Speaker 3: of training those people who'll come after them and take

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Speaker 3: over their patients. It's also the only special I think

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Speaker 3: the specialty there has the greatest burden of paperwork and

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Speaker 3: confirming and justifying what they do in terms of providing

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Speaker 3: care for their patients. So, on average, a general practitioner

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Speaker 3: who's working full time, in addition to spending that forty

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Speaker 3: or so hours a week in their practice actually seeing

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Speaker 3: patients probably spend another twenty to thirty hours completing documentation

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Speaker 3: and paperwork. Wow, very little support and very little justification

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Speaker 3: in some areas in my personal view as to the

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Speaker 3: need for that work to be done.

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Speaker 1: So, Robin, when you talk about the Northern Territory at

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Speaker 1: this point, what are some of the impacts that are

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Speaker 1: being felt sort of right now?

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Speaker 3: Well, we've definitely seen a significant an increase in patients

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Speaker 3: who are struggling to actually get to see a clinician.

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Speaker 3: And we've already talked in the last few weeks about

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Speaker 3: the fact that most practices now are no longer bolt

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Speaker 3: billing everybody, and that has seen certainly a large number

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Speaker 3: of people looking around trying to find another practice that

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Speaker 3: will see them and continue to bolt build them. I

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Speaker 3: think the problem that we're seeing here in the territory

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Speaker 3: particularly has been exacerbated by COVID. There was very much

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Speaker 3: a reliance on overseas medical graduates over the past few

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Speaker 3: decades for the normal territory and we lost that access

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Speaker 3: during COVID because we simply couldn't recruit for doctors to

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Speaker 3: come from overseas. And so what we've seen is a

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Speaker 3: large number of practices contract their workforce, and we've also

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Speaker 3: seen a significant number of practices clothes. So we aren't

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Speaker 3: able to replace those doctors. We've got a finite resource

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Speaker 3: of general practitioners available and increasing numbers of people who

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Speaker 3: are looking for here.

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Speaker 1: So Robin at the GP Superclinic, get the mind and

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Speaker 1: you know from your interactions with other GP clinics, are

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Speaker 1: there a shortage of gps right now in the Northern Territory.

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Speaker 3: Without question, without question?

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Speaker 2: And what impact does that have?

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Speaker 1: You spoke then about people, you know, not necessarily being

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Speaker 1: able to get in to see their usual doctor. But

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Speaker 1: does it also have an impact do you think in

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Speaker 1: terms of people then maybe presenting to the hospital and

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Speaker 1: or maybe not even going to see anybody until they

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Speaker 1: get to the point where they're really quite crook.

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Speaker 3: I think we are definitely seeing that we've heard the

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Speaker 3: anexotal evidence from the hospital system that they are seeing

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Speaker 3: increasing numbers of patients presenting. We're certainly finding a reverse,

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Speaker 3: a perverse reverse of referrals. So we're getting people who

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Speaker 3: are coming to us who're saying that they've presented to

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Speaker 3: one of the hospital ds and they've been strongly encouraged

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Speaker 3: to actually go back to their GP, because if they

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Speaker 3: remain in the ED day alive, not get seen for

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Speaker 3: several hours, or they just don't see that what they're

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Speaker 3: there for is relevant. And to be honest with you,

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Speaker 3: I think that's what ED should be doing. I think

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Speaker 3: one of the reasons we have is increasing pressure on

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Speaker 3: our hospital systems, and one of the reasons why we've

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Speaker 3: seen people move away from general practice is that over time,

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Speaker 3: the importance of general practice has been eroded by the

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Speaker 3: fact that people can just rock up to any D

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Speaker 3: to have their sub toe or their sniff will dealt with,

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Speaker 3: and hospitals, because of the nature of the way our

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Speaker 3: hospitals are funded, are not able to turn them away.

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Speaker 1: So, Robin, what do you think could be getting done

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Speaker 1: at this point in time, both on you know, on

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Speaker 1: a territory government level, but also on the federal government

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Speaker 1: level to try and fix this situation. And do you

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Speaker 1: think it's going to get worse if they don't start

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Speaker 1: to act.

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Speaker 3: I think what's absolutely critical is for governments, and it's

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Speaker 3: easy to say, we know it's probably never going to happen,

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Speaker 3: but the retric that's coming out. So the Albanezia governments

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Speaker 3: proposed to introduce urgent care clinics to address the pressures

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Speaker 3: on eds. For if they actually stopped talking about those

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Speaker 3: sorts of issues and started looking at why doctors are

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Speaker 3: not practicing in general practice and actually refined the requirements

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Speaker 3: around that so that there'd be more doctors encouraging taking

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Speaker 3: up general practices a specialty, those pressures in ED departments

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Speaker 3: would start to ease because there'd be greater access, they'd

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Speaker 3: be greater availability. One of the easiest things the government

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Speaker 3: could do at a federal level is to enable practice

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Speaker 3: to charge a small co payment with the Medicare billing.

