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Speaker 1 (00:00):
A Code Yello, as we have reported earlier on the show,
has been called at Royal Darwin and Palmerston Hospitals after
capacity issues for more than a week, nurses and doctors
telling us earlier on the show that they've been pushing
for the internal emergency to be declared for eight days,
with dozens waiting in ed and no beds available.

Speaker 2 (00:21):
Now.

Speaker 1 (00:22):
The decision to declare the code yellow was made yesterday.
It's the first since the CLP came to power, acknowledging
that spike in demand for acute care and also meaning
that some measures are able to be implemented to try
to deal with those numbers. Now joining us on the
line is NT Health's chief executive, Chris Hosking's good morning

(00:43):
to you.

Speaker 2 (00:43):
Chris, Good morning Katie, and good morning to your listeners.

Speaker 1 (00:47):
Thank you so much for your time. Now, Chris, can
you talk us through the pressures currently being experienced at
well at both Royal Darwin and Palmerston Hospital.

Speaker 2 (00:57):
Yes, certainly, ken, Katie. So Obviously Royaled Owens our largest
hospital in the territory, but it's also our only true
tertiary care facility. So if you're really unwell, Royal Darwen
is generally where you need to be and Palmerston operates
as more or less as an annex of Royal Darwen,

(01:18):
and we have been really busy these past couple of weeks.
We certainly, as has been reported, we've had bead pressures
over recent weeks, and yesterday they reached a point where
a number of the preconditions for what we call a
code yellow, which is an escalation protocol, were met and

(01:39):
I had a proposal from the management at the hospital,
and so we've signed off on that and declared a
code yellow and issued a media release. But I guess
the key thing that leads to us to clearing the
code yellow is that the patient numbers we're experiencing at

(01:59):
the moment are not that much different to what we've
had in the past. We are very very busy that
Roald Owen generally is busy and operates close to capacity
a lot of the time. But what we've really seen
in recent days is the acuity of the patient so
how unwell they are and how much care they need

(02:19):
when they come into the hospital system has been higher
than normal and that places additional pressure on the system,
and so calling the code yellow was the right thing
to do, and that's what we've done.

Speaker 1 (02:31):
Chris, I know that some nurses and doctors have been
calling for this to happen for a number of days.
Why did you wait so.

Speaker 2 (02:39):
Long to call this one, oh, Katie. I don't want
to speculate on what some of the public messaging has been,
but certainly very aware there would have been lots of
discussion around the capacity issues. But to be really clear
that the proposal to declare a code yellow I received

(03:01):
yesterday afternoon. I approved that instantly, and we issued a
media release about ten minutes later. So I think this
perception that we've sat on our hands is probably not
a fair one. There are code yellow is something that
we take very seriously, and it's part of an escalation

(03:23):
protocol and when a number of those preconditions have been met,
the hospital management has put the proposal to me and
said we think a code yellow is justified. And look,
I know there's been a lot of speculation over the
last little while about code yellows and why they may
or may not have been called. I've long maintained a

(03:44):
view that if the threshold was met for a code yellow,
we would absolutely call it, and that's what we've done yesterday,
and I think that's the right thing to do.

Speaker 1 (03:52):
So there's no cover up or no sort of will
of the executive to not call a code yellow.

Speaker 2 (03:58):
I can explicit rule out any suggestion of cover up
or interference, and I actually spoke about this during the
recent estimates the committee back in June Kadie, where the
suggestion was that the Code yellow was being stifled or silenced,
and I made very clear remarks on the public record

(04:20):
then that Royal Darwin is a very busy tertiary hospital
and we do have demand pressures. It's a very old
hospital and to be fair, the territory has probably outgrown it,
but we do our people do an amazing job and
we do the very very best with what we've got
available to us. And I've been really clear that if

(04:43):
a code yellow set of conditions was reached, we would
absolutely call it, and we've done that yesterday and I
stand behind that decision.

Speaker 1 (04:51):
Now. We spoke to the AMA a little bit earlier
this morning. We also spoke to the Nursing Amywi Re
Federation and certainly we know, and we have spoken about
this on numerous occasions, that we have got a number
of aged care patients within Royal Darwin Hospital and I'm
assuming potentially out at the Palmeston Hospital as well, that

(05:12):
realistically should be in an age care facility. It's an
issue we've been dealing with for many years. I've spoken
to the former Health minister about it. I've spoken to
former staff about it over the last few years. Where
are we at in terms of, you know, getting these
additional aged care beds up and running and getting that

(05:35):
facility built. The last that I had heard from the
Health Minister and also from the Federal Member for Solomon
Luke Gosling, was that there were discussions happening between both
the Northern Territory Health Department and also the Federal Department
of Health.

