ABC Australia Wide
As the number of coronavirus cases climb, Australia’s regional, rural and remote health services are feeling it. To ease some of that, the Federal Government will soon give patients the option of Telehealth consultations with their doctors and other health professionals.
In other measures, borders are closing to try and limit the spread of the disease. But the big question is will regional facilities that were already stretched be able to handle a massive influx of patients?
Mark Coulton is the Federal Minister for Regional Health. Minister, the focus has squarely been on equipping the large metro hospitals to deal with this pandemic. Small country hospitals do tend to be on the end of the supply chain. Can you guarantee that regional hospitals will have an adequate supply of equipment to look after their patients?
Yes, the regional hospitals, regional health through state governments and through the primary health networks, the process has been working right from day one.
Thankfully the cases in regional Australia have been low. They're obviously going to climb over the next number of weeks, but there are processes in place, we are setting up what's known as fever clinics that will operate separate to the local health systems so that the corona patients will be treated separately and not impact with the treatment that normal people who have other conditions that- impacting in these hospitals.
There are issues obviously in the smaller more remote areas, and I was speaking to the Royal Flying Doctor Service yesterday and they are looking at acquiring, leasing more aeroplanes and pilots to look at what might be an increase in demand. But they are very, very accomplished in dealing with patients, transferring those patients who are considered infectious and they've been doing that for a long, long time. So there are processes in place.
What sets us up as having an advantage, those of us that live in regional centres, is our relative isolation. But that can work against us.
Minister, when it comes to the Royal Flying Doctors, as you said, when people get unwell many will need to be airlifted out to get to bigger hospitals. What is their ability to - can they double the amount of flights they’re doing? What sort of numbers are we talking?
They do have an ability and obviously some of the other work that they do can be - if it's not essential, obviously will be prioritised to do more of the essential transfers. So you don't want to be prematurely making predictions how this will unfold but certainly everyone, including the Royal Flying Doctors Service, are taking this very seriously and are doing a lot of work in preparation.
We are very hopeful that we will have enough resources and planes at the time, when the time comes. But ultimately our aim is to try and keep as many of those smaller regional centres free of the virus as possible.
We already have low numbers of doctors and nurses in regional areas, will they be supplied with adequate PPE to do their job safely?
Yes, that PPE has been an issue, obviously. Speaking with Minister Hunt this morning, there is a large amount of procurement going on to bring the necessary equipment in as we need it.
But that certainly is under consideration and work is going ahead in making sure that those hospitals will be resourced.
As far as workforce goes, we are looking at bringing extra workforce in, whether it's recently retired doctors or nurses staff, medical students possibly could fill in the gap in some places under supervision.
But also you mentioned, in your introduction, the telehealth changes, and that will enable more doctors to work via Telehealth.
So doctors who may be older, maybe have some chronic issues that would make them vulnerable to see patients, or doctors with young children or who are pregnant, can still deal with and talk to patients now over Telehealth.
So not only will patients be able to use Telehealth to keep them away from potential infection that are gathering in doctors’ surgeries, we'll be able to bring a lot more doctors online as well because people who may be concerned about working in a public practice can work very effectively with Telehealth.
I spoke to a doctor today who works in a regional hospital that takes in a population of 55,000. He said he has four ventilators at his disposal. I suppose - I mean, if we do this maths, I mean, the maths are horrific if one per cent of the population gets sick, you know, you only have to think through that. What contingencies are there for intensive care in regional hospitals?
So there is obviously procurement of ventilators happening at the moment and that process is in place.
The fever clinics in these larger centres will have the ability - Aspen Medical who have a lot of experience in setting up hospitals in Africa or in war zones and places like that have been tasked with rolling out a lot of these clinics that can be set up - particularly if there’s an area in a town like you’ve mentioned that has a hot spot of people where that resources can come through.
But the point about the number of ventilators, it still reinforces why we are taking the other actions we are at the moment to try and keep as many people as safe as possible, and keep that level of infection as low as possible so that we can have the resources to handle the numbers of people coming through.
If we end up with a big spike, then that’s what makes it difficult to treat the patients.
At this stage all of those scenarios are being played out at the highest of levels, and we are watching as the virus does progress across the country.
Minister, you refer to fever clinics. Are fever clinics for testing or for treating?
They can be both. In the first instance, they would be for testing. And testing has become an issue for some, but probably by the time I’ve finished speaking to you today, we’re close to 150,000 tests, certainly more than 140,000 tests in Australia, with a positive rate of less than 1 per cent.
So, a lot of people are being tested.
You need to make sure that if you are unwell, you have spoken to your GP, or someone in one of these clinics to make sure that you get the testing, because we’ve got to make sure that we are using our resources to the best possible of effect. Blanket testing everyone does provide a degree of comfort for people, but it’s not the best use of the resources that we have.
You’re listening to Australia Wide with me, Sinead Mangan, and I’m speaking to the Federal Minister for Regional Health, Mark Coulton.
What's the trigger points to set up a pop-up fever clinic? At what point do you go, okay, we need one there.
Look, those locations are already being worked on, and some of those will be obviously in regional centres within a matter of days being ready for opening and occupation, and they are in different locations.
Some are in conjunction with well-established GP clinics, others may be in the local hospital. But that work has been going on now for a number of weeks in identifying where these hundred clinics will go, and working the logistics around to make sure that they are properly serviced.
But if there is a cluster of cases, would that be a trigger to open up a pop-up centre? In a particular- it could be a small town as opposed to a big regional centre.
Look, I think it depends.
In a smaller town, probably that would be more of a case of retrieval of people who are seriously unwell.
We've got to remember that 80 per cent of people who get the virus have mild symptoms and they- through self-isolation, can be monitored from home by Telehealth.
If they become more unwell - and that's more for the vulnerable people in the community that we are concerned about, our elderly and those people who may have chronic conditions otherwise - that need that higher level of care.
It's important to remember that not everyone that tests positive for this virus is going to need hospitalisation or higher level of care. But depending on the size of the location, obviously some of the larger regional centres will have that ability to treat them locally.
In some cases, the smaller country towns will probably be needed to have evacuations of the people who need that higher level of care with ventilation.
Can I ask right now, can regional fever clinics – the COVID testing clinics - can they process results there or do they have to go to metro areas?
The high number of cases that have been tested, that has led to somewhat of a delay. There are other processes in play that may become available soon where there can be a much quicker result that may give you a positive or a negative, and if you do receive a positive, then go on for testing.
That is not available yet, but we’re hopeful in the near future that will sort of give a quicker result.
At this stage, there has been a delay. So that’s why the process is in place of making sure that we are testing people who genuinely believe that they are at risk or have been in contact, are tested first because it's important that we don't clog up the system with people who want to test just for peace of mind.
Federal Minister for Regional Health, Mark Coulton. Thanks for talking to Australia Wide.
Thank you, Sinead.
Steph Nicholls 0417 314 920