The first Northern Territory specialist physician appointed to the board of the Rural Doctors Association of Australia is on a mission to get a voice at the table to address the “incredible rates of complex disease”.
In the wake of a severe shortage of health proffessionals in remote regions across the Northern Territory, Dr Simon Quilty says specialists have no decision-making influence, inflaming the distinct challenges faced by rural doctors and costing the government millions.
Dr Quilty said, as it stands, it costs up to $10,000 to fly a patient from Katherine to Darwin for specialist services that are simply not available close to home.
In Alice Springs, patients are transported to Adelaide at a cost of around $25,000.
“If you populate these small hospitals with the appropriate specialists and appropriate training then the cost savings can be enormous,” he said.
Dr Quilty has worked as a senior staff specialist at the Alice Springs Hospital for the past year, but prior to that spent eight years lifting the Katherine Hospital – once on the verge of shutting down – out of a crisis.
“When I arrived at Katherine Hospital, there were about 750 medical retrievals from Katherine to Darwin per year and by the time I finished last year, there were two physicians and we had reduced the number of transfers by half down to about 350,” he said.
“We more than paid for ourselves approximately 10 times over.”
In the Northern Territory where distance plagues the health care system, Dr Quilty says more needs to be done to build the strengths of remote hospitals.
“There is a lot of economic sense in developing services,” he said. “Alice Springs Hospital provides a fantastic example of how things can work really well.
“Committed specialists are really well looked after and happy to be here, and as a consequence of that, far fewer people need to fly to Adelaide for treatment, because we can provide a hell of a lot of treatment locally.”
With the majority of specialists hailing from urban centres, Dr Quilty said health resolutions for rural patients are often delayed as access to wider training is lacking.
“What a rural and remote-living person experiences is referrals to three or four different sub-specialties, which slows the process very substantially,” he said.
“I’ll be advocating for specialists to have a broader scope to meet the needs of the community and recognition that there are some significant challenges for rural and remote specialists that are very different from challenges facing their urban counterparts.
“There is a lack of advocacy for these rural specialists because they are under-represented at almost every single organisation.”
‘We are very excited to welcome Dr Quilty to the board’: RDAA president, Dr John Hall
RDAA president, Dr John Hall, said the appointment is long overdue, but comes at a time the association is advocating strongly for more training opportunities and better measures to attract consultant specialists to work in rural settings.
“Over seven years in Katherine, [Dr Quilty] developed a comprehensive acute care and outreach service and developed the local hospital as a remote training hub for doctors and consultant specialists – demonstrating the opportunities for small hospitals to provide better healthcare, closer to home, in cost effective ways,” he said.
Dr Hall said that while the career of a rural consultant specialist is “extremely rewarding” they often face significant challenges he hopes can be tackled with the help of the Federal Government.
“There is an ongoing shortage of consultant specialists in the bush, and a lack of incentives and supports makes it difficult to recruit more consultant specialists to make a sustainable workforce,” Dr Hall said.
“Rural consultant specialists also face challenges in accessing ongoing training and continuing professional development near to where they live and work, which means they often need to leave their community and patients for weeks at a time to access this.
“These are key issues we want to work with the Federal Government to improve.”
Overworked and underrepresented
Dr Quilty said rural consultant specialists are a critical part of the rural medical workforce but are often overlooked in healthcare policy.
Despite “incredible rates of very, very complex disease” there are only a handful of specialist physicians in the NT, who Dr Quilty says are overworked and not represented at the decision-making table.
“First and foremost is to develop jobs that are sustainable and to support specialists so they want to come in the first place,” he said.
He said there was opportunity to work with the Federal Government to make changes to make rural practice more appealing, “particularly at the point they are trying to decide on their future career direction.”
“Part of this is expanding the training opportunities that trainee consultant specialists have in rural and remote settings, in order to give them a great experience of working as a specialist in the bush.
“Improved supports and incentives, and better access to ongoing training closer to home, will also help entice and retain more consultant specialists in rural and remote Australia.