Why the Lismore disaster matters to all health service providers

Why the Lismore disaster matters to all health service providers

The shocking lack of support for health service providers in the Northern Rivers region should be of great concern to medical professionals everywhere. Natural disaster hit Lismore earlier this year, but with climate change triggering increasingly severe weather events around the country, every private health business in Australia is at risk.

EIGHT MONTHS AFTER epic floods destroyed homes, businesses and livelihoods in Lismore, health services are still struggling to rebuild. While the Government recently announced a much-needed buy-back scheme for homeowners in the region, financial support has been insufficient for flood-devastated private health services, which have been left to try to self-fund their own hugely expensive recovery. The situation is so dire some are considering closing their doors permanently.

There is something uniquely cruel about floods. They often leave the building standing but everything inside completely ruined. It appears salvageable, but once inside – even after you’ve gutted the contents, replaced the electrical wiring and redone the plumbing, peeled the flooring and ripped up the carpets, repainted the walls and replaced all the fixtures and furnishings, a faint smell of mould often remains. A reminder that you’ll never completely be able to put the experience behind you.

After months of being ignored, Lismore dermatologist, Dr Ken Gudmundsen acknowledges he is desperate. 

“It’s been a tough time – a distressing time financially, personally, mentally and physically…”

“In the flood, I lost virtually everything in my medical practice – computers, beds, equipment, stock, lights, loupes, etc. The walls, floors, ceilings, the kitchen, the bathroom, all were destroyed,” Dr Gudmundsen said.

“Then followed weeks to months of cleaning up the building and sheds, removing debris, dirty furniture, destroyed equipment and stock. Working, with staff and others, in the dirt, the smell, the mould, the rain and grey days – on and on.”

And, months later, the rain keeps falling… as water levels rise so do the debts, the anxiety and fear that they can’t continue.

“The slow pace of government help for my practice is a scandal. This neglect and incompetence on behalf of the Governments has added to my stress and gives me great uncertainty as to whether I can or should keep practicing in Lismore,” Dr Gudmundsen said.

He spends hours every night writing letters, sending emails, talking to health groups – just looking for answers – the mental toll is obvious.

“I have had an offer to relocate to a practice in Brisbane by a colleague who is helping me through this nightmare,” Dr Gudmundsen said. “I rejected this at first, but unfortunately, slowly but surely, my thoughts are turning to this not being such an impossibility and leaving this god-forsaken town in which government has no interest in, or appreciation of, its medical workforce doesn’t seem so bad.”

Health services providers, like Dr Gudmundsen, including general practice owners, pharmacists, dentists, and other specialists, have begged and borrowed, pleaded and petitioned, but the funds they’ve received from Government have been a pittance – a drop in the bucket compared to what they lost. 

Most are eligible, and have applied for, a $50,000 Small Business Recovery Grant. While appreciative of the funding, business owners said it doesn’t begin to cover the damages to the premises, as well as their equipment, consumables, lost wages and income. 

“I am not a wealthy person – I currently live in my caravan with my partner, infant baby and three-year-old son. We do not have the financial capacity to rebuild and restore to where we were prior to the flood. I feel an obligation to my staff and the community to keep providing the services our business is renowned for, but we need assistance to do so. The small business grant of $50k was welcome but basing grants off staff numbers fails to take into account the many, many variables and costs associated with businesses like ours,” said pharmacist and owner Kyle Wood.

The NSW Government also offers a $200,000 flood grant to medium sized businesses that employ between 21 and 90 staff; however, the health care businesses in the region do not meet these criteria.

The NSW Rural Doctors Network (RDN) developed the Healthcare Flood Recovery Grant Proposal in response to Northern Rivers floods in late February/early March. In the proposal it argues that the current eligibility criteria for grant funding, which is based on the business’s number of staff, has no alignment to the value of the service to the community (and therefore government).

“Eligibility should be aligned to the significance of the impacted service to the community, and to the quantum of damages occurred,” it stated.

The proposal also identified that the approval process for the grants was a barrier to some health service providers.

“Currently applicants must have spent the money prior to grant approval, let alone receipt of grant funding. This is problematic when businesses may not have funds available to pay upfront, or the business viability of the rebuild relies on the grant funding.”

The RDN estimates there are 25 healthcare businesses that sustained damages in the region, with 10 of those experiencing a “very high level of damage”. Several of the affected businesses have incurred damages more than $1 million. 

Many of these businesses are not insured for flood as such cover is unavailable or unaffordable. In addition to the 2022 floods, these businesses are suffering the compounding impacts of multiple disasters and emergencies, including the 2017 floods and the COVID pandemic.

The proposal recognises that affected businesses are currently deciding whether they can afford to restart operations, and if continuing, whether they can afford to offer the same levels of service and product to the community as they did prior to the 2022 flood events.

The RDN argues rural and regional populations are already seeing the impacts of decreased healthcare access on patient populations due to COVID, and that these will be exacerbated if non-government healthcare businesses are not adequately supported to return to pre-flood operation levels. 

Some of the impacts of reduced healthcare access on the population include decreased vaccination clinics, decreased chronic condition management, decreased screening, and decreased support for vulnerable patient cohorts. 

The GP shortage is a crisis across all of NSW and for the Northern Rivers community, further deterioration in healthcare access would be devastating. 

In addition to ongoing physical health requirements, residents in Lismore and surrounding areas continue to face significant mental health impacts from the flood disaster. Residents are traumatised and the continued threat of flooding is worsening the toll on their mental health.

The loss of Dr Gudmundsen, who has been providing services to the Northern Rivers region since 1998, would be particularly difficult for patients in the area. The next closest practice is located in Byron Bay – about 45 kilometres away. He currently has 6500 active patients on his books.

There is a significant shortage of specialist dermatologists in Australia with under 600 nationwide, which equates to roughly two dermatologists per 100,000 Australians. The dermatology workforce shortage is even more acute in rural and regional areas. 

In September, AMA (NSW) gathered a group of stakeholders to ask the Federal and State Governments to support the NSW Rural Doctors Network’s Healthcare Flood Recovery Grant Proposal and provide $15m in immediate grant funding to all flood affected non-government primary health, health practitioners and heath service providers.

In an unprecedented show of support of the grant proposal, AMA President, Prof Steve Robson led an emergency summit of healthcare leaders that included AMA (NSW) President, Dr Michael Bonning, and leaders from the Pharmacy Guild, the Pharmaceutical Society of Australia, the Royal Australian College of General Practitioners, the Australian College of Rural and Remote Medicine, and the NSW Rural Doctors Network.

In addition to calling for immediate grant funding for the affected health service providers, the AMA announced the introduction of a new policy resolution declaring rural health services as essential services for the purposes of support and recovery in the event of a disaster.

The AMA is calling on Governments to recognise the policy statement, which if acknowledged, would give some surety to all healthcare providers going forward.

As floods hit Victoria and NSW in late October, healthcare providers should watch closely. 

It is Lismore today – is your town next?