Specialist on-country healthcare improving outcomes in remote Aboriginal communities
Dr Simon Quilty has specialist skills in a range of fields so he can treat patients with complex conditions. (ABC News: Stephanie Zillman)
In the last 10 years, progress towards closing the health gap has not just been slow — in some areas, it’s going backwards.
- Medical professionals have established a specialist on-country outreach service
- It means patients don’t have to travel more than 500 kilometres for treatment
- Katherine Hospital believes the move will see a reduction in admissions
For all the good will and money, why haven’t we made strides towards closing the Indigenous health gap once and for all?
Katherine Hospital’s general physician Dr Simon Quilty believes solutions don’t necessarily lie in medical breakthroughs, but in common sense.
He believes returning to a more traditional model of medicine, one where patients don’t have to travel hundreds of kilometres to see their doctor, is already seeing results.
Dr Quilty has co-pioneered the return of a specialist outreach service that hasn’t been run out of Katherine Hospital for more than 15 years.
“A lot of these people have a lot of chronic serious health conditions and it’s quite predictable that they’ll come into hospital sooner or later,” he said.
Taking specialist health services to remote communities massively cuts the burden of patient travel (ABC News: Stephanie Zillman)
“So we offer a point of continuity into the hospital and back home that the GP’s don’t.”
It’s a simple premise that’s seeing specialist healthcare delivered on-country, to Aboriginal people living in the remote communities of the Katherine region.
On the day the ABC tagged along on a visit to Lajamanu, Dr Quilty and sonographer Dimi Lupuleasa saw 36 patients, all of whom would have otherwise needed to travel the 550 kilometres into Katherine.
“The first person we saw today had one leg, so getting on a bus isn’t easy,” Dr Quilty said.
“Then culturally there’s a fear of coming in to Katherine or Darwin because they’re outside of their community and their native language isn’t spoken so they’re automatically at a disadvantage.
Without the service, patients would have to travel to Katherine for treatment — some 550 kilometres away. (ABC News: Stephanie Zillman)
“And obviously a lot of people have families and responsibilities that they have to leave behind — on the bus it’s a seven-hour journey one way.
“Then there’s the need for accommodation in town, and if you’ve got small children for instance [there are] huge barriers.”
Reduction in patient travel a coup for the public purse
Mr Lupuleasa said his scans regularly identified acute, and sometimes chronic issues in patients.
“[The benefit] can’t be underestimated I think … it is high,” he said.
“The patient is found with certain conditions early, it’s cheaper to treat early instead of leaving them to deteriorate.
Sonographer Dimi Lupaleasa says it is cheaper to treat patients before they deteriorate (ABC News: Stephanie Zillman)
“We cannot fit a list of what I see today on one day in Katherine, and it would be strategically quite hard to move all those people in one go.”
The Northern Territory Government’s Patient Assistance Travel Scheme (PATS) subsidises travel costs, so any reduction in patient travel positively impacts the public purse.
The Department of Health did not reply to requests for data relating to the cost of running PATS.
Katherine Hospital expected to record fewer admissions
In a statement, the executive director of medical services for Top End Health, Dr Charles Pain, praised the model in Katherine.
He said a steering committee was currently reviewing its existing outreach model for Darwin “to ensure these services best meet the needs of our community”.
Many people in the community have chronic health conditions that could lead to hospitalisation (ABC News: Stephanie Zillman)
“This work will be undertaken this year and recommendations will be made regarding future models for specialist outreach,” Dr Pain said.
As it stands, Darwin hospital sends specialists in areas like cardiology, respiratory and renal medicine to remote clinics — but their service is only relevant to a select few, unlike the service offered by general physicians like Simon Quilty.
The general manager of Katherine Hospital, Angela Brannelly, also believed that over time, and as a direct result of the general physician’s outreach service, Katherine Hospital will record fewer admissions and better health outcomes for its patients.
“They’re keeping people in the community and preventing them from being transferred on for admission in Katherine hospital and potentially on to Darwin hospital,” she said.
Young and old are able to receive medical treatment in Lajamanu thanks to the service (ABC News: Stephanie Zillman)
“If they do have to come in to hospital, the doctors that they’ve seen in their community are the doctors that are looking after them here in the hospital.
“So they have already made that connection and that relationship.”