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Northern Territory Department of Health Library Services Historical Collection TERRI,:OIH .HEAL TH SERVICES lllllllllil/llllllllll!llllllllilllllllllllllll!llil!llllllllllllllll!lll!llllll 3 0820 00019933 6
47098
R E P O R T
of
Corrunittee of Review
Provision of Aerial Medical Services
South of Katherine
1983 Appointment of the Committee
1. Minister for Health met with the RFDS Federal President and the Execuiive Council of the RFDS (SA and NT Section) on 2 February 1982.
2. Government decided to establish a Committee of Review to examine the provision of aerial medical services south of Katherine.
3. Preliminary meeting held in Darwin on 2 April 1982. Present were Messrs B. Lodge, P. Dossett, I. Wiese representing the RFDS. Departmental representatives were Ors Fleming, Anderson, Kirke. This meeting accepted the Terms of Reference for the Committee as amended by Mr Lodge (Attachment 1) and a working plan for the Committee (Attachment 2) presented by Mr Lodge.
4. On 14 April 1982, RFDS nominated its three Committee members.
5. Committee membership was formalised as follows:
Dr Keith Fleming Chairman Mr Barry Lodge Mr Sam Calder Mr H. (Ossie) Watts Mr Lyel Kempster Dr Allen Limmer.
Secretariat: Dr Don Anderson, Mr Peter Dossett.
6. Press release on 14 May 1982 by Minister for Health (Attachment 3) advising of the appointment of a Committee of Review and its functions.
Committee Meetings and Action Taken
The first meeting was held on Monday 19 April 1982 in the Conference Room, Alice Springs Hospital. Those present were Drs Fleming, Limmer; Messrs Lodge, Calder, Watts; and Secretariat: Dr Anderson, Mr Dossett with apologies from Mr Kempster. 2
Copies of a telex submission from Tillair (Attachment 4) were tabled.
The Terms of Reference was given to participants and agreed.
The Committee adopted the working plan as presented by Mr Lodge, and the following was to be undertaken:
(a) Up to date data, at present in short supply, was to be gathered from the follm,,ring "consumers 11 of air medical services -
pastoralists; rural communities, mainly Aboriginal; mining companies; and tourist authorities.
(b) This data was to be obtained from a questionnaire sent to the above groups, accompanied by a "Background Information" document.
(c) The questionnaire would seek to gain information on:
communications; aircraft; and medical services.
The above documents, including the questionnaire, were sent and submissions invited from th~ following:
NTAMS and Alice Springs Hospital staff; private doctors; Central Australian Aboriginal Congress; Department of Aboriginal Affairs; General Aviation industry - Tillair, Chartair, Tennantair, Leach Aero Services, etc; St John Ambulance; certain Public Service Departments - Conservation Comrnission, Tourist Comrnission, Police Department; and Town Councils in Alice Springs, Tennant Creek and ine. 3
Fifty eight stations in the Alice Springs and Tennant Creek area were sent questionnaires and information documents. (Attachment 5). Mr P. Dossett and Mr D. Miller (Pastoralist/ Councillor for RFDS) approached Mr Malcolm Roberts (Secretary of the Centralian Cattlemens Association) and explained to him what the Committee was trying to achieve. Mr Roberts contacted all the stations receiving the questionnaire and asked them to respond.
An advertisement (Attachment 6) was placed in the following newspapers:
Centralian Advocate 12 May 1982 Alice Springs Star 14 May 1982 The Tennant & District Times 14 May 1982 Katherine Advertiser 13 May 1982.
Prior to the second meeting, the Secretariat met in Alice Springs on the 16, 17 June 1982.
(a) questionnaire returns and submissions were collated:
~ thirty seven statibns responded from fifty eight circularised;
four mining companies responded from thirty one circularised;
no response from the thirty four coach/tour operators circularised.
(b) submissions received were summarised (Attachment 7);
(c) replies from the thirty seven questionnaires were analysed (Attachments 8 and 9). 4
The second meeting was held on 18 June 1982 in the Conference Room, Alice Springs Hospital. Those present were Ors Fleming, Cooter (vice Dr Limmer); Messrs Lodge, Calder, Watts, Kempster and Secretariat: Dr Anderson, Mr Dossett.
The Committee studied all the submissions and questionnaires received and the analyses and summaries produced by the Secretariat.
The Committee decided that the study should be extended to cover the area around and south of Katherine itself and that further questionnaires should be sent to stations in this area. Seventy eight questionnaires were sent to the Katherine area on Wednesday 30 June by Alice Springs Regional Health Office.
A press statement was made by the Minister on 9 July 1982 (Attachment 10).
The third meeting was held on 5, 6 August 1982 in the Conference, Room, Alice Springs Hospital. Those present were Ors Fleming, Hagley (vice Dr Limmer); Messrs Lodge, Miller (vice Mr Calder), Watts, Kempster and Secretariat: Dr Anderson, Mr Dossett.
Committee members studied the replies received from the seventy eight questionnaires sent to the stations in the Katherine area.
From the replies received, there appeared to be a problem with communications in the area. However, as the response was so poor, the Committee decided that the stations be circularised again, and all nursing sisters in the bush similarly invited to respond to the questionnaire (Attachment 11).
Mr J. Tilley, of Tillair, spoke to his submission.
It was further decided to seek the assistance of Mr Cliff Emerson, Secretary, N.T. Cattlemens Council to obtain a better response from stations (Attachment 12). 5
Prior to the fourth meeting of the Committee, information and maps requested at the third meeting were supplied to all members. (Attachment 13) .
The fourth meeting was held on 7,8 October 1982 in the Conference Room, Alice Springs Hospital. Those present were Drs Kirke (acting Chairman), Limmer; Messrs Lodge, Calder, Watts, Kempster and Secretariat: Dr Anderson, Mr Dossett. Apologies were received from Dr Fleming. Agenda and report of meeting at Attachment 14.
There was a much better response to the second request to return questionnaries; thirty five replies being received as compared to seventeen from the first request. This made a total of one hundred and one questionnaires returned from two hundred that were sent to all "consumers" of air medical services.
l The main respondents were pastoralists and from one hundred and thirty stations sent questionnaires, a total of eighty stations replied; a percentage return of 61 per cent.
Committee members studied the replies received from the latest responses and considered all the summarised information gathered to date. This revealed that there was generally a high level of satisfaction with the existing services out of Alice Springs and less satisfaction with those in the Katherine area.
The prime factor in all the problems looked at by the Committee was the need for reliable communications, a fact that became evident during the discussions at the Committee's third meeting in August. 6
Other problems dealt with were the availability, response time and suitability of aircraft and the frequency of medical and nursing visits. It appeared the former were related to the nature of the private charter companies providing the aircraft and the latter were "in house" problems for the Department of Health to solve, but which could be prevented in many cases by adequate communications.
A review of emergr:.:ncy flights out of Alice Springs revealed an average cost to the Department of approximately $1.8 per mile for aerial evacuations, compared to an approximate cost of $5.4 per mile for road ambulance services.
The Committee reviewed the terms of reference as at Attaclunent 1 and agreed that -
the demands made by consumers and the needs as seen by experts did not always coincide and that the onus of maintenance of medical kits, radios, aerials and airstrips rests with the owners;
statistics do not support the view that aerial medical services favour Aboriginal persons;
a function of an aerial medical service is to provide information to "consumers" on the availability of medical advice, frequency of medical visits, scheduled times for radio medical services, use of the radio etc;
a doctor experienced in the local situation should be available for emergency calls 24 hours per day and that a medically trained person, acting as the co-ordinator, m11st decide how the evacuation is to be conducted and who is to act as aerial attendant(s); 7
a lack of co-ordination would produce misuse of resources, duplication and could cause occasional catastrophies; the communications system based in Alice Springs - the RJ:""'DS base - was excellent but there were some deficiencies in the system servicing the Katherine area; medically equipped aircraft, dedicated solely for aerial medical use, produced advantages in terms of response time; cost effective use be made of single engined aircraft; an escalating problem exists with the increasing number of tourists coming to the TeTritory by coaches, which have no suitable means available for summoning assistance; strategically placed sub-regional centres would be appropriate somewhere in the Victoria River and Barkly Districts, and south west of ;~lice Springs, and these centres should have an all-weather airstrip, regularly maintained communications equipment and additional medical supplies Bnd resident trained hEalth staff (cg sisters, ambulance officers, doctors, Aboriginal Health Workers); the report tabled by Mr Watts covering the per mile cost of the various organisations providing aerial medical services (Attachment 15) was germane to the fifth term of reference. The report in summary shows the cost of the RFDS operation is approximately $1.3 per mile compared to other charter companies of approx imately $1.9 per mile. 8
Further Correspondence
Subsequent to this meeting advice was received from the NT Tourist Commission concerning tourist nu~bers and movements (Attachment 16).
