Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Right now, though a bit of a change of pace,
because we know Sint John Ambulance is no longer going
to be able to perform two life saving, high risk
procedures after a directive from NT Health, High acuity lower
currence procedures conducted by intensive care paramedics have been immediately
suspended due to clinical governance concerns. Now, the AMA's NT President,
(00:23):
doctor john's Orbis told News Corp. While the procedure could
be life saving, they aren't safe without proper training and oversight.
The AMA's NT president joins me on the line right now.
Good morning to you, doctor's Orbis.
Speaker 2 (00:38):
Good morning, Katie, thanks for having us.
Speaker 1 (00:39):
Yeah, good to have you on the show. Can you
explain what these two procedures are.
Speaker 2 (00:45):
Yeah, So, the two procedures we're talking about. One is
called a finger thawer costomy, and that's where we cut
into the side of the chest to release a deadly
amount of pressure inside the chest that can be pressing
against the lungs or the heart and if not treated,
will result in death. The second is pre hospital emergency anesthesia,
and that's the use of sedation for emergency procedures and
(01:06):
that might help to secure an airway, making sure that
someone can breathe. There's a few uses for it. These
are very high risk procedures. We call them life saving,
but they can also be life ending if they're not
done properly.
Speaker 1 (01:17):
Yeah, right, So why are the paramedics no longer going
to be able to perform them?
Speaker 2 (01:23):
So there was a review done by Dr Craig Ellis,
commissioned by the government to look into some concerns around
practices at Saint John's and what they found was there
was a lack of governance around the training and support
for paramedics to do these procedures. You can imagine this
is the pointing end of the spere in medicine, these
types of procedures, and they do need a lot of
(01:44):
training around them. Even in expert hands, things can go wrong.
So the government report suggested that without that training, these
procedures are doing more harm than benefit and they should
be suspended until we can get that training back in place.
Speaker 1 (01:58):
Have there been, as far as you know, have there
been instances where these procedures have been used and have
had unintended consequences.
Speaker 2 (02:07):
Members came to us with concerns, which is what led
to our original complaints about a year year and a
half ago about things they were seeing that raised eyebrows,
were asking some questions about whether these procedures should have
been done. Now we asked for them to be investigated.
My understanding is they have been. You know, we can't
talk about specific cases, there's confidentiality around those, but certainly
(02:29):
you know, doctors were coming to us with concerns.
Speaker 1 (02:31):
In terms of, you know, where things are at now
or what's going to sort of happen for Saint John
in terms of being able to perform these procedures. I
understand that the suspension is going to remain in place
until a chief medical officer is appointed. My understanding is
that they've not had one for a couple of years.
(02:52):
Why is that needed?
Speaker 2 (02:54):
Yeah, And look that's the point of frustration for us
because when we identified these issues, what we said to
John's at the time was you need a medical director,
you need a chief medical officer, just like every other
paramedicine service in Australia, and they chose not to do that.
Now that's led to the situation wherein now where the
ability to do these procedures has been suspended. We welcome
(03:15):
that decision obviously for reasons of safety. But now is
the time for them to rapidly re establish that position,
because that position is the person who has the expertise
and the skills to make sure that these procedures are
done safely, both in their training and when they're used
on the road.
Speaker 1 (03:32):
All right, So it sounds like there does need to
be you know, there is going to be a bit
of work there. We are going to catch up with
Saint John's this morning after ten o'clock, so we'll see
what further detail we can find or what we can
get from them. I mean, from your perspective, is this like,
is this enough? Do you feel as though you know
this is a good move and it is the right
move for Territorians.
Speaker 2 (03:52):
Yeah, we think it's the right mode for Territorians. And
you know, I'm somebody who's used this service. I've been
injured on the side of the road waiting for an
ambulance and I want every Territorian to know that their
paramedics are safe to do what they do. And yes,
we're the doctors that the paramedics are asking for this
as well. The Paramedic Union has made these same requests,
so we welcome the decision and now it's up to
(04:13):
Saint John's to move swiftly on the second part of
his problem, which is get that director back in place,
and let's let our paramedics do what they do best.
