Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
The budget estimates process still underway this week and the
Health Minister Steve Edgington in the hot seat. Yesterday, there
were questions raised about code yellows at Royal Darwin Hospital. Now,
when we last caught up with the outgoing NT President
of the AMA, doctor Robert Parker, he had said to
us on the show that there had been a directive
(00:20):
from NT Health not to call them even though they
were needed. Now the Minister rejected those claims, saying there
were regular meetings to address any capacity concerns or pressures. Now,
what we do know is there were eleven code yellows
called at Royal Darwin and Palmerston Hospitals in the twenty
three to twenty four financial year, but there have been
(00:41):
none since the COLP came to government last August. The
Health Minister and Health Executive remaining firm that there hasn't
been a need to call code yellows with patient flows
and capacity issues being managed in other ways. But is
that the case? Well, joining me on the show is
the NT branch President of the AMA, the Australian Medical Association,
(01:05):
doctor John Zorbis. Good morning to you, Doctor.
Speaker 2 (01:08):
Zorbis, Morning Katie. Thanks having us back and buddy.
Speaker 1 (01:11):
Listeners, thank you so much for your time this morning. Now,
doctor Zorbis, I mean code yellows, capacity issues, whatever you
call them. Are we still having them at our hospitals.
Speaker 2 (01:22):
Yes, that's clear. We've been like this since roughly twenty sixteen,
and whatever you call them. And I'm glad you're pointing
out that you know there's a labels are just labels,
whatever you call it. We're full, We're more than full.
And the problem is still there.
Speaker 1 (01:37):
Doctors Orbis, why would there be a need or a
push to not call them code yellows if that's something
that gets called around the nation and other hospitals do it.
Speaker 2 (01:48):
I think the problem with a code yellow is it's
a blurry measure. So a code blue, which is when
there's a medical emergency in a hospital, is very clear.
A code blue across the country looks the same everywhere. Okay, yellow.
It's finicky, and it's often designed or managed by people
who aren't working on the front line. It's not clear
(02:08):
when they should or shouldn't be called. And that's a
problem because really what we need is a good response
to a hospital that doesn't have enough beds for the
patient demand. That it's seeing.
Speaker 1 (02:18):
So doctor Zorbis talk us through some of the capacity
issues that we are experiencing. I mean, is it at
both Royal Darwin and also the Palmerston Hospital or is
it a situation where it is really the emergency ward
at Royal Darwin Hospital that is copying at most what's
the go.
Speaker 2 (02:36):
Yeah, so you can treat both hospitals in the same bucket, really,
because if a patient is seen at Palstan and needs
to be admitted under surgery or medicine, they need to
be transferred to Royal Darwin. So ultimately that's still a
bed that we need. The eds are a symptom of
a bigger problem. The emergency departments are a beautiful window
(02:57):
into your health system. If you want to see where
the problems are and your healths, go go sit in
your emergency department. And I know any of your listeners
who've been at Roll Dalnald Palmerston, not even recently, I
mean in the last few years, will know that the
weights are getting longer and longer for beds.
Speaker 1 (03:13):
Yeah, so are you able to quantify that a little
bit for us? I mean, just what kinds of periods
are people waiting for? Or you know, are we having
to sort of see people. I don't know whether you
call it double bunked or what you call it when
there's a couple of people in the one sort of area,
talk us through us.
Speaker 2 (03:32):
Yeah, Look, there is a thing called access block, and
I want to talk about that because that's the national
objective measure of when you've got a bed pressure problem.
So access block. If you rock up to an e D,
you get seen and the doctors say, look, you need
to come into hospital, you start a timer. And if
(03:52):
eight hours later you still haven't gone to where you
need to go, if you still haven't gone to your
ward bed, if you still haven't gone to the operating theater,
if you still haven't gone to the ICU, your hospital
where your emergency department is in access block, and that
is the clearest sign that you don't have the available
beds that you need to support the patients that you're seeing.
And we can talk about how long people wait, and
(04:13):
everybody's got a story because this is the reality. You know,
we've had there's a ABC investigation recently on mental health
and we have patients in New South Wales waiting for
longer than eighty or ninety hours in ed now we
definitely have seen that in the territory before. Everybody's got
long waits. What I want to focus on is longer
than eight hours to get to your bed. That's a problem.