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Speaker 3: So one of the reasons why people are really struggling

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Speaker 3: with not having billing medical practices now, it's not because

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Speaker 3: the practices are necessarily charging a large gap. It's because

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Speaker 3: they have to pay the full amount up front, not

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Speaker 3: just the gap. So that very simple change would make

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Speaker 3: a huge difference to people being able to access care

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Speaker 3: and to encourage doctors to reconsider how they might view

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Speaker 3: general practice and actually go down that path.

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Speaker 2: Why do you.

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Speaker 1: Reckon they're so resistant that, you know, on the medicare stuff.

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Speaker 3: Well, I think initially it's because they had all of

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Speaker 3: this promotional discussions around the fact, you know, you get

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Speaker 3: bolt build you never have to put your hand in

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Speaker 3: your pocket. But what they've always done is neglect to

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Speaker 3: really reinforce the people that bolt billing is not an

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Speaker 3: insurance system, it's not a fee schedule. It's simply a

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Speaker 3: rebate that the government's prepared to provide an individual to

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Speaker 3: help support the cost of their care. And it's never

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Speaker 3: ever covered the full cost of what the care is.

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Speaker 3: And there were studies done as late as the late

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Speaker 3: nineteen nineties which proved that the costs were not covered

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Speaker 3: by bolt billing. So if they were honest about that

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Speaker 3: and really started messaging that bolt billing is a rebate

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Speaker 3: for patients to support their care, and that they're happy

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Speaker 3: for doctors to apply for that rebate directly and patients

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Speaker 3: only have to pay the gap, I think that that

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Speaker 3: would be a different discussion for people. So instead of saying, oh,

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Speaker 3: you'll have to pay out of pocket, but I pay

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Speaker 3: my medicare, the thing we often get is I pay

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Speaker 3: my medicare levy, Why should I have to pay any

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Speaker 3: more than that? But people don't have that same conversation

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Speaker 3: when you talk about private health insurance. They know that

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Speaker 3: that's not going to cover the entirety of their care.

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Speaker 3: They expect to pay the amount of pockets. So I

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Speaker 3: think we have to change the conversation around that. We

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Speaker 3: have to really start selling general practice is a really

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Speaker 3: worthy and important component of our health system, and we

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Speaker 3: really have to start looking at why doctors who are

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Speaker 3: graduating are not taking up general practice and those issues

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Speaker 3: need to be addressed well.

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Speaker 1: Robin Carl, I always appreciate your time, particularly this morning.

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Speaker 2: Thank you very much for having a chat with us.

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Speaker 3: Not a problem, Katie.

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Speaker 2: Thank you.

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Speaker 1: That is Robin Carl, who is indeed the Palmeston GP

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Speaker 1: Superclinic CEO. They've got the respiratory clinic out there as well.

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Speaker 1: Now that number if you do want to send us

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Speaker 1: a message this morning zero four double nine seven double one.

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Speaker 2: Three six zero.

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Speaker 1: But she has said this morning that GP practice around

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Speaker 1: the nation really and in the territory is at that

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Speaker 1: crisis point and we need more of those graduates obviously

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Speaker 1: going into that sector. But it is being felt right

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Speaker 1: now as well in the Northern Territory. Now coming your

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Speaker 1: way in just a couple of moments, we are going

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Speaker 1: to catch up with Craig Garaway from Saint John's and

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Speaker 1: find out a little bit more about this incident that

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Speaker 1: occurred overnight. So what we do know at this point

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Speaker 1: in time is there was an explosion. It's being called,

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Speaker 1: I guess a smaller explosion, but I know that there

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Speaker 1: was a heck of a lot of emergency service, well

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Speaker 1: police fieries everybody involved in the aftermath last night. It

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Speaker 1: happened about eighteen last night down Austin Lane. Really keen

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Speaker 1: to hear from you this morning. If you happen to

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Speaker 1: be out and about having dinner or in Austin Lane

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Speaker 1: and you saw the event unfolding, give us a call.

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Speaker 1: Eight nine four one one four nine is the number.