Speaker 1 (04:21):
Well, as I said, we will talk to them this
morning after ten o'clock. I do want to ask you,
doctors orbus Obviously, big announcement yesterday with the Northern Territory
government planning to launch this trial of the OC spray
to eligible territorians as a tool for self defense, is
it a move that Northern Territory doctors support.
Speaker 2 (04:39):
Look overall. No, If the answer is peppes pray, then
wants the question. And if the question is reduction in crime,
we're not confident that that's actually going to fix the problem. Now,
it's not the AMA's job to tell people what they
can and can't do in their own homes. Let me
be very clear on that. But if we're talking about
the public health of giving pepper spray out more widely
(05:00):
than at the moment where it's quite restricted, the outcome
and we know this from wa We've done this in
w A. People will feel safer, but they won't be safer.
We know in w A rates of assaults, both domestic
and non domestic, continue to rise faster than rise in population.
Same for threatening behavior, deprivation of liberty, sexual assault. And
what we see in the emergency departments is you know,
(05:22):
victims of misadventure or the pepper spray getting in the
wrong hands. It's not that hard to see, you know,
pepper spray being bought legitimately and ending up in the
hands of a criminal instead. So we've got concerns.
Speaker 1 (05:33):
Do you anticipate more pressure on the health system as
an unintended consequence?
Speaker 2 (05:40):
Yes, although you know, I don't want to sit here
and cry wolf. It's not going to outstrip the resources
that we have in the emergency departments. If you compare
it to something like the misuse of alcohol, I mean,
they're chalk and cheese. That's a much, much, much bigger
problem for us. But there are also injuries that don't
have to happen. So we're talking about, you know, the
three year old found mommy or daddy's pepper spray, or
(06:01):
the twenty two year old cop who was just doing
his job and got spray trying to apprehend a criminal.
A seventy four year old who's marked outdoors and couldn't
respond quickly enough to grab his pepper spray. I mean,
these are the victims we see.
Speaker 1 (06:13):
Yeah, it is certainly a broad discussion that we are
continuing to have doctors orbis. Just before I let you
go this morning, has there been much of an update
or much change since c C station of maternity services
at Darwin Private Hospital in terms of, you know, additional
pressure or anything like that on Royal Darwin.
Speaker 2 (06:33):
Look too early to tell and you're going to get
the most accurate numbers from Royal Darwin. We do know, however,
that our obstritions have concerns about changes that are being made.
And yesterday on the ABC, you know, we said we
made a call to the minister to say, look, the best,
the best answers to your questions are going to come
from the front line. Speak to your obstricans, speak to
your midwives, speak to your patients to make sure you've
(06:56):
got your finger on the pulse when it comes to
the changes in maternity.
Speaker 1 (06:59):
So what are the concerns from obstetricians Right now?
Speaker 2 (07:03):
There's reactionary moves to try and deal with the closure
of private maternity services and obviously you know, I don't
envy the government. They've got to move quickly. I understand that.
But moving quickly and consulting properly they can still be
done at the same time. And you know, for example,
there's a proposed model for private practicing midwives to be
in Rodau and now we've got great relationships with our
(07:25):
midwives up here in the territory that are the most jurisdictions.
It's a good place to work. But if you launch
a model of care in a different way of doing
things in a place where they're already doing a pretty
good job and expecting the obstritionans to pick up the
pieces when things go wrong without talking to them, you
can understand where the problem lies. So all we're asking
(07:45):
is that the obstritions be part of this conversation. Make
sure that things are done properly and safely. Yes, we
need to move quickly, but we can't move in a
way that's unsafe.
Speaker 1 (07:55):
Well, Doctor John Zorbust the Australian Medical Associations into president.
Good to speak with you, jees, you've had to hit
the ground running having your mind you look, I.
Speaker 2 (08:06):
Mean, it's always fun in the territory. That's why we
live here.
Speaker 1 (08:09):
Yeah, absolutely, doctor's orbis good to have you on the show.