(04:35):
And past that it's just it's just more more hours.
But that the trigger should be eight hours.
Speaker 1 (04:40):
Well, and I can't even begin to imagine the strain
and the stress then that that puts all the staff
that are in the emergency department under you know, when
you've then got additional people turning up needing that emergency
care and then you're already full and you're trying to
get people on towards it must be really difficult for staff.
Speaker 2 (05:00):
Yeah, absolutely, because when you are blocks like that, it
means you have less space to do what you need
to do. So in the emergency department, that's less room
to take care of the emergencies. But I will say
this isn't just the emergency department. So the ward staff,
you know, they're always under pressure to discharge people the emergency.
The operating theaters are always under pressure to get through
more cases. This is across all of health, even outside
(05:23):
general practice, where you know people people are not able
to get into general practice or the general practitioners are
forced to deal with more and more, more and more complexity,
and more and more patients presenting to their clinics. So
it's just across the whole system.
Speaker 1 (05:37):
Doctor's orbis in terms of you know, that access block
and people waiting more than eight hours to then get
into a ward or to go to where they need
to go. How often would you say that we're dealing
with that in the NT daily basis.
Speaker 2 (05:53):
So you know, every now and then we'll have a
day where we're lucky or things have worked well for
whatever reason. You know, every everybody's out camping, But for
the most part, it's a daily occurrence.
Speaker 1 (06:06):
So from your perspective, and I mean since taking on
the role, because it is something that we've spoken to
doctor Robert Parker about. I mean, had there been a
directive to not call code yellows or to not sort
of call when there is these concerns.
Speaker 2 (06:24):
Yeah, so the Health Department have said that they haven't
suppressed code yellows and I haven't seen anything to say
that that's not the case. But look, a lot of
this comes down to bureaucracy. I suppose if you're full,
you're full, Whether you call a code yellow or not.
You know, now we're talking semantics and rearranging deck chairs
on the Titanic. You know, full hospital is a full
(06:46):
hospital and we just we want to focus on that.
You know, there were eleven code yellows under the last
management and zero. Now, anybody who's been into our hospitals
will know that doesn't mean we've suddenly found a lot
of space for our patients. We're still and that's the
real problem.
Speaker 1 (07:01):
Well, it's more managing a pr issue rather than a
capacity issue, i think, which really doesn't treat the issue.
Speaker 2 (07:09):
Yeah, and it's important that this government have committed to
funding the operations of the new mental health ward. We've
got a new general ward being built above the cafe
area in Roaldo and it's important that that's funded as well.
But these are things we've been calling for for many
many years now. Roll DA has been full for a
long time. Part of the issue is that when you
(07:31):
look at how we're funded on a federal level, we
get short changed. So territorians are not getting as much
money as they should be. So the sickness that we
have here for the number of people that we have here,
and we've had conversations with the Health Minister about this,
and we're in lockstep on making sure that the federal
government funds US to the level that we need.
Speaker 1 (07:51):
Doctor's orb us in terms of what can be done
or you know, how we can change things, you know
what needs to be changed to try t'sryan have an
impact here. Obviously that additional federal funding is something I
know the AMA has been calling for for a very
long time. What else can be done at this point, Yeah, the.
Speaker 2 (08:11):
Low hanging fruit have been picked, that's for sure. I
don't think there are magical efficiencies we're going to suddenly
find that we haven't thought of. I think there are
two main things we need to focus on. One is
the resourcing, and that's making sure that we're funding our
health service to the level that it needs to be
funded at to deliver what we need for territorians. And
(08:32):
the second is talk to the front line. So if
you want to make solutions for the healthcare problems that
we have, there's no point talking to the layers in
the middle. Come to the frontline. Come to your emergency departments,
come to your wards, come to your theaters, come to
your general practices, come to your remote clinics and talk
to the people delivering the services. Because those doctors and
nurses have been doing this job for a long time,
they know where the problems are and often, you know,
(08:54):
a solution come up the well, yeah, obviously that's what
we need to fix. The more we can focus on
those problems at that level frontline to management, the more
we can do with what we've got.
