Mr HENDERSON - 2001-02-21
All of us here know that the A&E department of RDH is an appalling facility that fails to meet the appropriate standards of patient care Territorians deserve. Dr David Green, in the same letter to your department in February 1999, stated -
Mr Burke: When was that letter again? February 1999?
Mr HENDERSON: Yes, that is right. What have you done since then?
Mr Burke: Right. It is now February 2001 ...
Mr Stirling: And you have done nothing!
Mr SPEAKER: Order!
Mr HENDERSON: You don’t like it, do you?
The current facility is inadequate and inappropriate for the emergency care of this community. Its small size and lack of beds compromises the dignity and privacy of the acutely ill on a daily basis and this is unacceptable.
Minister, you promised a new $6m emergency department would be built by June 2000. Eight months ago.
Mr Burke: It is being built.
Mr HENDERSON: You promised it by June 2000, eight months ago. I seek leave to table the article from the NT News ‘$6m upgrade for emergency centre’.
Leave granted.
Mr HENDERSON: Minister, you broke your promise. Today, and for at least another two years, if the on again, off again new emergency department is ever built, Territorians will have to be treated in a facility which is unacceptable. What will you do now, today, to improve the current facility or will Territorians and the long suffering staff at RDH continue to have to put up with the existing archaic emergency department?
ANSWER
How dare you. How dare you get up in here and say that the emergency facility is unacceptable. That is not true. Mr Speaker, the Accident and Emergency Facility at Royal Darwin Hospital is able to be massively upgraded. That is true and is accepted by government and that is underway. Let’s get that out of the way.
Let’s look at the issue of whether it does its job. The Accident and Emergency Facility has dramatically improved its waiting time over the last six months. Dramatically.
Dr Toyne: That is because nobody bothers to go there.
Mr DUNHAM: The interjection is that nobody bothers to go there. The unfortunate situation in the Northern Territory is that if people are acutely ill they have but one hospital to go to in Darwin, in the greater Darwin area, that is the Royal Darwin Hospital. Unlike our southern counterparts, they are unable to make a choice. Some of our southern counterparts are able to put a little placard up in their A&E saying sorry, we are full, go elsewhere. We can’t do that. We must take all comers and a massive proportion of our admissions to Royal Darwin Hospital come through A&E. Greater than any other hospital in Australia, perhaps, something I am told approaches 80% from time to time.
But the issue really is not whether we are going to build a new A&E, because we know that is to be the case. The issue is not really whether people are choosing not to go there because we know that is also the case because people must go there; it is an Accident and Emergency facility with no other option but to go there.
The issue is, how do we compare against other hospitals in Australia. It is very interesting, because these issues are now benchmarked in national guidelines and the waiting times in all triage categories in the hospital now exceed national guidelines of 22 peer hospitals. So we have been compared to 22 peer hospitals and we exceed the national guidelines at Royal Darwin. This has been a remarkable achievement because, as I said, the Royal Darwin Hospital treats more acute patients in terms of its admissions into the hospital than any other hospital.
We have no capacity to pass off patients into a hospital which is in close proximity because the next A&E of any worth is at Katherine Hospital, 300km away. So it is a nonsense to say that people are choosing not to go there. It is a monopoly provider. We would prefer that that is not the case, but our numbers show that we are getting more people through. I am quite happy to put some of these figures into the Parliamentary Record, because indeed I am very proud of them. They are issues that go to quality, and they are issues that go to the commitment of staff who work in a very stressful environment.
We have ordered changes in the triage practices and we now achieve national thresholds across all categories for the first time. It is important to note that there are five triage categories where people are assessed when they go to the Accident and Emergency, and they go from high acuity at 1 down to less acute at number 5. It is the case that we get high levels of people attending the hospital who are assessed as triage categories 4 and 5, which puts a lie to the assertion made by the Labor Party that people choose not to go to Accident and Emergency because often people in category 5 could possibly attend a GP on the next working day, but have chosen to go to Accident and Emergency because they believe they have to present to a doctor.
Some of this goes to the incapacity of people to attend doctors in after hours clinics and we, as a government, are trying to address that also. In the Palmerston Health Precinct, for instance, we will have extended hours GPs so that those people in Palmerston who have a concern about their child perhaps having to see a doctor, and who have had in the past to travel all the way to RDH, can go to the health precinct at Palmerston and have that child attended to. So this is not just one shot in the gun; this is making sure that the health system addresses the needs of Territorians right across.
The triage category 1, these are people who need life support and attendance immediately pretty much. The national guideline means that 100% of patients are seen immediately. The RDH consistently meets those guidelines and always has. Triage category 2 means the patient should be seen within 10 minutes. The national guideline is 75%. The value achieved by the major 22 hospitals that we are recording against is 78% and Royal Darwin is achieving 65% to 80%. Triage category 3, patients seen within 30 minutes; national guideline 70%; Royal Darwin is achieving 75% to 85% above that. Triage category 4, patients seen within 60 minutes; the national guideline is 70% and Royal Darwin Hospital achieves 70% to 78%. Triage category 5, patients must be seen within 120 minutes; the national guideline is 70% and the Royal Darwin achieves 85% to 95%.
I am pleased that those numbers are on the public record because perhaps what that will mean is that when the Labor Party continues this campaign of trying to erode the public’s confidence in this fine institution called Royal Darwin Hospital they will have to use the facts.
