Archive for the ‘health checks’ Category

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September 25, 2008

I was having chat with someone involved in the dental therapy aspect of the intervention.  I was quite impressed at the numbers of kids that they have managed to see – around 2000.  I remarked that they must have pulled a lot of teeth.  I shouldn’t be surprised by anything at this stage, but nevertheless I was by the response.  Very few teeth have been pulled, not because my take on dental therapy was quite crude, but because they weren’t offering treatment, but were doing follow-up checks on the referrals from the child health checks.  Of the 2000 children seen, only 16 received treatment at that point.

Of course, many of these were to be referred on (again) to hospital for their dental treatment, but the sheer stupidity in not resourcing this to provide treatment at that point, is astounding.

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Update

May 21, 2008

The Intervention hasn’t been front page news for some time (besides the odd hiccup), but things have been quietly ticking over behind the natural disasters and scandals of the headlines.

The Intervention is in 3 phases, and we are currently in all three. Phase 1, the child health checks, are still going on, for reasons which remain unclear to me. Phase 2, the health ‘blitzes’, particularly for ENT surgery, are happening, and the planning for Phase 3, the permanent enhancement of health services, is underway.

Permits
The abolition of permits to enter Aboriginal Land has itself been abolished.

Welfare Quarantining
Has hit it’s first, very much expected, hurdle, and is being revised. Having found that the store cards were being traded for cash, the Govt has announced that it will phase out the store cards and introduce debit cards.

Housing
Slow but steady progress in being made. As pat of the intervention, house ‘surveys’ are currently being conducted. The surveys are identifying urgent work that is needed to be done to ensure that houses are safe to live in.
The NT and Federal Govt’s have come to some basic understandings on funding and objectives for housing. There is a new program, the Strategic Indigenous Housing and Infrastructure Program (SIHIP) which has a $647 m budget for the next 3 years. He plan is to build 750 new homes, demolish and replace 250 and refurbish a further 2500. The stated aim is to reduce the average occupancy rate to 2 people per bedroom. Not 2 per house, 2 per bedroom. It’s currently a bit higher than that. This isn’t enough funding to achieve the stated aim, so one objective of the program is to achieve significant reductions in building costs. Other than through economies of scale it doesn’t say how it will achieve this. By my reckoning, the cost savings will need to be in the region of 50%, which is highly unlikely.

Health Services
Phase 2, providing the follow-up services identified as required in Phase 1, is facing workforce problems. Dentists are hard to come by. In one central Arnhem Land community where Phase 2 services are meant to begin in a few weeks, the doctor shortage is such that the doctors from the Clinic have been approached to help out. Kind of defeats the purpose.
Looking to Phase 3, the boosting of Primary Health Care services across the NT, the Federal Govt has just called for tenders to establish the Remote Health Corps Agency. This will be the organisation/group charged with the weighty responsibility of finding all the extra health staff required to expand services. The unwise idea of looking for short-term appointees (fancy a holiday in the desert?) still seems to be a core strategy. $100 million has been allocated for these services over the next 2 years and the NT Govt, DoHA and AMSANT are working on basic criteria to ensure a conssitent and workable approach to distributing these services across the NT.

The Intervention has certainly changed significantly since June last year. Some of the pointless aspects have been jettisoned though a combination of common sense and a change of government, while some significant funding commitments, that were originally excluded, are now coming front and centre.

Health

November 15, 2007

The Federal intervention in the NT continues, albeit without much significant coverage, Four Corners being a notable exception. 

My own involvement is in the field of health and the current state of play can be summarised in a single word – confused. 

The much heralded child health checks (CHC) continue, though seem to be shutting down for a Christmas break. The scheduled checks will continue into next year and should be finished by June at the latest, given that this is the date that the intervention is meant to enter Phase 3. As I’ve said before, the CHCs have been a very expensive and time consuming circus, the prime outcome being lots of pieces of paper.  The CHC teams have been sending out referrals to NT Health Dept staff, like myself, telling us that child A, whom I already know, has condition X and requires services. Gee thanks. 

Phase 2 of the intervention is meant to be about actually trying to provide some of the services that are lacking.  Now that will be useful, but the intervention circus wasn’t required to figure out what was lacking.  There will be a focus on ENT and dental services in this next phase, sometime in the first half of 2008.  But, in a testament to brilliant planning that is the NTER, it isn’t quite clear exactly how and when this will occur.  To help figure some this out, the Federal Govt has put together the succinctly named, Northern Territory Emergency Response Health Expert Panel, which has meet several times to try to clarify some of the practical details, such as which health professionals are required, how they will be found, employed, deployed and supported. That this is still being talked about is some measure of the making-it-up-as-we-go-along approach.   

Fortunately there are some good people and organisations on the Panel, it’s just a matter of whether their sage advice will be acted on.  If Brough and Howard had been serious about this intervention, the Panel would have been formed before, not after, it began.  And the Panel would have advised against the ill-thought out CHCs. 

Child Health Checks

September 26, 2007

The NTER child health checks continue in the Top End.  I’ve been to various remote community health centres over the past few weeks where the teams have been and gone. The verdict is unanimous- a waste of time and money.

Why?  Because the visiting teams see fewer kids than the clinics do, they find already known problems and provide no services to meet the identified needs. 

The most that can be said is that they leave behind a pile of referrals.

TaskForce Update

September 7, 2007

It’s an unofficial update as official information is hard to come by. Just have a look at the taskforce media centre here.

A few bits and pieces surface via the ABC. This one from yesterday is very interesting. NTERT’s operational head, David Chalmers, made this claim,

He says two-thirds of the children in remote communities have had health checks, and that about 20 per cent of those will need follow up treatment for dental problems.

Well, I can guarantee you that 60% of Indigenous kids in the NT have not had a health check courtesy of the NTERT. The health checks have not even started in most communities in the northern half of the NT, where well over half of the Indigenous population of the NT live. Many won’t see one of the medical teams till November. Checks have started at 2 of the largest communities, Wadeye and Maningrida, but only 150 and 60 children respectively have been seen so far. To give you some idea of what sort of progress this represents, Wadeye’s 0-15 population is 600 according to the Census (which almost everyone thinks is a serious underestimate, it’s probably closer to 800-900). The health checks have been going for just over 2 weeks, with 3 weeks to go. They’ll do well to see 50% of the kids in Wadeye.

But the second part of Chalmers’ statement is where the most significant problem lies. So, 20% of kids need a dentist (I’m stunned it’s so low)? Where is the dentist coming from? The knee-jerk nature of the response is exposed yet again – do medical checks so you can make referrals to services that don’t exist in sufficient quantity to meet the need. It’s particularly ironic that dental services were mentioned. Back at the start of the Howard Government it was public dental services that were slashed in its’ cost cutting exercises.

There has been no effort to expand on-going health services to meet the needs in remote communities, which makes the visiting health teams an expensive exercise in futility. The Federal Government is also starting to have trouble attracting volunteers, which is hardly surprising given the current shortages of medical staff across Australia.