Speaker 1 (09:06):
So, I mean, we're too from here for those doctors, nurses,
all of the healthcare stuff that are really working in
our hospitals at the moment. As we're you know, as
we're dealing with these capacity issues. We're not calling code yellows,
but we're still having to deal with those capacity issues.
You know, we're too for them. Man, What is the
message really for the government.
Speaker 2 (09:28):
The message is exactly what we've said this morning, is
to talk to those stuff, hear their concerns, hear their problems,
hear their solutions, and let's make earnest efforts to work
towards them. I don't think this is an unfixable problem, right.
It's a very very hard problem and it's a problem
we're seeing across Australia, not just here. But there are
(09:49):
certainly things we could be doing better in the NT
and that's what we'll keep doing, and we want your
listeners to make sure that they advocate for that through
their own members of Parliament and their own interactions with
people they might know in healthcare and you know, let's
get this sorted.
Speaker 1 (10:04):
And doctors orbis. I know there has been you know,
there's been some like you touched on the new mental
health ward that is obviously going to help, I would imagine,
I know they've been the announcement with the federal government
prior to the federal election for additional aged care beds.
I mean, we know all of these things will help,
(10:24):
but I guess it's just how quickly they can get
online too.
Speaker 2 (10:28):
Yeah. Yeah, a lot of this stuff needed to have
been built yesterday. And if we know that that's been
our message for a long time. It's good to see
that there's some money starting to flow. But we're going
to have to move a lot faster than this, and
especially in aged care. So we're now you know, two
federal governments in on promises for funding in age care
(10:49):
and age care facilities. We've got a huge number of
acute hospital beds that are being occupied by patients who
belong in care facilities and that's a big one, really
big one.
Speaker 1 (10:59):
Well on Zorbis always appreciate your time. Thanks so much
for having a chat.
Speaker 2 (11:03):
With us this morning, anytime, Katie.
Speaker 1 (11:06):
Thanks, thank you, thank you.
The budget estimates process still underway this week and the
Health Minister Steve Edgington in the hot seat. Yesterday, there
were questions raised about code yellows at Royal Darwin Hospital. Now,
when we last caught up with the outgoing NT President
of the AMA, doctor Robert Parker, he had said to
us on the show that there had been a directive
(00:20):
from NT Health not to call them even though they
were needed. Now the Minister rejected those claims, saying there
were regular meetings to address any capacity concerns or pressures. Now,
what we do know is there were eleven code yellows
called at Royal Darwin and Palmerston Hospitals in the twenty
three to twenty four financial year, but there have been
(00:41):
none since the COLP came to government last August. The
Health Minister and Health Executive remaining firm that there hasn't
been a need to call code yellows with patient flows
and capacity issues being managed in other ways. But is
that the case? Well, joining me on the show is
the NT branch President of the AMA, the Australian Medical Association,
(01:05):
doctor John Zorbis. Good morning to you, Doctor.
Speaker 2 (01:08):
Zorbis, Morning Katie. Thanks having us back and buddy.
Speaker 1 (01:11):
Listeners, thank you so much for your time this morning. Now,
doctor Zorbis, I mean code yellows, capacity issues, whatever you
call them. Are we still having them at our hospitals.
Speaker 2 (01:22):
Yes, that's clear. We've been like this since roughly twenty sixteen,
and whatever you call them. And I'm glad you're pointing
out that you know there's a labels are just labels,
whatever you call it. We're full, We're more than full.
And the problem is still there.
Speaker 1 (01:37):
Doctors Orbis, why would there be a need or a
push to not call them code yellows if that's something
that gets called around the nation and other hospitals do it.
Speaker 2 (01:48):
I think the problem with a code yellow is it's
a blurry measure. So a code blue, which is when
there's a medical emergency in a hospital, is very clear.
A code blue across the country looks the same everywhere. Okay, yellow.
It's finicky, and it's often designed or managed by people
who aren't working on the front line. It's not clear
(02:08):
when they should or shouldn't be called. And that's a
problem because really what we need is a good response
to a hospital that doesn't have enough beds for the
patient demand. That it's seeing.