Recommendation s
The Committee after seven months of deliberation, discussion and research , presents the following recommendations:
1 An HF base ( similar to the RFDS base station in Alice Springs) be established in Katherine.
2 The RFDS (Central Section) be inv ited to operate services ou t of Katherine and Alice Springs and to cover Tennant Creek .
3 Sub-regional "strategic " bases be established at \. Timber Creek, Borroloola, Ayers Rock, Elliott and Ti-Tree.
4 A handbook be produced for consumers i n rural areas providing information as to the availability o f medical advice on a 24 hour ba sis, schedules for radio medical sessions, routin0 medica l v isits, the use and maintenance of medical chests, basic first aid, requirements concer:1ing the maintenance of communications s y stem s and airstrips, night landing requirements etc.
5 Single eng ined aircraft capability be maintained in both Al ice Spriny s and Katherine to be used at the discretion of the medical co-ordinator of aerial medical services in the particular a;ea. 9
6 Further attem pts be mad e to reduce the illegal use of emergency frequenc ies by Aboriginal co~munities to t he south west o f Al ice Spr ings.
7 Leg i slation be en~cted to provide f or tourist coaches being fitted with appropriate HF radio sets and drivers having current first aid certificates .
(' ATTACHME:NT ;t'.
;:
/ COM.11ITTEE OF REVIEW - PROVISION OF AERil~L MEDICAL SERVICES SOUTH OF KATHERINE
Pollowing a meeting between Dr Fleming and R.F.D.S. representatives in Darwin on Friday 2 April 1982, the following Terms of Reference were agreed to:
1. To review the· function of aerial medical services in the Alice Springs and Barkly Regions to determine what are the needs and demands for the supply of health services by ai~.
2. To consider what personnel are required to undertake this function and their "mix".
3. To determine the source of these personnel in the light of the contributions that can be made from the various agencies supplying health care.
4. To consider the equipment and cilities available to carry out the function at term 1. having regard to geographic deployment of resources.
5. To recommend the most cost effective operation from the various~ options to supply air medical services.
For the information of all Committee members.
D.A. Anderson PD
15 Apr 1982 ATTACHMENT 2 •
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.. :)'{__ f . 1. Ascertain requirements of client population and other interested groups. 1.1 Pastoralists 1.2 Mining Companies 1.3 Aboriginal Communities 1.4 Tourist Authorities - e.g. Coach Companies In terms of Clinics In terms of Evacuation Capability In terms of Method of Staffing In terms of Deployment of Aircraft In terms of Type of Aircraft In terms of Communication. 2. Invite submissions from interested parties - NTAMS Staff, Private Doctors, CAAC, DAA, General Aviation Industry and St. Johns Ambulance, Alice Springs Hospital. 3. Assess requirements - expressed as a result of 1. and consider input received as a result of 2. 4. Define solutions that satisfy requirements. 5. Make recommendations. ::· , ,1 (.!:· .' .~ 'I·. r - ... ~ 'j, ATTACHMiN"L' 3. --·tie•'" \. T ' ... ~ '. ,· / -~ ..L I, .:i ~ : l ;· ~ 1 •.• : r· ,' J / / MINISTER FCR HE/,LTH, i. Po, sex 3145. DARV/:N, :,4,7 5794 PRESS RELEASE TELEPHQl';~ 89 G:'.33 MAY B:, 1982 i 4-73/82 The Heal th Department is to carry out a review of air mec:ical service ::unction in the Territory, south of :Katherine. The Corruni tt2e, chaired by the Secretary for Heal th, Dr. Fleming, includes representation from the Royal Flying Doctor Service, t.rie Aviation and Communications industry. As one of its first functions, the committee is to collect up-to-date data from consul'i',e::cs of the air-medical-services. These include pastorali s ts, rural corn:muni ties, which are mainly I,boriginu.l, mining cor.1panies and tourist authorities. '::'he Conuni ttee will question these groups to seek info:::-r,1ation on corrrrnunications, o.ircraft ;:ind medicctl servicGs. 2\nnouncing the formation of the Committee, the Eeal th Minister, Mr Tuxwort11, ~ snid submissic:1~" relating to the provision of ; aerial medical Eervices south of Ku;,,,herine also would be invited from the Northern Territory Air and Medical Service and Alice Springs Hospital staff, from private doctors, from the Central AustraliQn ~boriginal Congress, the Department of ltborisinal Affairs, the General Aviation Indt:stry, St. John Arnbulance, some Pul:;~ ic Service Dep0,r ~"'Tlents, including the C:or;servation Corrunission and L1e Tourist Com.'Ttissior: aEd the ,;,)olice Department crnd Town Councilc: i,1 Alice Sp,:;:ings, 'l'ennan t Creek Qnd Katherine. Mr Tuxworth said the Hec1.lth Department wc1s attempting to obtain the best possible aervice for all Territorians living o~tside main tmms, v.nfl, consequently without ready a'-, ::::ess to meclical facilities. - ~ -- -,_ This i :3 why the Comrni t tee of Review hc1c1 b0en set up. Until now aerial medic3l cover for the Northern Territory has been the responsibility of the Northern Territory Aerial Medical Service, which is a brcinch of the NT Heal th Department. In the Alice Springs Area the Aerial Medical Service contracts its wo~k to the Royal Flying Doctor Service, while in Tennant Creek and Kath~rine, local charter.operators provide aircraft fo~ the service. Questions covered in the survey include: * whether aircraft are readily available,. whether they, are suitable to particular:.areas a11d able to operate into isolated airstrips. * whether corrmunication with t~c Aerial Medical Service is available and whether it is satisfactory * whether those ~roups using Aerial Medical Services have adequate facilities to allow them to deal with routine medical problems Mr Tuxworth said since the introduction of the Royal Flying Doctor Service and the advent of the Northern Territory Aerial Medical Service there had been vast improvements in communication systems and access to the more remote areas of the Territory. "Better roads and faster; more comfortable vehicles mea.n it is now possible to reach many isolated communities far more quickly than was the case when medicine first took to the air", he said. "In view of the fact that these com.rnuni ties can now be reached quite quickly, we must ask ourselves whether it is still necessary for a large scale aerial medical operation to be maintained. 11 " These are the is .s u cs we ;,.., i 11 b c c .:.1 n \:r 2 s sing in the review • SNDS ' . ATTACHM.EN'l' 4. 'I j ... ' ,. \. 0 :,, . -, --r · .: ' : " . ~ \ : .. . .,.C ~' . ,, . :,, . \ I .). l:·- .. : ~ . . ·! i# \ i.' ,; - .... ;J. ;tt~t~-1;:· ,-i.J1/1~.. -·. •::-.. ;;; ti ·~ 1: 1-fEAL TH AAS.5~71 .! r~; T l ~- /:, I R ;; A /3 S S C ,:J ~": f _i -, r . . i, . 1~~ , ! :7\ t.,t Y T 1 1 _:.~, \_. :_, J I .l. : scrne: COTTOM LINf: cc,sTINGS () i\ A IR CR/. FT I, HOURLY RATE HOURS DOLLARS !'1 MOMTHLY t-1 HH1.-i1.Jt1 ;,~: I l" $800 l CJ $48 ,OCO .00 : ;, 40:2C ':t 37 S Bn :t :1 C, CDO.OC 402C :;J85 SC .. ,. - -~ ~-' . ) ! 180C 60 ,:i 0 ~·30, coo. 00 ,I '.j c: PROPJET 402C TOT/,L $'57,S,000.00 $]60,000.00 $J69,000.0C $369,600.00 :tS76,000.00 $]50,000.00 936,000.00 ;i I flj ,: ~. '2, 21-:-1, hOO. 00 •I t369,6CO.OO :~~ ·i .. ATTACHMENT ;5 • '' / ] •I J . ~-·~ ' t ~. I-• •.J...:. .._p· i~~t~.'\· ~-:·,, .. v,·:" .·\·,:• "1.1:i~:..