Speaker 2 (05:50):
I think it is yeah, no, very very good question, Codie.
I'm glad you raised it because it is a major
contributor to bed pressures in the public hospital system here
and every state and territory has this problem, but it's
worse here in the territory than anywhere else. And to
give you some background numbers, there are only forty seven

(06:12):
aged care beds available in the territory per thousand people.
Everywhere else in Australia, that's about sixty seven, so we
are much worse off than other states and territories. Aged
care is a clear responsibility of the Commonwealth, not states
and territories, and on any given day, across all of
our territory hospitals, there would be around about eighty hospital

(06:34):
beds being utilized by patients who are approved to hand
off into an age care facility. But unfortunately there's nowhere
for these people to go, and particularly here in the
top end, we tend to accommodate those patients at Palmerston
Hospital and to give you an example today there are

(06:55):
forty two long stay aged care patients in Palmerston and
that's a one undred bed hospital. If we had those
people accommodated in aged care facilities in the community where
they can better be looked after, we wouldn't be calling
co Jello today. We simply wouldn't have the same pressures
on our hospital bedstock. So I am pleased to say

(07:18):
that there's been some terrific advocacy from the Northern Territory
in this space over the last year or so, and
since the return of the federal government back in May.
We we've been working with the Commonwealth for some months
now and the the Commonwealth government made an election promise

(07:41):
of sixty million dollars towards the construction of an aged
care facility in Darwin and we're holding them to that
promise and we would like to see that facility built
on the Palmerston Hospital campus on that holds package of
land there. We have land available and the Northern Territory
government has come to the table with funding for design

(08:04):
works and headworks for utilities and water and power and
those sorts of things. The Commonwealth are proceeding with that.
They recently ran a grant program and they've sought proposals
from aged care providers and there is a mature industry
for those types of providers, both not for profits and
for profits. We are and we know there are viable

(08:30):
proponents in that grant round and whoever's the successful proponent,
we expect will receive the Commonwealth funding contribution towards the
construction cost of the facility, and that that would also
be accompanied by a long term contract to provide the
service for the aged care facility. And we're just waiting

(08:51):
to hear the outcome of that assessment process. Now. We
talk regularly with our Commonwealth counterparts and they're working through
their assessment of those proposals, but we would hope to
know about that in the next little while. We had
previously done the engineering and scoping works for a one
hundred and twenty bed facility. As I mentioned, there's about

(09:13):
ahy odd hospital beds that are being utilized for this
purpose in a given day, but we'd like a bit
of capacity there for future growth. And if we can
get that out of the ground and built on the
Palmerston Hospital complex, particularly right next door to the hospital
where we headquarter our geryontology service at clinical services for

(09:33):
older people, it'll be a huge win for Territorians and
I think it's something that we really need to push
through over this next term of the Territory and the
Commonwealth governments because we were getting good cooperation between the
levels of government and I think the time's right to
really see that facility built.

Speaker 1 (09:52):
Yeah, it's got to happen, you know, and it has
to happen sooner rather than later. I mean in terms
of that next stage that you've just spoken about, and
by the sound of it, the tender being awarded you'd
said in the next little while. I mean, Chris, are
we talking months how long are we talking here.

Speaker 2 (10:06):
Look, I would expect to know the outcome of that
in the next month or two. Obviously, to get a
facility like that built, there's a lead time. I would
imagine it's probably a couple of years before we've got
it built and operational, but the sooner the Commonwealth can
choose a successful proponent, And we have been engaging with

(10:30):
the proponents who are in that grant round. We've had
some of them come to Darwen and walk around on
the site and talk to our hospital people. We've talked
to their engineers and they're construction people, and a lot
of these age care providers are quite capable of managing
their own construction projects, you know, they do these things
around Australia. So I'm quietly optimistic that we're finally going

(10:54):
to see some extra capacity here in the territory. And
now that's taken a lot of work, but I think
we're much much closer to that than we have been
in the past, and we're sitting as patiently as we
can hoping to get a positive announcement.