Speaker 2 (08:13):
Thank you, Thanks Katie, Thanks thanks
Right now, though a bit of a change of pace,
because we know Sint John Ambulance is no longer going
to be able to perform two life saving, high risk
procedures after a directive from NT Health, High acuity lower
currence procedures conducted by intensive care paramedics have been immediately
suspended due to clinical governance concerns. Now, the AMA's NT President,
(00:23):
doctor john's Orbis told News Corp. While the procedure could
be life saving, they aren't safe without proper training and oversight.
The AMA's NT president joins me on the line right now.
Good morning to you, doctor's Orbis.
Speaker 2 (00:38):
Good morning, Katie, thanks for having us.
Speaker 1 (00:39):
Yeah, good to have you on the show. Can you
explain what these two procedures are.
Speaker 2 (00:45):
Yeah, So, the two procedures we're talking about. One is
called a finger thawer costomy, and that's where we cut
into the side of the chest to release a deadly
amount of pressure inside the chest that can be pressing
against the lungs or the heart and if not treated,
will result in death. The second is pre hospital emergency anesthesia,
and that's the use of sedation for emergency procedures and
(01:06):
that might help to secure an airway, making sure that
someone can breathe. There's a few uses for it. These
are very high risk procedures. We call them life saving,
but they can also be life ending if they're not
done properly.
Speaker 1 (01:17):
Yeah, right, So why are the paramedics no longer going
to be able to perform them?
Speaker 2 (01:23):
So there was a review done by Dr Craig Ellis,
commissioned by the government to look into some concerns around
practices at Saint John's and what they found was there
was a lack of governance around the training and support
for paramedics to do these procedures. You can imagine this
is the pointing end of the spere in medicine, these
types of procedures, and they do need a lot of
(01:44):
training around them. Even in expert hands, things can go wrong.
So the government report suggested that without that training, these
procedures are doing more harm than benefit and they should
be suspended until we can get that training back in place.
Speaker 1 (01:58):
Have there been, as far as you know, have there
been instances where these procedures have been used and have
had unintended consequences.
Speaker 2 (02:07):
Members came to us with concerns, which is what led
to our original complaints about a year year and a
half ago about things they were seeing that raised eyebrows,
were asking some questions about whether these procedures should have
been done. Now we asked for them to be investigated.
My understanding is they have been. You know, we can't
talk about specific cases, there's confidentiality around those, but certainly
(02:29):
you know, doctors were coming to us with concerns.
Speaker 1 (02:31):
In terms of, you know, where things are at now
or what's going to sort of happen for Saint John
in terms of being able to perform these procedures. I
understand that the suspension is going to remain in place
until a chief medical officer is appointed. My understanding is
that they've not had one for a couple of years.
(02:52):
Why is that needed?
Speaker 2 (02:54):
Yeah, And look that's the point of frustration for us
because when we identified these issues, what we said to
John's at the time was you need a medical director,
you need a chief medical officer, just like every other
paramedicine service in Australia, and they chose not to do that.
Now that's led to the situation wherein now where the
ability to do these procedures has been suspended. We welcome
(03:15):
that decision obviously for reasons of safety. But now is
the time for them to rapidly re establish that position,
because that position is the person who has the expertise
and the skills to make sure that these procedures are
done safely, both in their training and when they're used
on the road.
Speaker 1 (03:32):
All right, So it sounds like there does need to
be you know, there is going to be a bit
of work there. We are going to catch up with
Saint John's this morning after ten o'clock, so we'll see
what further detail we can find or what we can
get from them. I mean, from your perspective, is this like,
is this enough? Do you feel as though you know
this is a good move and it is the right
move for Territorians.
Speaker 2 (03:52):
Yeah, we think it's the right mode for Territorians. And
you know, I'm somebody who's used this service. I've been
injured on the side of the road waiting for an
ambulance and I want every Territorian to know that their
paramedics are safe to do what they do. And yes,
we're the doctors that the paramedics are asking for this
as well. The Paramedic Union has made these same requests,
so we welcome the decision and now it's up to
(04:13):
Saint John's to move swiftly on the second part of
his problem, which is get that director back in place,
and let's let our paramedics do what they do best.