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Speaker 1: But I know that there was a heck of a

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Speaker 1: lot of first responders there incredibly quickly, including our ambulance

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Speaker 1: paramedics to make sure that everybody was okay. But it

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Speaker 1: has indeed been described as well a ball of flame

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Speaker 1: that went up and extinguished rather quickly. Inside that premises

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Speaker 1: joining me on the line right now to tell us

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Speaker 1: a little bit more is Craig Garaway from Saint John's.

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Speaker 1: Good morning to you, Craig.

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Speaker 4: Good morning Katie.

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Speaker 2: How are you not too bad? Craig?

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Speaker 1: I understand there were five people injured last night in

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Speaker 1: that incident.

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Speaker 4: Yep, that's correct, Katie. About eight o'clock we did receive

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Speaker 4: pe below call in regards an explosion in the Austin

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Speaker 4: Lane there. We responded a number of resources to that location.

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Speaker 4: On the arrival there, we did come across five people

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Speaker 4: had a number of burned thankfully, you know, obviously not

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Speaker 4: too serious, but obviously they still had burned to their

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Speaker 4: face and chest areas, hands required treatment and transport to

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Speaker 4: the Royal Doune Hospital where they're being treated by the

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Speaker 4: hospital staff there at the moment.

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Speaker 1: Goodness, may I mean five is quite a large number

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Speaker 1: I guess to be dealing with in one incident, is it, Craig?

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Speaker 1: It is?

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Speaker 4: You know obviously, you know, we're obviously busy all the

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Speaker 4: time and getting those resources into town very quickly to

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Speaker 4: look after those people is challenging for Communications center with

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Speaker 4: all the other work that's still ongoing at that time,

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Speaker 4: but we were able to get to I think about

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Speaker 4: four resources there very quickly to obviously start treating those people. Obviously,

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Speaker 4: burns very painful injury, and you want to start treating

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Speaker 4: them as quick as you can to reduce infection, and

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Speaker 4: obviously the stress on the people involved.

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Speaker 1: And Craig, it's obviously always a pretty busy area down

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Speaker 1: there in Austin Lane, but I understand that the markets

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Speaker 1: were taking place as well. Is that the case, and

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Speaker 1: how did that sort of potentially hinder everybody being able

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Speaker 1: to get in or first responders being able to get in.

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Speaker 4: Yeah, look, I don't believe there was any problem with

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Speaker 4: us getting in there. Obviously it's a busy area at

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Speaker 4: the best of times. Anyway to hold off the main area,

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Speaker 4: but you know, obviously and she resources were able to

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Speaker 4: get in quite quickly. A lot of people around, so

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Speaker 4: that does make it challenging because obviously everyone's concerned, and

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Speaker 4: you know, it makes it very chaotic. But that's what

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Speaker 4: mergency services all training is, obviously managing those chaotic situations

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Speaker 4: and calming everything down and getting everyone to the best

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Speaker 4: care they can as quickly as they can.

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Speaker 1: Yeah, Craig, I know, obviously not your realm, but any

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Speaker 1: idea whether there was much sort of damage around the

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Speaker 1: place or was it pretty well contained from what you

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Speaker 1: guys could gather.

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Speaker 4: Yeah, look bit chaotic, so it was a bit hard

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Speaker 4: to tell how much damage was done. Obviously that's all

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Speaker 4: being assessed this morning and obviously works. They will be

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Speaker 4: in there today having a look to try and understand

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Speaker 4: what's gone wrong there, and I'll have a bit more information.

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Speaker 4: But my understanding is that it was a flash type style

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Speaker 4: fire and contained very quickly, but obviously that didn't help

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Speaker 4: the people that were actually burned.

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Speaker 1: No, Craig, it sounds like an incredibly busy night for

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Speaker 1: everybody involved, and I certainly hope that those five people

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Speaker 1: are going to be okay. Sounds like they had very rapid,

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Speaker 1: very rapid response from some and hopefully they're on the mend.

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Speaker 4: Yes, look they are. And thank you to the fire

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Speaker 4: service and police who will also assisted us in that incident.

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Speaker 4: You know, without them, you know, it makes it really hard.

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Speaker 2: It really does.

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Speaker 1: Craig Garaway from Saint John's always good to catch up

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Speaker 1: with you. I appreciate your time this.

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Speaker 4: Morning, no problem, Katie, thank you you too.

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Speaker 1: It is just on nine point thirty coming your way

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Speaker 1: in just a couple of minutes. We are going to

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Speaker 1: be speaking to Ruth Palmer, who is the Chief Executive

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Speaker 1: of the Property Council here in the Northern Territory.