Speaker 1 (11:09):
Well yeah, but all the while, obviously, you know, our
hospitals are under pressure, Chris in terms of you know,
the Code yellow that's implemented right now, What does that
mean in terms of those elective surgeries? Obviously they have
been delayed. How long do you anticipate that this is
going to need to stay in place.

Speaker 2 (11:28):
Look, it's hard to put a specific timeframe on it, Katie,
but based on experience, generally Code yellow circumstances manifest for days,
not weeks. So it is a temporary set of really
extreme intense work pressures, and we have a range of
things we do to try and respond to that. We

(11:50):
step up our daily monitoring processes. We look at our
patient flows, We look at how we can get people discharged,
particularly where we've had people from regions come into our
dh because they need to access the clinical care. If
we can get them discharged and back to the region
where they can have their follow up care closer to home,

(12:10):
that's a really good thing. We look to expedite those
sorts of things. And so we would generally see a
code yellow set of circumstances abait over several days, but
really we monitor that three times a day, and there's
a whole set of performance metrics that we monitor very closely.

(12:31):
And as we see some of those settle to more
normal levels. I would expect to receive a proposal from
the hospital management to say, hey, look that things are
trending a little more normally. Now, we're probably not in
code yellow anymore. We'd like to close that off. That
doesn't mean we relax discipline, but it does mean that
we step down one level from what is probably more

(12:56):
of an emergency response.

Speaker 1 (12:58):
And christ to anybody listening this morning who is feeling frustrated,
you know, maybe they are trying to get in for
elective surgery. You know, maybe they have been waiting for
quite some time. To anybody that's listening this morning that
is feeling really very frustrated by this situation, what do
you say to them?

Speaker 2 (13:18):
I look to the people in the community. I really
just ask that we certainly understand the frustration when you're
waiting a long time for elective surgery. Obviously, in the hospital,
we work on a triage basis, and we see the
sickest people the most urgently, and sometimes elective surgery does

(13:41):
not get the same level of prioritization. And to be fair,
if you're waiting on a hip replacement, it probably doesn't
feel like elective surgery. You really need that surgery, and
we have had to deprioritize some of that, but I
am pleased to say we haven't. You know, we've got
cardiothoracic surgery happening today. Now that's not elective, that's life

(14:03):
saving surgery. But we've got specialists visiting cardiothoracic surgeons here
today and despite all the pressures, those procedures are going ahead.
So we do prioritize the stuff that is the most
clinically significant. And I do really want to assure your
listeners that if you come to Royal Darwin you will
get seen. We do not turn people away. We take

(14:25):
people in and we give them the very best care
that we can, and that's how we sometimes end up
with these capacity issues. I think yesterday, I think we
had thirty six patients double bunked in the emergency department,
and that means two beds per cubicle, so seventeen cubicles

(14:45):
thirty thirty four beds. Today, that's settled a little bit.
We've only got twenty two patients in across eleven cubicles,
so those numbers are trending down, which is a good thing.
But as I said, the presentations themselves the people are
more unwell than what we've seen over previous weeks, and
so the code yellow was the appropriate response to that.

(15:06):
But I do really want to assure your listeners, if
you're sick and you need to come to hospital, you
will absolutely get the care you need. It might be
a bit of a busy, noisy environment, but that's because
our people are working really hard to get you the
clinical care. And if I could, Katie, I'd just really
like to send a shout out to our staff at

(15:27):
the hospital, our doctors and nurses and the people who
have been really putting in the hard yards over recent weeks.
So I think they do an amazing job and we
really appreciate the work that they're doing absolutely, and I
do want to emphasize the Territorians and doctor John's Orbis
from the AMA spoke on radio earlier today and we

(15:47):
asked the question about, you know, is this set of
code yellow circumstances unsafe for people coming to hospital? And
he absolutely ruled that out, and so do I. It
means we've got to work harder behind the scenes to
get the care delivered to our patients. But that's exactly
what we do. Our patients, our staff step up and

(16:09):
make sure that people get that care. So people can
be reassured that if you do have to come to RDH,
the front doors are open and our people will give
you the very best.

Speaker 1 (16:20):
You'll get that service. Well. NT Health Chief Executive Chris
Hosking really appreciate your time this morning. Thank you so
very much for having a chat with us.

Speaker 2 (16:29):
Thanks for the opportunity, Katie.

Speaker 1 (16:30):
Thank you
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