Speaker 1 (04:21):
Well, as I said, we will talk to them this
morning after ten o'clock. I do want to ask you,
doctors orbus Obviously, big announcement yesterday with the Northern Territory
government planning to launch this trial of the OC spray
to eligible territorians as a tool for self defense, is
it a move that Northern Territory doctors support.
Speaker 2 (04:39):
Look overall. No, If the answer is peppes pray, then
wants the question. And if the question is reduction in crime,
we're not confident that that's actually going to fix the problem. Now,
it's not the AMA's job to tell people what they
can and can't do in their own homes. Let me
be very clear on that. But if we're talking about
the public health of giving pepper spray out more widely
(05:00):
than at the moment where it's quite restricted, the outcome
and we know this from wa We've done this in
w A. People will feel safer, but they won't be safer.
We know in w A rates of assaults, both domestic
and non domestic, continue to rise faster than rise in population.
Same for threatening behavior, deprivation of liberty, sexual assault. And
what we see in the emergency departments is you know,
(05:22):
victims of misadventure or the pepper spray getting in the
wrong hands. It's not that hard to see, you know,
pepper spray being bought legitimately and ending up in the
hands of a criminal instead. So we've got concerns.
Speaker 1 (05:33):
Do you anticipate more pressure on the health system as
an unintended consequence?
Speaker 2 (05:40):
Yes, although you know, I don't want to sit here
and cry wolf. It's not going to outstrip the resources
that we have in the emergency departments. If you compare
it to something like the misuse of alcohol, I mean,
they're chalk and cheese. That's a much, much, much bigger
problem for us. But there are also injuries that don't
have to happen. So we're talking about, you know, the
three year old found mommy or daddy's pepper spray, or
(06:01):
the twenty two year old cop who was just doing
his job and got spray trying to apprehend a criminal.
A seventy four year old who's marked outdoors and couldn't
respond quickly enough to grab his pepper spray. I mean,
these are the victims we see.
Speaker 1 (06:13):
Yeah, it is certainly a broad discussion that we are
continuing to have doctors orbis. Just before I let you
go this morning, has there been much of an update
or much change since c C station of maternity services
at Darwin Private Hospital in terms of, you know, additional
pressure or anything like that on Royal Darwin.
Speaker 2 (06:33):
Look too early to tell and you're going to get
the most accurate numbers from Royal Darwin. We do know, however,
that our obstritions have concerns about changes that are being made.
And yesterday on the ABC, you know, we said we
made a call to the minister to say, look, the best,
the best answers to your questions are going to come
from the front line. Speak to your obstricans, speak to
your midwives, speak to your patients to make sure you've
(06:56):
got your finger on the pulse when it comes to
the changes in maternity.
Speaker 1 (06:59):
So what are the concerns from obstetricians Right now?
Speaker 2 (07:03):
There's reactionary moves to try and deal with the closure
of private maternity services and obviously you know, I don't
envy the government. They've got to move quickly. I understand that.
But moving quickly and consulting properly they can still be
done at the same time. And you know, for example,
there's a proposed model for private practicing midwives to be
in Rodau and now we've got great relationships with our
(07:25):
midwives up here in the territory that are the most jurisdictions.
It's a good place to work. But if you launch
a model of care in a different way of doing
things in a place where they're already doing a pretty
good job and expecting the obstritionans to pick up the
pieces when things go wrong without talking to them, you
can understand where the problem lies. So all we're asking
(07:45):
is that the obstritions be part of this conversation. Make
sure that things are done properly and safely. Yes, we
need to move quickly, but we can't move in a
way that's unsafe.
Speaker 1 (07:55):
Well, Doctor John Zorbust the Australian Medical Associations into president.
Good to speak with you, jees, you've had to hit
the ground running having your mind you look, I.
Speaker 2 (08:06):
Mean, it's always fun in the territory. That's why we
live here.
Speaker 1 (08:09):
Yeah, absolutely, doctor's orbis good to have you on the show.
Speaker 2 (08:13):
Thank you, Thanks Katie, Thanks thanks
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