Speaker 1 (02:18):
So doctor Zorbis talk us through some of the capacity
issues that we are experiencing. I mean, is it at
both Royal Darwin and also the Palmerston Hospital or is
it a situation where it is really the emergency ward
at Royal Darwin Hospital that is copying at most what's
the go.
Speaker 2 (02:36):
Yeah, so you can treat both hospitals in the same bucket, really,
because if a patient is seen at Palstan and needs
to be admitted under surgery or medicine, they need to
be transferred to Royal Darwin. So ultimately that's still a
bed that we need. The eds are a symptom of
a bigger problem. The emergency departments are a beautiful window
(02:57):
into your health system. If you want to see where
the problems are and your healths, go go sit in
your emergency department. And I know any of your listeners
who've been at Roll Dalnald Palmerston, not even recently, I
mean in the last few years, will know that the
weights are getting longer and longer for beds.
Speaker 1 (03:13):
Yeah, so are you able to quantify that a little
bit for us? I mean, just what kinds of periods
are people waiting for? Or you know, are we having
to sort of see people. I don't know whether you
call it double bunked or what you call it when
there's a couple of people in the one sort of area,
talk us through us.
Speaker 2 (03:32):
Yeah, Look, there is a thing called access block, and
I want to talk about that because that's the national
objective measure of when you've got a bed pressure problem.
So access block. If you rock up to an e D,
you get seen and the doctors say, look, you need
to come into hospital, you start a timer. And if
(03:52):
eight hours later you still haven't gone to where you
need to go, if you still haven't gone to your
ward bed, if you still haven't gone to the operating theater,
if you still haven't gone to the ICU, your hospital
where your emergency department is in access block, and that
is the clearest sign that you don't have the available
beds that you need to support the patients that you're seeing.
And we can talk about how long people wait, and
(04:13):
everybody's got a story because this is the reality. You know,
we've had there's a ABC investigation recently on mental health
and we have patients in New South Wales waiting for
longer than eighty or ninety hours in ed now we
definitely have seen that in the territory before. Everybody's got
long waits. What I want to focus on is longer
than eight hours to get to your bed. That's a problem.
(04:35):
And past that it's just it's just more more hours.
But that the trigger should be eight hours.
Speaker 1 (04:40):
Well, and I can't even begin to imagine the strain
and the stress then that that puts all the staff
that are in the emergency department under you know, when
you've then got additional people turning up needing that emergency
care and then you're already full and you're trying to
get people on towards it must be really difficult for staff.
Speaker 2 (05:00):
Yeah, absolutely, because when you are blocks like that, it
means you have less space to do what you need
to do. So in the emergency department, that's less room
to take care of the emergencies. But I will say
this isn't just the emergency department. So the ward staff,
you know, they're always under pressure to discharge people the emergency.
The operating theaters are always under pressure to get through
more cases. This is across all of health, even outside
(05:23):
general practice, where you know people people are not able
to get into general practice or the general practitioners are
forced to deal with more and more, more and more complexity,
and more and more patients presenting to their clinics. So
it's just across the whole system.
Speaker 1 (05:37):
Doctor's orbis in terms of you know, that access block
and people waiting more than eight hours to then get
into a ward or to go to where they need
to go. How often would you say that we're dealing
with that in the NT daily basis.
Speaker 2 (05:53):
So you know, every now and then we'll have a
day where we're lucky or things have worked well for
whatever reason. You know, every everybody's out camping, But for
the most part, it's a daily occurrence.
Speaker 1 (06:06):
So from your perspective, and I mean since taking on
the role, because it is something that we've spoken to
doctor Robert Parker about. I mean, had there been a
directive to not call code yellows or to not sort
of call when there is these concerns.
Speaker 2 (06:24):
Yeah, so the Health Department have said that they haven't
suppressed code yellows and I haven't seen anything to say
that that's not the case. But look, a lot of
this comes down to bureaucracy. I suppose if you're full,
you're full, Whether you call a code yellow or not.