-.;·.;.., ··· t-~·· AERO MEDICAL SERVICES SOUTH OF KATHERINE A Committee of Review has been appointed to study the operati0n of Aeromedical services in your area. For the study to be meaningful the Committee must have L1forrnation from recipients of the services. To this end a good rcspons~ to the questionnaire in the attach2d documents is essential and must be sent to the following address by the 30th May:- The Secretary Committee of Review Regional Health Office P.O. Box 721 ALICE SPRINGS N.T. 5750 I' The Committee is widely based and is made up of the follow \. ing persons:- Dr. Keith .Fleming Secretary for Health Chairman Mr. Barry Lodge Mr. Sam Calder Mr. Ossie Watts Mr. Lyel Kempster Dr. Allan Limmer .. INTEPESTED PArtTIES Committee of Review has been appointed to study the operation of Aero Medical Services in· t~e area The attached documents have been =irculated tG all potential users of the service. As an interested party the Corcunittee 1.vishes tc give you the opportunity of presenting any views that ycu may have concerning the existing services or of any suggestions you may have which you consider to be a preferable a:'._terr,ative. The Comrni ttee expects all written submissions to reach the following address by the 30th May. The Secretary Committee of Review Regional Health Office P.O. Box 721 ALICE SPRINGS N.T. 5750 AIR MEDICAL SERVICES SOUTH OF KATHERINE BACKGROUND INFORMATION The Department of Health is endeavouring to get the best possible service to all Territorians living outside the main towns and consequently without ready access to medical facilities. To this end, the Government has set up a Committee of Review to study air medical services south of Katherine. Aeromedical cover for the Northern Territory to date has been the responsibility of the Northern Territory Aerial Medical Serivce {NTAHS) which is a branch of the N.T. Department of Health. At this time the NTfu'v1S discharges its responsibilities in the following manner: ALICE SPRINGS AREA Aircraft The NTAMS contracts the flying and communication functions to the RFDS. Three RFDS medically dedicated aircraft comprise two Piper Navajos and one Beech Baron. The Baron is to be replaced by a new Navajo in September 1982. These aircraft arc equipped for all weather, day/night operation and are crewed by RFDS instrument rated pilots. Back-up crewing is supplied under contract by Chartair at Alice Springs. Communications The RFDS maintains a modern communications base operating on 5 SSB high frequency channels. The base can be activated 24 hours per day, permanently. The St. John communications centre controls call:: after hours and at weekends. RFDS aircraft carry two H.F. transceivers to enable continuous contact with the Base. Medical Staff The NTAMS has five District Medical Officers and four Rural Health Sisters who deal with all medical calls. The NTAMS initiates ·and provides staff for all flights whether of a routine or emergency nature. .. TENNANT CREEK Aircraft There are chartered from the local operator Tennantair who provides one twin-engined aircraft and a selection of single engined aircraft. 2 .!':"'-,.. Cornmunications Radio conu-rmnica tions are through the existing Heal th Departwent radio system currently based at Tennant Creek Hospital. Jirect telephone conununication is available to certain areas such as Warrabri, Elliot etc. Medical Staf:: One District Medical Officer and 2 Rural Health Sisters on call from the rural health services constitute the, available NTAMS staff. k\F,.THERINE AP~El'1. Aircraft These are chartered from the local operator Tillair who provides a mixture of twin-engined aircraft. Occasional use is made of NTAMS aircraft based in Darwin. Commun.ications Radio communications are through the normal Health Department raaio nebmr-k and also via the Department of Communication's outpost radio (VJY) for medical consultations directed to the Katherine District Medical Officer. YJY patches Katherine radio staff through the telephone system. Medical Staff Three District Medical Officers and 3 Rura~ Health Sisters constitute the available NTASM staff. NORTHtiRf\l T~RRITORY OF AI-ISTR.t:1.LIA. TELEX 81289 DEPARTMENT OF HEALTH All. correspondence to· TELEPHONE 50 22 1 1 REGIONAL DIRECTOR. TELEGRAMS. ·'HEAL TH" ALICE SPRINGS ALICE SPRINGS. NT ALICE SPRINGS & B~RKL Y REGION, PO. BOX 721. ALICE SPRINGS. NT. 5750 IN REPLY OLJOTE I MJ:MJ May 11, 1982 / Aero Medical Services. DJ.ring the last fe»1 days you will have received a questionnaire relating to the above services. It has been r:ointed out that the questionnaire does not provide adequate s_tB.ce for resr:ondents to fully indicate their thoughts in reply to the questions asked. E.!closed is a revised questionnaire.which allo\\lS adequate space for reply to each question. If you have already replied on the original fonn please disregard this advice. If not please use the revised form. It is essential that these questionnaires be returned as the tYP3 and scope of services provided in the future may well be based on infor:rna.tion received in this survey. A reply paid envelope is enclosed for your convenience. M.~ for REGIONAL DIRECTOR OF HEALTH ALICE SPRJNGS & BARKLY REGIONS. QUESTIONNAIRE NAME •...... II •••••••••••••••••••• ADDRESS : ...... •...... •...•..• ...... AIRCRAFT 1. Is the availability of aircraft to your satisfaction? / e.g. Are they readily available to you from where they are currently based? 2. Are the aircraft suitable to your area? e.g. Can they operate into your airstrip? ------·------.;i\ ------3. Have you any other conunents regarding the aircraft which you consider important? COMMUNICATIONS 1~ Is communication with the Aero Medical Service readily available to you? e.g. Is the quality of communication satisfactory? 2/ .. 2. Is the communication with the Aero Medical Services suitable for your requirements? e.g. Can you communicate with appropriate medical staff? 3. Have you_any _comment regarding communications at all? / MEDICAL 1. Do the facilities you have at your disposal e.g. Medicine Chest, access to radio consultation, allow you to deal with most of your routine medical problems? ''- 2. Is your access to scheduled radio medical consultation satisfactory? 3. Does the Aero Medical emergency evacuation service operate to your satisfaction? 4. Have recent evacuations been satisfactory? 3/ .. 5. Do you consider the current routine medical clinics adequate? 6 • Have you any comments at all regarding the delivery of medical care? • ATTACHMENT 6 • ''- I -, \.• - ; .•··- . , . . ~ .. ·. • • • -i .:.-; .,' f~"'-;.<\~=:. ·7~\!-..:t-,--~~.;:_,!..\:-~: ~ ~ - ;<.... ~}~.:~~~~ ··. · ":·. • . - ... ~ ¥.• ADVERTISEMENT PUBLIC NOTICE The Minister for Health has established a Comi.t1ittee of Review to examine the provision of Aerial Medical Services south of Katherine and to make recommendations regarding the type and · level of services required. Submissions· in writing to the Corrmlittee are sought f:tom interested parties and should be sent to The Secretary Committee of Review Regional Health Office P.O. Box 721 ALICE SPRINGS NT 5750 to arrive by 31 May 1982. Telephone enquiries can be directed to Darwin 802510. ·. ,:;: :r.. - 1. -" •• ·: • u· - - .. --... ·tr·:-" .9 ;. : r· l. . · e,·: • ATTACHMENT 7 • '· ~ I ,, . ..;' / ·.,,. ~-?i. .. ' .. . ' .;--.t-' •:: "i •, •! I COf1MITTEE OF REVIEW - PROVISI0t.: OF .