Dilapidated and poorly maintained health infrastructure in the Northern Territory is impacting Aboriginal Community-Controlled Health Organisations to deliver vital services, a new survey has revealed.
Conducted by peak body the Aboriginal Medical Services Alliance Northern Territory (AMSANT), the survey of 11 member ACCHOs across the NT found nine of the organisations aren't sufficiently resourced to maintain facilities that are safe and fit-for-purpose.
As a result, the ability to deliver adequate health care to some of the most vulnerable people in the country is severely hindered, exacerbating the already critical workforce shortage.
AMSANT chief executive John Paterson said health facilities and staff housing which isn't fit-for-purpose posed enormous challenges and barriers for both recruitment and retention of health professionals in remote communities across the NT.
"The workforce crisis is being experienced across all professions, but the decline in numbers of doctors, nurses and Aboriginal Health Practitioners is particularly concerning and is threatening to reverse some of the life expectancy gains we have made for Aboriginal people during the last 20 years," Dr Paterson said.
More than three-quarters of ACCHOs said the poor conditions had a detrimental impact on their recruitment ability and said there were concerns they'll not be equipped to meet demand in the future without improved facilities.
Amongst other findings, nine out of 11 ACCHOs don't believe they have sufficient resources provided by the government to maintain their facilities to a safe and acceptable standard; nine out of 11 feel the condition of their facilities negatively impacts their ability to deliver primary healthcare services; and four out of 11 have had to reduce services due to equipment and facilities not being maintained in the past year.
"The workforce crisis is being experienced across all professions, but the decline in numbers of doctors, nurses and Aboriginal Health Practitioners is particularly concerning and is threatening to reverse some of the life expectancy gains we have made for Aboriginal people during the last 20 years," Dr Paterson said.
"An Expert Advisory Group are developing practical solutions to the workforce shortages in Aboriginal primary health care, but as it stands, we cannot transition these services to community control or employ people in facilities that are falling down.
"As a baseline we need to provide infrastructure and housing that is fit for purpose and allows staff to both do their jobs and live in facilities that are safe and appropriate. At the moment, we simply cannot offer that, to the detriment of the staff and communities who rely on those services."
The survey comes amidst a sector-wide workforce shortage, with staff vacancies at First Nations-specific primary health care providers in the NT doubling in the four years to 2023.
Miwatj Health Aboriginal Corporation's Steve Rossingh reported GPs at the Yirrkala clinic in East Arnhem were seeing patients in corridors due to lack of space, whilst the Gapuwiyak clinic has lost both the mental health and two-week trachoma team visits and would likely lose the next optometrist visit due to no available accommodation.
Poor road and airstrip conditions further hampered access to remote communities, and the Sunrise Health Service reported six of their eight facilities were neither fit-for-purpose nor offered vital security measures.
"The staff accommodation we have is falling apart. We have lost staff as a consequence of the standard of accommodation we can provide," Sunrise Health Service chief executive Rebecca Bond said.
"It's very difficult to access funds for further security measures and to ensure contingencies for communications and internet access. Several of the clinics in our catchment have been without communications for weeks at a time, presenting considerable risk to community members and staff."
Delivered to all NT parties before the upcoming election, AMSANT's six-point-plan for improving the health of Indigenous Territorians includes calling for urgent government action to audit all clinics and staff housing, as well developing an asset upgrade and replacement plan for ACCHOs to best deliver their vital services.
AMSANT chair Rob McPhee echoed calls for urgent action to support fit-for-purpose infrastructure, arguing the survey responses showed the need to work together with the Federal and Territory government to "repair facilities and establish a long-term plan to maintain and improve health infrastructure" in order for ACCHOs to meet the growing demand for their services.
"The sector is currently under immense pressure to obtain funding from grants for health infrastructure and acquire trades, leading to delays and insecurity over future timelines," Mr McPhee said.
"Rather than wait for things to fall down and expect at-capacity providers to apply for individual funding, we need to develop a long-term plan to ensure facilities remain fit for purpose and fit for the future."