Mr Burke: When was that letter again? February 1999?
Mr HENDERSON: Yes, that is right. What have you done since then?
Mr Burke: Right. It is now February 2001 ...
Mr Stirling: And you have done nothing!
Mr SPEAKER: Order!
Mr HENDERSON: You don’t like it, do you?
The current facility is inadequate and inappropriate for the emergency care of this community. Its small size and lack of beds compromises the dignity and privacy of the acutely ill on a daily basis and this is unacceptable.
Minister, you promised a new $6m emergency department would be built by June 2000. Eight months ago.
Mr Burke: It is being built.
Mr HENDERSON: You promised it by June 2000, eight months ago. I seek leave to table the article from the NT News ‘$6m upgrade for emergency centre’.
Leave granted.
Mr HENDERSON: Minister, you broke your promise. Today, and for at least another two years, if the on again, off again new emergency department is ever built, Territorians will have to be treated in a facility which is unacceptable. What will you do now, today, to improve the current facility or will Territorians and the long suffering staff at RDH continue to have to put up with the existing archaic emergency department?
ANSWER
How dare you. How dare you get up in here and say that the emergency facility is unacceptable. That is not true. Mr Speaker, the Accident and Emergency Facility at Royal Darwin Hospital is able to be massively upgraded. That is true and is accepted by government and that is underway. Let’s get that out of the way.
Let’s look at the issue of whether it does its job. The Accident and Emergency Facility has dramatically improved its waiting time over the last six months. Dramatically.
Dr Toyne: That is because nobody bothers to go there.
Mr DUNHAM: The interjection is that nobody bothers to go there. The unfortunate situation in the Northern Territory is that if people are acutely ill they have but one hospital to go to in Darwin, in the greater Darwin area, that is the Royal Darwin Hospital. Unlike our southern counterparts, they are unable to make a choice. Some of our southern counterparts are able to put a little placard up in their A&E saying sorry, we are full, go elsewhere. We can’t do that. We must take all comers and a massive proportion of our admissions to Royal Darwin Hospital come through A&E. Greater than any other hospital in Australia, perhaps, something I am told approaches 80% from time to time.
But the issue really is not whether we are going to build a new A&E, because we know that is to be the case. The issue is not really whether people are choosing not to go there because we know that is also the case because people must go there; it is an Accident and Emergency facility with no other option but to go there.
The issue is, how do we compare against other hospitals in Australia. It is very interesting, because these issues are now benchmarked in national guidelines and the waiting times in all triage categories in the hospital now exceed national guidelines of 22 peer hospitals. So we have been compared to 22 peer hospitals and we exceed the national guidelines at Royal Darwin. This has been a remarkable achievement because, as I said, the Royal Darwin Hospital treats more acute patients in terms of its admissions into the hospital than any other hospital.
We have no capacity to pass off patients into a hospital which is in close proximity because the next A&E of any worth is at Katherine Hospital, 300km away. So it is a nonsense to say that people are choosing not to go there. It is a monopoly provider. We would prefer that that is not the case, but our numbers show that we are getting more people through. I am quite happy to put some of these figures into the Parliamentary Record, because indeed I am very proud of them. They are issues that go to quality, and they are issues that go to the commitment of staff who work in a very stressful environment.
We have ordered changes in the triage practices and we now achieve national thresholds across all categories for the first time. It is important to note that there are five triage categories where people are assessed when they go to the Accident and Emergency, and they go from high acuity at 1 down to less acute at number 5. It is the case that we get high levels of people attending the hospital who are assessed as triage categories 4 and 5, which puts a lie to the assertion made by the Labor Party that people choose not to go to Accident and Emergency because often people in category 5 could possibly attend a GP on the next working day, but have chosen to go to Accident and Emergency because they believe they have to present to a doctor.
Some of this goes to the incapacity of people to attend doctors in after hours clinics and we, as a government, are trying to address that also. In the Palmerston Health Precinct, for instance, we will have extended hours GPs so that those people in Palmerston who have a concern about their child perhaps having to see a doctor, and who have had in the past to travel all the way to RDH, can go to the health precinct at Palmerston and have that child attended to. So this is not just one shot in the gun; this is making sure that the health system addresses the needs of Territorians right across.
The triage category 1, these are people who need life support and attendance immediately pretty much. The national guideline means that 100% of patients are seen immediately. The RDH consistently meets those guidelines and always has. Triage category 2 means the patient should be seen within 10 minutes. The national guideline is 75%. The value achieved by the major 22 hospitals that we are recording against is 78% and Royal Darwin is achieving 65% to 80%. Triage category 3, patients seen within 30 minutes; national guideline 70%; Royal Darwin is achieving 75% to 85% above that. Triage category 4, patients seen within 60 minutes; the national guideline is 70% and Royal Darwin Hospital achieves 70% to 78%. Triage category 5, patients must be seen within 120 minutes; the national guideline is 70% and the Royal Darwin achieves 85% to 95%.
I am pleased that those numbers are on the public record because perhaps what that will mean is that when the Labor Party continues this campaign of trying to erode the public’s confidence in this fine institution called Royal Darwin Hospital they will have to use the facts.
Last updated: 09 Aug 2016