~.M.S. SER.VICES SOUTH OF KATH ER I ME I Submissions Received: CONSERVATION COMMISSION OF THE NORTHERN TERRITORY. P.O. BOX 1047, ALICE SPRINGS. TELEPHONE: 522 7 8 8. DR. R. PETERKIN HARTLEY MEDICAL CENTRE P.O. BOX 1194, ALICE SPRINGS TELEPHONE: 522991 AUSTRALIAN ORES & MINERALS LIMITED P.O. BOX 6049, PERTH W.A. 6000 TELEPHONE 3259822 DR. J.M.H. PEVIE 1 TRAEGER AVENUE, ALICE SPRINGS TELEPHONE 523842 " .• ·:"": DR. J. GRAY ,. LYAPPA MEDICAL SERVICE \. PAPUNYA, VIA ALICE SPRINGS > ' . TELEPHONE: 524466 MR. M.J. TILLEY P.O. BOX 1596, KATHERINE. URSULA WAUGH STERLING STATION, VIA ALICE SPRINGS WAYNE DICKSON HELICOPTER SUPPORT 3 WALLIS STREET, ALICE SPRINGS ST. JOHN AMBULANCE P.O. BOX 2609, ALICE SPRINGS TELEPHONE 525050 WESTERN MINING CORPORATION LIMITED P.O. BOX 57, ST. MARYS S.A. 5042 TELEPHONE 2769199 Conservation Commission of the N.T. Advice only as to expected development at Yulara Tourist Resort. Dr. Ross Peterkin 1. Holds fortnightly clinics at Ayers Rock using own aircraft. 2. Wishes to continue. 3. Happy with cooperation received from Department of Health. 4. Does not receive financial or material help from Department of Health. 5. Service incurs considerable loss. 6. Evacuates patients in o~n aircraft at no charge. 7. Wishes to be involved in discussions re any change in delivery of health care in this area. Australian Ores and Minerals Ltd. . ' No comments. Dr. J. Pevie Suggests that Doctor/Pilots may be able to supplement existing routine medical clinics with their own aircraft. Lyappa Medical Service, Papunya. Personal views of Dr. Jennifer Gray. 1. Suggests that charter aircraft be on stand-by when R.F.D.S. aircraft not available. 2. Suggests that relevant Government Departments be urged to upgrade airstrips to all weather standard where possible. 3. The numbers, locations, types, and availability of helicopters be studied. 4. Suggests that major coffitt1unities have helicopter 1anding arec1.s. 5. Comments thc1.t the A.M.S. are most helpful. 6. States there·is sometimes difficulty in communications at night. 7. States that it would be better if the patching system could be refined so a third party could talk to us directly. 8. Criticises two way radio system. 9. Complains of poor personal communication re referred patients in Alice Springs Hospital. 10. Happy with evacuations and repatriations through the A. M. S. John Tilley. 1. Sugges~s that the time is now right to position Cessna 402 type commercial aircraft in Tennant Creek to serve all needs of the town and district. 2. Tillair is prepared to look after Tennant Creek through Chartair at Alice Springs. 3. Suggests that the R.F.D.S operates one or two aircraft at Alice for evacuations only. Other medical work should be done by Chartair. ,, 4. Chartair intends upgrading services to· major communi ti·es. · 5. Feels that charter pilots are more experienced to undertake certain tasks than R.F.D.S. pilots. Ursula Waugh - Stirling Station Advice only - not now affected by service. Wayne Dickson. 1. Felt helicopter backup not sufficiently experienced. 2. Helicopter operations limited in summer. 3. Wished to be considered for future tenders. St. John Ambulance Service 1. Detailed suggestions re aircraft and equipment that should be carried. 2. Expresses strong criticism toward evacuations carried out by Tennant Creek Charter operator in Barkly area. 3. 1CbncerneJ re interference by illegal transmitters on HF network. 4. Does not believe ambulance officers are adequately used in air evacuations. f Western ~ining Corporation. Do not consider matter applicable to their operations. Aboriginal Health Organisation of South Australia. 1. Unhappy with patching system via St. Johns after hoursc 2. States there is undue delay in receiving Alice Springs Hospital discharge statements and other documents. Sister-in-Charge ,Health Clinic Areyonga. Only complaint is that transmission of medical memos, when received by an Aboriginal Health Worker, is not satisfactory. Alice Springs Town Council. Suggests that there should be formal landing area in the Town of Alice Springs for helicopters. \. Petrocarb Exploration N.L. Has redirectErlour enquiry - no result. D.A.A. 1. Concerned at the withdrawal of nursing sisters from remote Aboriginal communities. 2. Other matters mentioned appear to concern Health Department and other Government agencies, rather than the committee. / • .. ) ··' I ', ,;, V ;,, - /Q/ I, ''1,,l- . ·· . , .. I· ,.•. ·. :- ·-~' f • • '. .... • ATTACHMENT 8 . / i ~· ! ' . f ·~. !<-- '. ·~ :.<· -.: ~ ·-../;.. -:--"~.:=·; :~;·· -F~.. ~ .:_.. :-.~-::2 :\··L -~- ... , t f •. ----~i---~~ ~:~!-~...i=-~~~ ...~ ~ \iJ::.\(~_!& i~~;; ::._~ L. AVIl:.T ION QUEST IONS ANSWSRS TO QUEST ION l. YES NO 37 6 6 Comments re Question 1. 4 . Dissatisfied with Charter 5 Road used 8 Aircraft not always available 9 Aircraft not always available 14 Qualified 21 No airstrip 23 fielicopter only 26 Aircraft not always available 34 Daylight only 36 No airstrip 39 Use road transport 48 Claims only available to Aboriginals 49 Not always. ANS~SRS TO QUESTION 2. YES NO N/A 42 1 6 Comments re Question 2. 24 Qu&lified Outstation not fer 26 As for 24 30 Qualified Single engine or helicopter be better 34 Qualified One airstrip only. 43 Qualified. Emergency only due state of strip. 48 Road only available ANSWERS TO QUESTION 3. YES NO N/A 16 28 5 Comments re Question 3. 3 Baron no. due room/ access. Insufficient working for staff. 4 No evacuation capability of aircraft. 5 Difficult to load structure. 6 Difficult to load stretchers. 8 Aircraft usage restricted pilot? 9 Aircraft not suitable. 12 During wet only Helicopter ~uitable. 14 Limited space current aircraft. 24 Single engine desirable for outstation. 26 Requires properly equipped aircraf~-~ 30 Helicopter preferred. 31 Satisfactory. 32 Prefer S/E suitable 90% 34 Aircraft not suitable for outstation. 48 Too much emphasis on Aboriginal health care. COMMUNICATION QUESTIONNAIRE. ANSWERS TO QUESTION 1. YES NO N/A 42 5 2 Comments re Question 1. 8 Network should be set up in Barkly. 30 Problem with Aboriginal use of radio. 30 High frequency network not reliable. 38 Communications good 75% of time. 46 Problem with R.T. 48 Qualified. Not always satisfactory. 49 Qualified. Need improving at outstation. ANSWERS TO QUESTION 2. YES NO 42 3 Comments re Question 2. 1 Qualified. 5 Qualified. Normal use telephon·e 8 N/A query. 26 Alice Springs O.K. Tennant Creek not satisfactory. 34 Cannot com.rrmnica te with private doctor. 48 Qualified. Except out of working hours. ANSWERS TO QUESTION 3. YES NO N/A 14 32 3 Comm en ts re Question 3. 2 Use~ Rural Health O.K. 3 Qualified. A.H.W. use of radio ·--.. --- ~------~-,t:;:,.___ ----- ~ -~ - - ___,;____:.,_; · . m.k -- -11; 40 ------· I -- 4 R.F.D.S. O.K. Criticises B.o. frcqu2ncy. See answer to medical H.D. problem. 7 Query response time 8 N/A query. 1~ Good service phone and radio. 14 Communciation difficult. A.H.W. 's should have radios. 25 Problem with telephone availability. 26 Desires radio network to Tennant Creek A~ta. Query R.F.D.S ed/Springs. Lack of communication Health at Tennant Creek. 30 As for 1. Separate frequency. 34 Require updating. 37 Problem with Aboriginal interference. 41 Difficulty R.F.D.S. at night. Telephone preferable when available. 43 Qualified. Use telephone. 44 Not answered. 45 Very good service. 48 Not for Europeans. - ---·"' 32 Well serviced, appreciate emergency service. 35 Extremely happy with visits from Sisters. 36 Complimentary. Satisfactory. 