Remote Australian City Bridging Health Resource Gap but Still has a Long Way to Go

The most remote city in New South Wales is catching up to match or beat the health resources found in larger centres.

But experts say it still has a long way to go to bridge the health resource gap between it and metropolitan cities.

“All Australians should have access to the best technology, the best care, regardless of where they live,” surgeon Ashish Agar said.

Dr Agar has been involved with the latest resource for Broken Hill, performing an advanced form of surgery to treat glaucoma on four locals this week.

Glaucoma is a leading cause of blindness in Australia and the minimally invasive surgery, which was quicker and less intense than the traditional operation, has mostly been performed in metropolitan cities.

Beryl Thomas was one of the Broken Hill patients and was glad she did not have to travel to Adelaide like she has for other eye treatments.

“It makes the world of difference … the convenience of having it in your hometown with people you love around you is much nicer,” she said.

Other equipment, specialists and programs established in Broken Hill over the past two years have encouraged more patients to stay in the city for treatment instead of driving or flying hundreds of kilometres for it.

One included health hubs where university student provided allied health services in Broken Hill schools.

A nurse wears blue gloves as she pricks a young girl's finger with a small needle while the girl sits on her smiling mum's lap

Another was the establishment of the Broken Hill Environmental Lead Program, which has worked with local organisations to reduce blood lead levels in children.

The far west’s Aboriginal health organisation Maari Ma started a healing program to help victims and perpetrators deal with the stressors that led to domestic violence.

And the Broken Hill Health Services’ Midwifery Group Practice has provided medical and emotional support for pregnant women who were at risk of having an early miscarriage.

GPs do their part to provide services

A woman and man stand and smile in front of a large bulky white MRI machine

These initiatives are complemented by the basic medical equipment that has recently been brought to the dusty city.

Until October 2016, Broken Hill locals had to take a 600-kilometre round trip to Mildura to get a magnetic resonance imaging (MRI) scan.

Broken Hill’s general practice Interhealth conducted an online survey and found that 88 per cent of the 500 respondents who were referred for an MRI scan did not get one because of the travel barrier.

While that percentage has improved since the practice purchased the machine, it said about one-third of its customers who needed a scan were not getting one because of the cost.

The Federal Government bulk bills about half of the MRI machines across Australia, and Interhealth has been lobbying to get its technology covered.

“Cost is a prohibitive barrier to people accessing the service,” Interhealth owner Heather Attard said.

“If we could get a Medicare provider number it would make a huge difference with that.”

The service also recently purchased an ultrasound machine and said it had put a dent in the hospital’s waiting list.

Telehealth takes off

An old lady holds an electronic tablet in two hands to communicate with a doctor on the screen

The isolation of outback cities such as Broken Hill has prompted the installation of more cameras and computers so specialists can interact with patients remotely.

Western NSW Primary Health Network (PHN) chief executive Andrew Harvey said telehealth was becoming an increasingly important service for the bush.

“It’s been around for a while but it’s much more sophisticated now than it’s ever been before,” Mr Harvey said.

“It doesn’t take away from the importance of physical contact between a doctor and patient, but it means it’s more accessible … and probably more convenient.”

There are more than 50 video or audio conferencing units in far west NSW, which are used for a range of disciplines including mental health, rehabilitation, speech therapy and intensive care.

Western NSW PHN provided four of them in Broken Hill’s residential aged care facilities.

It said since September, more than 80 per cent of GPs rated the experience as better than face-to-face consultation.

It also resulted in a 30 per cent drop in patients being transferred to the emergency department.

Gap still gaping in some areas

But despite the progress, Broken Hill doctor Ramu Nachiappan believed the quality of patient care had gotten worse compared to a decade ago in some ways.

“Despite being one of the most famous regional cities in Australia, we are unfortunately lagging well behind other major regional centres in terms of health services,” Dr Nachiappan said.

Blurred image of a doctor with a patient at the Curtin Medical School with a door marked "clinical skills" in the foreground.

“Patients aren’t able to secure appointments in a timely manner [and] there are some specialities we had in Broken Hill … which we no longer have.

“The technology is there, however health [services] have not embraced technology to the level other areas of society have.”

Broken Hill Health Service general manager Ken Barnett disagreed the city was lagging behind others, but conceded more work could be done, including continuing to upgrade ageing monitors and basic equipment.

“We have a lot of people who come from the metropolitan areas to work in the hospital and they’re often amazed by the quality and the level of equipment and staffing we have,” Mr Barnett said.

“There’s always opportunities to do more … and we’ll always have a wishlist that we’re looking to upgrade all the time.

“We want to try and provide services as close to home as possible. It’s a major priority for everyone.”