- On May 7, 2019
- May/June 2019
Healthcare in Outback NSW
AMA (NSW)’s Senior Advisor, Fabian Flintoff shares insights from his recent visit to Broken Hill with AMA (NSW) President, Dr Kean-Seng Lim.
In late February 2019, AMA (NSW) visited primary care providers in the town of Broken Hill and the Broken Hill Base Hospital. The so-called Silver City is 1160km from Sydney and has around 17,000 people – a much smaller population than when its mining industry was at its peak.
Broken Hill has an illustrious history as a mining city and was one of the economic hotspots of NSW. The town itself has a unique character. Apart from its rich mining history, fine architecture and many achievements, it is also a centre for outback artists. Large murals and quirky artist studios are a feature of the town. In fact, noted outback artist Jack Absalom had a studio in Broken Hill. He sadly passed away at the age of 91 in March just following our visit.
Broken Hill occupies a unique position on the map. It is one of the few major NSW towns that is closer to Adelaide than to Sydney. Such geography and remoteness pose a unique set of challenges, particularly as the population ages, and the prevalence of chronic disease increases. Other major health issues include obesity, smoking, and the use of alcohol. Despite such challenges the level of care delivered is very good.
Broken Hill has a large Indigenous population. The purpose-built Maari Ma Aboriginal health service opened in Broken Hill in 2015 to provide primary healthcare and community services for the more than 3500 Indigenous people living in the area.
Our visit was bookended by dust storms and a heatwave, but we enjoyed very pleasant conditions. We had the pleasure of meeting with local GPs, the PHN, emergency doctors, palliative care doctors, the Royal Flying Doctor Service (RFDS) and administration at the Broken Hill Base Hospital. All demonstrated an impressive commitment to healthcare in the town.
We were given good insight into the primary healthcare challenges by local GP Dr Ramu Nachiappan, whose practice is in downtown Broken Hill. Dr Nachiappan originally moved from Queensland and brought with him energy, intelligence, and a quirky sense of fun. He and his wife Sorna are engaging, articulate art lovers who run a busy practice. AMA (NSW) President, Dr Kean-Seng Lim was pleased to discuss a range of issues with Dr Nachiappan. The practice is making huge strides in monitoring the health challenges of its patients through the use of technology.
Equally engaging was the Director of Emergency Services at Broken Hill Base Hospital, Dr Andrew Olesnicky. Dr Olesnicky is a practical and personable practitioner well on his way to what Broken Hill residents term an ‘A Grader’ (a local). He shared the challenges of working in the ED with us. A number of JMOs from Concord work in the hospital as part of a rotation. From our general discussions it seems as though challenging situations and adverse outcomes at the hospital are being reviewed more regularly and more systematically. The hospital has a very committed staff but could always benefit from the presence of more experienced nurses.
We also met with representatives of the local PHN which covers the Western and Far Western region. The PHN makes an important contribution to the town. Its staff were very helpful in facilitating some of our visit. The PHN was abuzz as it was about to move to new premises not far from Broken Hill Base Hospital.
We were also pleased to discuss a range of issues with Far West LHD Chief Executive Mr Stephen Rodwell. Mr Rodwell worked in Coffs Harbour prior to moving to Broken Hill.
On our final day we had the privilege of seeing the Broken Hill Base of the RFDS. The RFDS remains extremely important to the entire Far West region. Its continued good reputation is a testament to the importance of a strong culture in a health organisation. The ageing population in the region will provide continued challenges to the RFDS, including the sometimes-vexed issue of air transfers of elderly patients.
AMA (NSW) is hoping to facilitate closer cooperation with healthcare stakeholders in this area in the pursuit of better health outcomes for this remote town.
There is scope for services that target the main health issues of Broken Hill residents. Although Broken Hill locals are challenged by low incomes, a harsh climate and a degree of isolation, they have a strength of character that we could all learn from. We enjoyed our visit to the Far West and hope to return in 2020.