39 Sa ts if acto ry. 40 Sisters satisfactory A.H.W. 'snot always available. Sy stem works. 44 Comolains re labelling of prescriptions and also delay of usually 3 weeks. Medical teams do not carry sufficient drugs. 45 Praise for R.F.D.S. care. 47 Very satisfactory. 48 Thin~s clinics staff should visit more often. 49 Fast communication should be available with aircraft a.tall times. MEDICAL QUESTIONNAIRE ANSWER TO QUESTION 1. YES NO 42 4 3 Comments re Question 1. 9 Refer answer not impressed. 12 Not alway~ need strong analgesic 14 Not ~nswer~d 44 Supplies insufficient for number of people on station. 45 Qualified. Need strong analgecis for pain. 48 Qualified. Medicine chest too basic. ANSWERS TO QUESTION 2. YES NO 40 3 6 Comments re Question 2. 5 Use road evacuations for past year. 9 N/A 14 Need more schedules 17 N/A 22 N/A 26 Alice Springs Yes, Tennant Creek No. 46 No answer 48 Qualified. Fair,accid2nts happen at other than sched. times. A1\fS\'·lE PS TO QUESTION 3 • YES NO N/A ------·-- 39 4 6: Comments re Question 3. 8 N/A 9 Due aircraft not readily availc1ble 17 N / l\. 24 Pr ~3 f :? , C n CC ~; l V C n t O Ab Or i CJ i. n al S 26 Not always 33 Consider tcomuch preference given to Aboriginals 34 Does not have 24 hour cover. Most of area not covered at all. 39 No, use road transport. 49 N/A ANSWERS TO QUESTION 4. YES NO N/A 33 3 13 Comments re Question 4. 4 Delay on one occasion. 6 Excellent 9 See answer 21 N/A 22 N/A 23 Use road 34 Had to drive 35 N/A 37 Due to communication problem. 39 N/A 42 Nil evacuations last 10 years. 43 No evacuations since 1979 47 Very satisfactory 48 None occurred ANSWERS TO QUESTION 5. YES NO N/A 40 3 6 Co~nents re Question 5. l Clinic not available 4 Health care could be improved if A.H.W. 1 s issued with radios. 6 9 I':ot ansv.rered 14 More routine clinics for. A.H.W. training. 21 N/A 26 But ·not frequently enough. 33 Qualified. Have little need. 34 They do not come to this property. 38 Do not participate. 41 Dont use clinics. 43 Qualified. 46 No answer 48 Qualified. ANSWERS TO QUESTION 6. YES NO N/A 27 20 2 Comments re Question 6. 1 Adequate and satisfactory. \... 2 . Good. 6 A.M.S. Staff excellent. 7 Good qualit~ pleasant courteous staff. () 9 Not answered. 14 Night evacuation policy, patient repats. More coordination with Q'ld and W.A. medical and hospital services. 16 Satisfactory. 18 Preference given to Aboriginals. 21 Happy with Rural Health Sisters. 22 As for 21 23 No aero med. Have to arrange own evacuations due to no sister available. 26 Prohlem with delivery time for Complain about no pharmacist at Tennant Creek. 28 Service excellent. 29 Good. 30 Query hospital admissions at weekends. 1..::, ,;: ·t, ATTACHMENT 9 ,t .. , . . . ~ . ,j . ... ~ ., .ll l:, .'. i :j \.. ( i i -· ;• \ - . ~'~ ... •t-, •• / .. • .. ·~ .. • • 7 :~ -~, ., -:=::1,,:::,~b~t'.f~'r t~!1trlti~t:ttJi}i~,i~~ · QUESTIONNAIRE AI RC RAF'l' : 1. Is the availability of aircraft to your satisfaction? e.g. Are they readily available to you from where they are currently based? Percentage Response: YES NO N/A 76% 12% 12% 2. Are the aircraft suitable to your area? e.g. Can they operate into your airstrip? Percentage Response: YES NO N/A 86% 2% 12% 3. Have you any other comments regarding the aircraft which you consider important? Percentage Response: YES NO N/A 33% 57% 10% QUESTIONNAIRE COMMUI'HCJ\T I00JS: 1. Is communication with the Aero Medical Service readily available to you? e.g. Is the quality of communication satisfactory? Percentage Response: YES NO N/A 86% 10% 4% 2 . Is the communica on with the Aero Medical Services suitable for your requirements? e.g. Can you communicate with appropriate medical staff? Percentage Response: YES NO N/A 8(:i % 6% 8% 3. HavP you any comment regarding communications at all? Percentage Response: YES NO 29% 65% 6% QUESTIONNAIRE MEDICAL 1. Do the facilities you have at your dispoial e.g. Medicine Chest, access to radio consultation, allow you to deal with most of yo~r routine medical problems? Percentage Response: YES NO 86% 8% 6% 2. Is your access to schedule radio medical consultation satisfactory? Percentage Response: YES NO 82% 6% 12% \. 3 • Does the Aero Medical Emergency evacuation service operate to your satisfaction? ~centage Response: YES NO N/A ( ( 80% 8% 12% 4. Have recent evacuations been satisfactory? Percentage Response: YES NO N/A 67% 6% 27% 5. Do you consider the current routine medical clinics adequate? Percentage Response: YES NO N/A 82% 6% 12% 6 . ~ave yov any comments at all regarding the delivery of medical care? Percentage Response: YES NO 55% 41% 4% (\ .··!l • ,h~ . ~.: ~· "!• ::n:r~:!~r: 'i!:' . i. ATTA°CI-IM.EN'r 1 0 • /:. \ ...... ·, \. I , . ~i '.::. .,.. ·.•· .. ·t _j. ·, a • .. .~ ... _...... i,{d,,i~1.°tf~'.;;tfl~::f::f~-~A ;:~4ht·,~~1J/J.:i.,;;J~:? 1/.IN!STER FOR HEAL TH. PO DOX 3146. DARWI~~. N.T 5794 TELEPHOt-lE 89 6233 PRESS RELEASE 4-96/82 9 July 1982 c rn Territory Department hos expanded a revie\y of ae riai iredical services it 1s conducting in the Territory south of Ka nnc. The Heal th Mjnister 01r TtL\.worth said todav GI1 .1ddi tional 78 stations rn the Katherine arc.:1 hoJ invited to p~iTti~ipatc in the survey. In , 58 s "'c.a t ions tJ1c Alice Springs district were sent qucs tionnaircs re l2.t to the aerial med service. '111.is was p0.rt of a 111~1icYr surwy which includcc.J mining companies> tour st opcr.:1tors, rur:l.L conn11Lu1i ties includ ;\bori ginal groups, ;md though there had been good response from the Barkly / Alice Springs " area, very little infonnat 1 \vas recei vecl from the Katherine district, Mr Tu~~orth said. Jn v1ew of this~, the cornm.i ttcc which was conducting the review was now seeking infonnJ.t ion inJividual st2tions. 111~ 81m of the rcvic'.Y\v is tc) collect up-to-d:itc datJ. from consumers of the air medical services. A :.tee hcadcc.l by the SccrC'tary for ilcal Dr Fleming,. ai1d including rc-pn:~sentations from the l{oyal Flying Doctor Service, tJ1e aviation and commu.nica tion indus t·:- i.cs) l1as been asked to recommend a program for on 1, .... / ~ /" I 1/!Q I11 ~he ;\lice \'.iO rk :.c :11 rcrJ.ft for t.}1c service. include 2nd ab1e to " a .i\c; r: :11. cc 1s c1v::i.::.J le and 1·:hcthcr .~ t is those 1·ou2s using aerial cal se:-\,·iccs h:ivc ~1de:quJ.te facili tics to o.l thcin to Jca: \-;i routine medical r: lcrns '.',::i1c: srncc t:i:c introduction or t1"1c lZoy~11 Flying Doctor :·nee: and ::.he cidvent. c'i" the 0lorthem Territory /\cri::il access to the more rcn:otc ~ire as of the TerT i toTy. scale a~rial mccli cal operations b2.sed on needs which existed i::1'thc past, but which r.q' no longer 2pply. . ' 1, • • ~ • ' • .,. .... ' . ; . r. ... , ,; r \, / .: r - ~ I ~; i AERO MEDICAL SERVICES Committee of Review Notes of Meeting in Alice Springs, August 5 - 6, 1982 Present: Dr K. Fleming (Chairman) Mr B. Lodge Mr H. Watts Mr L. Kempster Dr s. Hagley vice Dr A. Linuner Mr D. Miller vice Mr s . Calder Secretariat: Dr D. Anderson Mr P. Dossett Committee members given copies of the 17 replies received from the 78 letters sent to stations south of and around Katherine.