June 22nd 2011
Islander creativity on show in health planning
Last night about 40 Magnetic Islanders met with senior Queensland Health bureaucrats to discuss the Island’s health needs for the next 15 years and, while there were plenty of problems raised, support for the Island Clinic’s emergency services couldn’t have been higher and some very creative ideas emerged which appeared to impress Dr Andrew Johnson, CEO of the Townsville District Health Services.
The meeting was part of a wider consultation throughout the massive north Queensland “district” which now reaches from Cardwell to Home Hill and out as far as Richmond.
Dr Johnson told the meeting, “We have a reasonable handle on how we are meeting community needs but want feedback,” admitting that, “It can be scary how challenging it can be to interpret data,” and that, “we want to pick up on areas to focus on”
Boiled down to basics the health team wanted to know:
*What do we understand is working well?
*What has improved?
*Where are the areas for improvement?
*What are the top priorities?
The locals were not slow to answer.
To start with the Island Clinic was “great for emergencies (this was repeated throughout the evening) but the rapid changeover of locum doctors led to a lack of consistency. Dr Johnson agreed strongly claiming that this was a real challenge and that it wasn’t for a lack of trying”.
The problem according to one Islander, “put patients at risk” as it was harder for elderly patients with complex problems to recall their details but it was acknowledged that the doctors “tried very hard” to learn about each patient’s history from the patients and files which were maintained at the clinic.
One wheelchair-bound elderly local told a horrific story of her need for permanent opiate based drugs and that because six different Island locums had prescribed them over a period of months the (Brisbane based) bureaucrats had determined she was “Doctor shopping” which led to her having to travel to Townsville every three weeks at her expense and as a pensioner to see a permanent doctor who understood her condition. Dr Johnson considered this “intolerable”.
The call, regularly heard on Magnetic, for an aged care or retirement village was again raised. Dr Johnson was clearly frustrated that the bizarre split between federal and state funding meant such matters could not be addressed by Queensland Health but offered to flag it as an issue.
Mr Phil landon, representing aged-support organisation, Magnetic Island Community Care, said that their numbers had increased by about 30 or 40 over the last two years to 120. “We’ve always seen the need for hostel-type accommodation. I don’t know if there are the dollars for a retirement village. We need a hostel for people we can’t maintain in their homes any more.”
Island GP, Dr Angela Moore added to this saying, “The biggest need on the Island is for people going to nursing homes (off the Island) and becoming completely cut off for the rest of their lives. Dr Johnson said, “That’s a really good point. I hadn’t twigged how different Maggie is with other places”
Evacuation was another issue. At present, patients needing to be evacuated from the Island in an emergency, are either taken directly to a helicopter or ferry and then to Townsville Hospital, or are stabilised at the clinic before the evacuation takes place. One elderly Islander told the meeting of his plight at having suffered a heart attack at midnight and there being no chopper available and then having to wait for the first ferry at 6am.
As there is presently just one emergency chopper to service this huge area questions over whether the military could be called in in some emergencies were raised but Dr Johnson said that although they are called on rare occasions it’s very difficult and choppers are not routinely available. Usually by the time one can be arranged other means of evacuation are found.
Waiting times for certain types of specialists in areas such as ophthalmology, orthopedic, ear, nose and throat and rheumatology were raised and Dr Johnson, while claiming that, “Waiting times for Townsville are better than most of the rest of the state and the country. Some services are limited by key personnel shortages in a globally competitive market.”
Dr Johnson was however confident that in the longer term the approaches taken in Townsville at JCU to train local doctors to treat northern Australia would help alleviate these issues.
Mental health was raised and some locals believed there had been an increase in the number of people with mental health problems moving to the Island. Dr Johnson couldn’t confirm this but believed the stats would show whether this was the case. Community Care was again applauded for their efforts to support the elderly who suffered from alcohol and depression. Dr Johnson agreed that this was a “most underdone service and has been a major issue in Townsville,” adding, “It’s a lot better staff-wise in recent years but what do you need re mental health?” Ric Thompson, a local professional in disability support said, “My understanding is that there is a need for continuity and access is very important.” Dr Johnson agreed saying, “Demands can be very episodic and unpredictable”.
Dr Moore suggested that a number of specialist out patients clinics for gerontologists, endocrinologists, dietitians and diabetes education on outreach from the renal unit would be very worthwhile as they required little equipment and if they came 4 or 5 times per year would make it much easier for many. Dr Johnson thought this, “an excellent suggestion”.
In a similar vein one local parent told of the “big deal” of having a kid with a suspect broken limb. They needed to see the local doctor to get a referral for an x-ray in Townsville then get that done and return to the Island doctor to see if there was a break before further treatment which may require another trip to town. Dr Johnson was “happy to look at this” with an idea in mind that in communities such as Ingham and on Palm Island orderlies can be trained to take simple x-rays which can be emailed to the hospital for examination.
Another, Island specific problem, raised by Magnetic Times, is that of Islanders being evacuated to hospital, perhaps without a wallet or even footwear, then finding themselves discharged after midnight. What do you do? Where do you go? Dr Johnson was quite exasperated at the issue which was confirmed by many others attending the meeting. “Sending somebody out into the dark...I do apologise. I will take that up again.” he said.
Ric Thompson was wary that, “As a bureaucrat, reforms can lead to things being taken away” but, on Magnetic Island, “There is an opportunity for running a pilot for the community becoming a leader in home health. Magnetic Times asked Ric to explain this further. “The great thing about the cyclone was how it builds contacts with people helping eachother but then we return to our respective holes and give over to the services,” he said. “There is a role the can community play to address these issues, whether it be dog walking groups, community food co-ops, community gardens, but it’s about sharing our gifts and talents.” Ric sees the Aquapella Island choir and Musos club as great examples of these activities but believes that the pubs are a type of surrogate men’s shed. He claims that “Men with sheds who would like others to catch up with them may not know quite how,” but believes that health services should be alive and willing to take up and support these initiatives. “There are big blokes with disabilities who can still lift trees after the cyclone and we should be shifting the perspective from what is broken to what they can bring”.
While these comments came from Ric after the meeting his approach was clearly impressing Dr Johnson who said, firstly, “There is no intention to cut back services here!” He then went on to say, “I’m really fascinated by the community owning its own health - community resilience. I’m really interested.”
Clearly this meeting was to gauge needs for health planning well into the future and not about immediate problem solving but, with the creativity and engagement in their community demonstrated by the Islanders in attendance, and the refreshing willingness on behalf of Dr Johnson, who claims to now be a part-time Island resident, one can justifiably hope for some very positive future developments for health on Magnetic Island.
Story: George Hirst
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