You know, now we're talking semantics and rearranging deck chairs
on the Titanic. You know, full hospital is a full
(06:46):
hospital and we just we want to focus on that.
You know, there were eleven code yellows under the last
management and zero. Now, anybody who's been into our hospitals
will know that doesn't mean we've suddenly found a lot
of space for our patients. We're still and that's the
real problem.
Speaker 1 (07:01):
Well, it's more managing a pr issue rather than a
capacity issue, i think, which really doesn't treat the issue.
Speaker 2 (07:09):
Yeah, and it's important that this government have committed to
funding the operations of the new mental health ward. We've
got a new general ward being built above the cafe
area in Roaldo and it's important that that's funded as well.
But these are things we've been calling for for many
many years now. Roll DA has been full for a
long time. Part of the issue is that when you
(07:31):
look at how we're funded on a federal level, we
get short changed. So territorians are not getting as much
money as they should be. So the sickness that we
have here for the number of people that we have here,
and we've had conversations with the Health Minister about this,
and we're in lockstep on making sure that the federal
government funds US to the level that we need.
Speaker 1 (07:51):
Doctor's orb us in terms of what can be done
or you know, how we can change things, you know
what needs to be changed to try t'sryan have an
impact here. Obviously that additional federal funding is something I
know the AMA has been calling for for a very
long time. What else can be done at this point, Yeah, the.
Speaker 2 (08:11):
Low hanging fruit have been picked, that's for sure. I
don't think there are magical efficiencies we're going to suddenly
find that we haven't thought of. I think there are
two main things we need to focus on. One is
the resourcing, and that's making sure that we're funding our
health service to the level that it needs to be
funded at to deliver what we need for territorians. And
(08:32):
the second is talk to the front line. So if
you want to make solutions for the healthcare problems that
we have, there's no point talking to the layers in
the middle. Come to the frontline. Come to your emergency departments,
come to your wards, come to your theaters, come to
your general practices, come to your remote clinics and talk
to the people delivering the services. Because those doctors and
nurses have been doing this job for a long time,
they know where the problems are and often, you know,
(08:54):
a solution come up the well, yeah, obviously that's what
we need to fix. The more we can focus on
those problems at that level frontline to management, the more
we can do with what we've got.
Speaker 1 (09:06):
So, I mean, we're too from here for those doctors, nurses,
all of the healthcare stuff that are really working in
our hospitals at the moment. As we're you know, as
we're dealing with these capacity issues. We're not calling code yellows,
but we're still having to deal with those capacity issues.
You know, we're too for them. Man, What is the
message really for the government.
Speaker 2 (09:28):
The message is exactly what we've said this morning, is
to talk to those stuff, hear their concerns, hear their problems,
hear their solutions, and let's make earnest efforts to work
towards them. I don't think this is an unfixable problem, right.
It's a very very hard problem and it's a problem
we're seeing across Australia, not just here. But there are
(09:49):
certainly things we could be doing better in the NT
and that's what we'll keep doing, and we want your
listeners to make sure that they advocate for that through
their own members of Parliament and their own interactions with
people they might know in healthcare and you know, let's
get this sorted.
Speaker 1 (10:04):
And doctors orbis. I know there has been you know,
there's been some like you touched on the new mental
health ward that is obviously going to help, I would imagine,
I know they've been the announcement with the federal government
prior to the federal election for additional aged care beds.
I mean, we know all of these things will help,
(10:24):
but I guess it's just how quickly they can get
online too.
Speaker 2 (10:28):
Yeah. Yeah, a lot of this stuff needed to have
been built yesterday. And if we know that that's been
our message for a long time. It's good to see
that there's some money starting to flow. But we're going
to have to move a lot faster than this, and
especially in aged care. So we're now you know, two
federal governments in on promises for funding in age care
(10:49):
and age care facilities. We've got a huge number of
acute hospital beds that are being occupied by patients who
belong in care facilities and that's a big one, really
big one.
Speaker 1 (10:59):
Well on Zorbis always appreciate your time. Thanks so much
for having a chat.
Speaker 2 (11:03):
With us this morning, anytime, Katie.
Speaker 1 (11:06):
Thanks, thank you, thank you.
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