· Evaluation of these replies appeared to demonstrate there was a communication problem suffered by most stations answering the questionnaire. \. Mr Kempster advised the Committee that he was impressed with the RFDS radio network operating from Alice Springs and that a similar network should be investigated for the Katherine. area, i.e. the RFDS be asked to set up such with Government assistance. Committee agreed that despite technological advances there is and would be a need for an HF radio network operating in rural areas for a number of years.in the future. Mr Kempster suggested the base for this network should be Katherine not Tennant Creek as this would assist in minimising interference from the Alice Springs area, particularly the very bad interference from the area south west of Alice Springs. Such a Katherine based radio net would improve communications throughout the area, particularly in the Barkly region. Mr J. Tilley met ,,1i th the Committee and re-inforced his views given in his submission to the Committee previously. Although he was critical of the need to have a .dedicated RFDS aircraft based in Katherine, his company was quite prepared and able to provide more than adequate aircraft cover; he welcomed the suggestion that an RFDS radio net be established there. He re-inforced the impression gained from the questionnaire replies i.e. communications were poor in the area. The Secretary to the Committee is to further circulate the stations in the Katherine area and endeavour to obtain a greater response to the questionnaire. 2 A draft report is to be produced for the Committee by the Secretariat and circulated to members before the Committee's next meeting in early October. I, . Anderson PD 9 August 1982 I '- -:~·. ~i.1~r,:. -~, 7~ ,: . . .:., \ ::,, _· l.. !. .\ ...; ....'", . . . ~ l ( I / ,· _.;~ :· 80/809 13 August 1982 Mr Cli Emerson Secretary N.T. Cattlemens Council 72 Cavenagh Street DARWIN NT 5790 Dear Cliff Please find attached copies of letter sent to· station owners questionnaire \ list of non-responding stations as at the beginning of '- this month. Your offer of assistance this morning to obtain on behalf of the Department an improved response to the questionnaire is very much appreci&ted. With many thanks. Yours sincerely C nderson istant Secretary - Planning and Development for SECRETARY FOR HEALTH Att: 1 ·~~·:::. l]~1~::n°}iiq;; 13 '~ ... •l· '!!![f ltlt ~':~~; ~ i, ·•• · :: •• · " ., ·: _.'._:·_);\Ct .> ... · ' ·· 1 - ·~.r~- ~··h l~.: ,·:··:··- r:· r p: ~~, . ,- ~, ,q., ·- -.J/·. •,\: ("·(. -1 ·-· • ,· . ,.'· 'i .. J 1: : ·.- 1 .. I. . . ,. .,• ~ '• ·,.I I'· ,. l' 4 :· .. ·~; ·: / MEMORANDUM: J'1EMBERS OF AMS COM.MI'l'TEE OF RLVIEh': 82/809 Please :ind attached for your info::-:nation: l Four maps of th.e Katherine, Tvrut2 n t Creek und Alice Springs Regions showing Map (1) stations and other respondents; number and position of ernerc3ency flights ex Alice Springs for the period ll/1/82 to 14/9/82. Also shows new boundary between l-,2 therine and Tennant Cr.-eck Reg ion'.3, ( thus ----) , 0.1 d LJoundary (thus X X :{) Map (2) pr1ncipal townc; ctnd ropuJ_ati.ons. No advice has been rec,,'ived as yet froi,, the Tourist. Commission concerning tourist numbers and movements. Map (3) centres having trained hc2lth staff, nu~ses or doctors Map ( 4) inc1 s Ler map to s-~lmc scale 2 estionnaire replies nwnbcr lB to SO Emergency flights recently undertaken (ll/7/82 to lil/9/82) from i\lice Springs numbered 107 2.s below: Mt Riddock -~/ :\yers Rock 10 Docker River 4 '--1,::;rvois Mine 1 P2punya 9 Ernabella 4 SA 1 ...., 'fuendumu J.. I i'·i t ca··vanag h l fJ"':.C)pia 4 Sandy Blight Indulkana ?.u SA fl.'i Tree 1 ":='re9on G SA JJ.rnicson J. Wl\ ;\1 ':. Javies WA t<::1pperby 3 Cr an i te 001.vns SA Mt. Ebenezer 5 L The :-::iles flown on t:.l1ese 107 flights were approx 28,000 miles. The miles flown on scheduled (routine medical) flights during the same ti~e were approx 9,000 miles. 2 The number of flyi!1q hours invol\'(;_( i.:l thcst: c:mergency flights \rlas 225 hours of which ~ ·,,:._:rt.:~ belie ter hours. The cost of those 107 cme·rgency f h ts WdS ,.l}.JI_)rox $52,000. The next meeting of the Committee i.s confirmed on 7 and 8 October, commencing at 1400 hour~~ on Thurs<.lay 7. Venue is the Conference Room, Alice Sprin~Js Bospit:.a.l. II I ·n. A. And er son SECRETARY TO COMMITTEE 2~/Septernber 1982 I \.. OR RSSPONDENT (t) i,s 0 0 0 {J. '7 (j 0 3s~ 0 .11 [] ~ 0 41Qi,,.?, 0"' ·----i·-· I 0 0 Q ALICE SPRINGS lj~R.1'1M'"1"""~ & 0 17/l,~ YONtr(l fil 0 O O ~ 0 0 L'"" K'uLf,r~ ..!t,.!1:.... ~ n( c~,.____;=~=------[8l ------aircraft not sati!:L1ctoc-y 0 all satisfactory u:J com;nunications not s;itisf.:ictory ~emergency flights ~ Relate to ~ medic~l facilities net satisfactory (number in red) Mt. Isa @ ~~ lI I • Ti::'l;e.r ! ! g ! 3orroloola 779 I I \~ I I'. ' t I l \ l I Tennant Creek 2806 e Ali-Kurung 844 I I• ~l I' I~ I I -- \1.. ___ e vu.en;..!umu • Uto,:iia 180 - l=?JO i 0 \ i H,1,18 •-~ Jluff Alice sorings. 19112 i I I \\ $ Santa Teresa 568 Ii \ ! ! i. I Docker Rive;: \ I !, \ . 230 fl Finke :22 5 I: L____ _ ·1·!,, ''I' .•.•...J) t: ~ ~Urnbakumba r:J Alyangula Angurugu 'ia.rralin Borroloola8 1. Wherel~Oappears (2J 0 ther~ .,,..a registe 0 Killarney I nurse(s) Victoria I i River I. 2. (o) 1doctor(s) 4. o - ~subsidised .Kitlkariii Beetaloo 0 agent" - manager's OWave Hill Malapunyah wife, teachers etc Elliott • Usually with some Daguragu first aid knowlecig •(Yiattie Creek) Newcastle• waters Walhallow• Lajamanu • (Hooi ~ ~l/Dental Clinic i Tennant .ireek ~~-1 ,.J Departmental Heal.t.'1 Cencre JI ILa L-----~, ! .,i Jworiginal Run Heal th Centre I 1,__ 1Mission/Council Health Centr :~BARKLY REGION ,1 i L t:} Independent Health Services I -1 \ Pastoral Property \ n All.-.U~ (Warrabri) ~--J- Willowra • I 0.turray Downs l_(Z)Neutral Lake Nash!Z) Stirling (;ii I Junction ALICE SPRINGS REGION I lllllt'l'i-Tri:e r·· Derrv Downs Ti-Tree .Station [Z ~ / · r'111 ------..IJI ~ I JAB l'uendu:r,u II '7- ' Tl·'I'ree r.J.Utoph (Urapu.ntj,J Co) LJMoun'C. r..llan (Nev,, ·2d!np) 1 0 r J [2'.JMount Swan N.c.pperby r7l 1 lLJ Alcoota i;, Baikal Papunya !Lyappai(O) i------..., __ ; . ) 0 : ,=;:;c.1-..A..c. (o Haa.sts Ellc,££8 :~:;;:;atakall!!A (") ., ,creek) (7: {•b_li.ce Springs v ·, ·. He=,.sburg.-; "- .d ------·· __ Areycnoc -----, --~ e,santa ?eresa c.J . I ,,. /------.. ----- I ~--, ,... 1..J.,rvvale r J [2'J I -.,__I . ~ _, I I Docker River I I L---1 I (Z)w;;unt i::benezer I I 4lJFinke (Apa tu la; ' e ~itjantjatja~A Homelands Medical Servi~A ,,----,~ ,------NORTHl:'.RN iE'.RRITORY. OF AUSTRALIA .. REGIONAuSATION MAP / (/ "'... m :~---'=-I 0 :t > C: . '" "'... ,. . T i. "' . ' > ,.. :::, ' 0 > S O U "'r H AUSTRALIA ~GIONAI. 90..NW!IES - SU3· REG!Cx-W. 90..t-OARiEs ·-·•• .. _ /' ' I. . ., . . · ' j , !· •' ,. \. / : .:' -. AGENDA 1. Summary to date - draft repo::_-t. 2. Response to questionnaires - Katherine Region. 3. Memorandum with maps and summary of 107 unscheduled evacuation flights (ll/8/72-14/9/82) cut of Alice Springs. 4. Review of Terms of Reference. * Fu net ions of Aerial :,1edical Services (needs and demands). (e.g. is road transport now an acceptable alter- native?). * Personnel required to meet needs and demands. * Source of personnel and contributions from various health agencies (e.g. R.F.D.S., Depart ment of Health, St. John l\mbulance Brigade, private sector, Independent Health Service etc.) * Equipment and facilities required and geographic deplo~nnen t. * Cost effectiveness of options. 5. Working Plan (appendix 2). PRESENT: MR. s . CALD:.:,f-:_ DR. A. MR. 0. v"ll\.TrI, 5 MR. L. K EI'.-1 p;; r-, Z·~ ~\ MR. B. LODGE 1 1 MR. p. DOSS :.: .