I’ve just seen an ad in the Weekend Australian calling for applications from organisations to establish a Remote Area Health Corps Agency to recruit and deploy health professionals to remote Indigenous communities in the NT.
The ad states the agency will have a “strong focus on the recruitment of urban-based health professionals.” Good idea, I say. Something I’ve been advocating for years, ever since I gave up doctoring the “worried well” in inner Sydney and headed to the NT providing services as a general practitioner to remote indigenous communities.
I’ve written letters, talked my head off, written articles and talked on radio. But the workforce remains meagre and stunted. Best practice requires doctors who are committed to staying in the one place for a while — six months at least in one stint I’d say. We’ve had the NT intervention child health checks come and go, generally staying for three weeks at a time. One week for orientation, one week seeing kids and one week debriefing as far as I can see. Looks a bit like a holiday. Some of these child health checks have been proper and appropriate, no doubt. But, I’ve seen many which have wasted our tax money.
One 12 year old was referred to me by the intervention doctor for contraception. Good, I thought. A realist here. Twelve year olds do have consensual s-x and there’s nothing stopping them. But, wait a minute, the child’s urine looked like smokey dark tea, full of protein and blood. Moreover, she had a urinary tract infection. A quick glance at previous pathology over the years revealed a child with urine probably indicating chronic glomerulonephritis, a serious condition which could easily lead within years to renal failure and dialysis.
Nothing was mentioned in the 15 pages of NT Intervention Health Check as to the past history of renal problems. This child was, once again, going to slip through the system. All it needed was for someone to look at the child holistically and see the alarm bells which have been ringing for years. Surely, that was what the Intervention team was being paid for.
“Did you look?” I asked the doctor who happened to be in the clinic at the time.
“Well, no,” he said.
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What is the doctor supposed to be doing, if not looking at past history which includes previous pathology tests?
“Where does the urine test go that you sent off?” I asked.
“Canberra, I suppose,” he suggested. “Don’t really know.”
Brilliant, I thought. How many others has this happened to?
Other children have been sent to major hospitals at vast expense as “urgent” cases to see paediaticians for investigation of heart murmurs which had not previously been documented. As these same paediatricians visit the community every six weeks or so, money and disruption to lives could have been minimised if they had merely referred the children to the visiting community paediatrician.
So what has this got to do with an agency being established to recruit urban-based doctors and other health professionals to provide services to remote aboriginal communities? A lot, I’d suggest.
If this agency recruits a corps of roving specialists who will actually come to the communities, fantastic. Audiologists, podiatrists, dentists, physiotherapists and other allied health professionals are so sorely needed and will be welcomed by the communities and their clinics. But when it comes to GPs, let’s encourage them to stay a bit longer, and let’s get a mob of GPs who work in and with the clinic, as an integral part of the existing health care team.
And while I’ve got your ear, could someone please make sure that the members of this health corps are not paid more than those who commit to working for longer periods. That really p-ssed me and my colleagues off no end.
Pampered and praised, these Intervention teams were paid heaps more than permanent clinic staff, and there were plenty of people around to thank them at the end of their holiday.
I’d love to be paid as much as the intervention doctors, and my oath, I’d love to be thanked by the powers-that-be, at least just once.