~ '~ DR. D. ( S e c n~ t 2. ry ) DR. K. KIRKE (Chai r:nan.) APOLOGIT::S: DR. K. FLE:1r.c~ Agenda 1. Summary to d2te. The attention of the Cor'."cL'.i t t.ee was c:rawn to the draft report. Dr. Ander~on was commended for work done on that report. Agenda 2. Response to Questionnaires. T1,.,ro addi t io,1al re spc:,nscs c:ons ide red from Katherine Region. One very critical of absence of Routine Medical Visits. (Response numbered 51). Agenda 3. Yiaps su1nmarising information gathered date considered. Considered in some det3il. Errors in geography (exam?lc Sandy Bligtt) and in population (e.g. Yuendumu) pointed Ol.lt. Cormnittee well enough aware of geography ana popu:ation aggregations for these matters to be of little consequence. Responses to questionnaires taken in conjunction with map cn2 (l' revealed generally a high level of satisfaction with existing services out of Alice Springs, however, there is some dissatisfaction in the Katherine Region. The Cammi ttee discussed these proble1c:s at sorr.e length and agreed thac the absence of reliable communications was tne prime factor. There were some complaints about the aircraft in terms of availability, response-time and suitability, and also some critical comments about the frequency of medical and nursing visits. It seemed that the former were related to the nature of the private charter company providing the service and the latter, "in house" proble~s for the Depart ment of Health to solve. It was noted that in this latter case, adequate communications would prevent many of the problems. A list of 107 emergency lights out of Al.ice Springs over a period of two month::; (lJ/7/82 to 111/9/82) was re\·iewed. It was noted that these flights, wh i.c:1 included 3 5 hours of helicopter travel, cost the Dcparlrncnt of IIe21lth 21pprox. $1.857 per mile. (for interest it r,,.:o.s noted that at present rates road ambulances using·the same figures would cost $5.425 per mile). Agenda Item 4 .. The terms of reference at attachment l in the draft report were re·vicwed. (i) It was agreed that the demands made by consumers and the needs as seen by experts jo not always coincide. The point was also made tlw t t.hc onus [or maintenance of radios, aerials and air strips rests th the owner, and that an aerial med al service is not resf_X)nsible but can advise. The same ng applies to medical kits. The matter of discriminati,m, in that, Aerial Medical Services are sometimes accused of favouring Aboriginal persons, was discussed and it was agreed that statistics do not support this view. Some responses to questionna i Y."C"3 suggest ignorance of how the systein can be used in terms of availability of medical adv , frequency of medica~ visits, scheduled times for radio medical sessions, use of radio etc. etc. It was seen as a function of an aGrial medical service to provide this information to consumers. ( ii) There was discussion re R.F.D.S. having its own medical officers based in Alice Springs. The Committee felt it had not the expertise to make recommendations on this matter. It was agreed that a doctor, preferably a doctor expe-ienced in the local situa~ion, should be available for emergency calls 24 hours per day, and that one medically trained person, acting as the coordinator, must decide how an evacuation is to be conducted and who should act as the aerial attendant(s), if any. (iii) The matter of coordination was discussed further at some length and it was apparent to all that lack of coordination would produce misuse of resources, dupli cation and probably occasional catastrophes. It was seen that, in the Alice Springs area, the Department of Health, St. John Ambulance, R-F.D.S.1 Private Aerial Charter Companies, Private Doctors, Independent Health Services, and so on, all have~ part to play but must be coordinated. It was made clear, thus correcting an apparent misunderstanding, that under the current situation the R.F.D.S. is not responsible for despatching aircraft. Department of Health staff are responsible for deployment routinely and in response to emergencies. (iv) The Committee aqreed that ::.he ::::c::1Jnunications system based in Alice Springs (R.F.D.S. Base) is excellent anc1 that there a.re def icie:-1c: i c::; i_n t:'le cc)rr1.1uur.ica.tior1s system servicin~; the Katherine area by cc;,,p2rison. It w a s al s o f c l t: th a _t rr. 8 d i c <1 ~ l ·/ c q u i 9 p e c. 2 i r c r i:l : t , . dedicated solely for aerial r:;1·,'.'.~cal use, :Jroduced aO·vantagcs in tc~1~rns of reSi_JCJ:~se: time.. S2-::(;::..e e:1gioe aircraft could oc used in ,". r.c c2.ses a::C:: '1.'ould be cheaper per miJ.2. There was cliscu::;sion appro:,c n" services avaiLible to t.}112 growing ~ur:1l)cr of to:_1r.i.~.~_::; or~ 01.'I.1. =cc.:1C.s ...D... problem, wl1ic..:h has already cc 1-.:rred ar:d ,.:1ich could escalate, has a.risen becau.:;e c:::::ach er2.tors do not carry suitable; high freqJe:1c~. t::::-ansceivers to call £or help i:1 c,n l':r1.ergency. The concept of sub-regional 20ntres strategically placed throughout the area and whic'., wc,uld ccmprisc of an all-weather airstrip, reguL1~~1'.z' r.:aintainecl cormnunica- tions equipment, additional ~edical supplies and resident, trained personnel (e.g. Sisters, 1"\.mbuli:rncc Officers,Doctors, A.H.W. 's) was discussed and thought to be appropriate somewhere in the Victoria district on the Norttern Barkly Tableland and South West of Alice Springs probably at Ayers Rock. (v) Mr. Watts tabled a report covering the per mile cost of various organisation providing an Aerial Medical Service. A copy of this re9ort is appended, but, in summary, the all-up cost to the N.T. Government of the R.F.D.S. operation is around Sl.J per mile compared to other charter companies at 2round $1.9 per mile. The Committee discussed the costs of various aircraft types 1 whether waiting time was charged for and so on. GENERi\.L' COMMENTS COM.MUNICl\.TIONS: Poor communications systems in Katl18rin.e area reit2rated, possibility of using a small meg freque~cy to ccnduct radio medical sessions in Sub-Regions (refe~ to 4.~~ above), illegal use of R.F.D.S. frequencies in Alice Springs Region an increasing problem (attempts at control so far dismal failures), compilation and distribution of a looseleaf hand book covering basic information related to use of radios and aerial medical services generally recommended. The vast difference between controls exerted by Government over transport of passengers by air and transport of passengers by road brought up several times. AV Il\TI O'l Some corr.0 nc,nts were ITL,dc regarding tl:c i..::::;c o.r- si2:_ le engined helicopters. Consic~·:::n,c1 to be a usc,",11 c,~;tion b:x:::. hiqh cost, low speed, limited ran0e and capacity together with poor safety r:L1rc;ins (especially at night) ,ru:~t be ta n i:1to CCffiP a rcount- .L .. ..:JI. - rns~r'~~irnc_,_.._. L.Ll\_,.___.._,,) ,..,;) "apply Ln._.,_ sinn'1°~-_._~.':.) C c,n0ir~.... _;.,,,.,\.....- U--..i....\...,.i_~ir~-aFt ..... also; I.?.R. is legiti~ace for aeri2l work but nc,t charter, in-flight rnedic2l 21 ter:tion is irnpu:c;::iLJc:, due tc::; limited space, ge:-ierally chc0pET per mile t-: c,r: tw.in e:::gine aircraft and certainly much c~eurer than he:ico~ter. Thought to be appropriate in some ::::ircwnstances. One CorrLr:1ittee member believed "over se2~,7icing 11 cculd be a problem. In his review of recent 09cr~tions he felt there had been some patients evacuated unnecessarily a~J occasionally there seemed no need for a trained n~rse escort. It was pointed out how difficult it is durin·J a radic cc::sultation to be absolutely certain of a patient's ccnditio~ and e tendency is to err on the side of ~2tient safe~y rather than patient risk. A current trend is fur duty doctors to fly out to see patients with the intention of initiating treat ment and preventing hospitalisatior1. ~his reflects in no change or perhaps a slight increase in flights but this is more than offset by di~inished hospitalisation of patients. It is believed that AeriQl Medical Service'in the area considered would occupy around 2, SO O or more f 1:/ ins hours per year. After seven months of deliberation, discussion and research the following options are presented for the Miniter's consider ation. 1. An H.F. base (similar to the R.F.D.S. base station in Alice Springs) be established in Katherine to overcome the communication problems so e\·ident in that Region, and that the R.F.D.S. (Central Section)r, be asked to advise. They have the expL~tise and a proven track record of high quality operation. The base in Katherine would include an alarm system in order to provide 24 hours cover to the surrounding Region as does the set-up in Alice S9rings. It would be important to guard against illeg~l use of the emersency frequencies, emanating from Aboriginal communities South-West o~ Alice Springs. Such a base in Katherine could be so designed as to be available to most stations in the Alice Spri:1gs Region but suffer rniri:n;;l int-cr ference from that illegal use and thus be availabe if the Alice Springs base becomes jammed. A telephone call from Katherine to Alice Springs could initiate deployment of aircraft in an emergency in this situation. 2. The R.F.D.S. (Central Section) should be invited to operate services out of Katherine and Alice Springs and to cover Tennant Creek. This option is based on cost structure, needs expressed by consumers in the Katherine Region, the ability to provide dedicated, medically equipped aircraft on a 24 hours basis, public subscription and support (mostly from South Australia). 3 . The es tab 1 i sh men t o f sub - re c_d. on cd 11 st r a t e q i c 11 bas e s w i th ci 11 -w c c1 t he r a i rs t ri p ~ , h' e 1J r~ a i. n Lci in c d comrnunicationE-; systems ·to major centre~:; 4. A Handbook could be produced providing in~ormation to consumers in rurcil cireas in rcl~t n to availability of medical advice on a 24 hour sis, schcc:iulcs for r a a i o rn ed i ca l s es s ions , rout in,::. ff·::: d i ca 1 v .i s i t ~_.; e t c . , the use and maintenance o[ mcdicct1 chc:sts, basic first aid , requirements regard i n g an d n~a int en an c e o f co mm uni c - ations systems and airstrips, ni.ghL lonc1ing requirements,· etc. etc. 5 . That s in g 1 e engined a i r c r a ft c .:1 p ,:. ~) i 1 it y s l c1 be main - tained in both Alice SprinCJS .:inrl 1':(1thcrinc to be used as ·a more economical alternative Ctt the discretion of the Medical Coordinator of Aerial Medical Services in that particular area. 6 . Further attempts should be m~dc to reduce the illegal use of emergency frequencies Aboriginal communities to the South-West of Alice Spri :::., . 7. In view of the increasing number of tourists, legis lation regarding coaches being fitted with appropriate H.F. radio sets and drivers having current first-aid certificates is strongly recommended. (N.B. There was nil response to Questionn~ircs sent to Tourist operators indicating their negative attitude to this whole matter). ·"'·t:t···i'{, -· ~/r-t. r~ ·'i.;-. - :.; ... ?\. ·, , ...... , ..... · ! i : ·:.,.:, ,, ; ;! , .'::, f,;. i (" ·p. \. / ...... -.. I. .:,... . .?~.; ....I ' ~.1 . r - ...... _ .. PAU-E 1. U.bJ ::.:0T0 of the EEPUK'l' .. to study that area or operations by the Aerial Medical ;jervice extending :::-ram Katherine :3outh to the ~outh Australian norder-- a generally westernly direction to the wcatern Australian border and a geuera.lly easterly direction to the ~-~ueenslo.nd border. TO stud.Y the operations or, Tillair .t\atherine. Tennantair Tennunt vreek. vhartair Alice ;jprings. R.F.D.S. Alice ~prings Central Australian ttelicopters Alice :::;prings. with the view ot· determining where the economies can be errected. TO determine the e:t'riciency ot· the aircra!'t used i11 relation to . . their cost and to the particular service reQuired ror a given 1·1ight.· TO summarise the results ot' the tmrvey. TO make a submission on the ways a11d means or· e.tTecting a reduction in the cost o:r aerial transport to the 1~orthern ·1·erri tory vovern ment JJepartment of Health. PAGE 2. .cL lGH'l' TI M.h:o .. The time interval betvv"~:·:n ~ time ::vcrhe.acl thepoint ')f departrn:e to the time overhead o.t d•.:;\3+~L10.tion. ::een taken t~rom tl1e rnanufc:1c Ll1rers s ec L lc~.:1.tions then reduced by oduce i t time. lnc racl'C en time to joln circuit, L·irLG ,lnd t.:J.xi. TRACK. -·--- the rno.g11eti 1 '. earing or c:-i~: locatio:1. to a.uot:1.er. MILb.:~ ar~ statute miles The !'lights have been Btructured to show a common factor i.e. a price per mile. i-o achieve a cost per mile the distance fo1.~ each leg o:r every flight \ \.. has been measured, converted rrorn nautic:.:l1 miles to statute miles ahd then divided into the cor,t or the rlignt. 1•·or comparison or operatiom3 waiting time is included in the cost 01' the flight [.111d, therefore, the cost 1-1er :1·or determination of cor,t 11('.•· mile tor eontr'act i,u::'~~)or,es wa:L ting time \ 1.s been deducted ·rrom 1.he total co~: t l>i:~r:)I':;:' tne c~llcc_lation is made. T1.ke-off ~anding tirrr2 i'' tt1e di.t't'er.·en:;~~ octwe::.;n ~·lL .t time and the time shovm on thf; L1volces. PAG~ 3. T A s used has tJeen tri<; t' L vures quoted re 7·~1o and c omn rmed by cmq_u tres f'rom pi1oL) erat the aircraft type PAl.:r;<.; 4. CHARI' AH{ OPEHAT I ::,.:J December· rcr·a:t't \1se,J +' .. ,Jl' a tot·: 1 l TENNAI·n'AIR UPEHAT 1 OL,S. Partenavja ~ 68 b fli t:=:. ror a totu} overage [., .nths ,[.• 8 lb r .·~. c: .L ._, 1..),_-, J :.:.?;o 0 PAGE 5 18 fl:i ~,, ~'<)I' a tot:-;L J:.· rhe cost wa.J The average cost per· milP sc;so tniles ~he average overall cost 6C:.5% _ "::rcen tage t.::ital cost .'.:'or· PMVS • 82% ?~rcentage or total f{UY .A_IJ ~1L)'ING nocrco1{ (~F~r:~~,,-1:,;E. ------. The per~od rcviH~ed w33 t~c month of uctubcr lScl but the average r "l"' c;_;, r::b :'uary 1§82. J.Juring uctUher 7'."., f'lj rhU, -,-;ere flown. ,~.,Cl,.--, t::i. ~he total ~ours flown fl/',_,'·,_, J68hrs fA m1ns. Total i'liec:ht time was l5C:hrs j 4 mins. r. A diff'E::r~ncc betw ;en U e '.'fiO ot' lCJ: ~'S -.:~v mins. Duri.ng the performance of the 73 f'li ht0 173 ta.Ke-o.t't's a.Ld 1?3 landingr were carried out. PAG.1:<; 6 • .tWYAL l<'L'{ 11,(1 DOCTOR SBffC'} '; 1,:. ( ,.:ont. ,' ..-.... 'l'hi f: si ve::-· a tuke-rHT und l·:tnding tirn(: '. J 3. lo rdns perun t. - Tri,~ ·hour:.· ~)'ND arc Cl t t "." rate 0 t" ,:S 1 · _,: l i.i::.s ·· ,, L (-'! ,51.:~. 60 Th A fixec'J ~::Jr; ts are C }-; fl Y) r:-r) ,-J at il-i h o u r L.'! rate or ..• ··. ;.{l ::. .• ,,,_· i.· ·-1,1.s lC;'lo of the 1 1 f'1'Xf'r]"- _,,._. C •) ~ ·1·,, µ...... _.,11r:llr'· f .• 11 I L f'. ;61716;?, ··:·c ttl, ·· - , -;)Wur:.c; ', ...;,,,a::·ds the cost of' bas,:: radio ; 1nd AdJr: i ni E tr•:: t:, ion etc. Dic,tar_ce t:·avelJeci i'or U:'.:, month 'f,'.H' lbl. 1~ N1. P. H Ave-n:.1.ge I.ii.!. C[~ f'lown ovc,r ; , r::onths Average mi]Rage cost il~G ~ivided by ltl.lS MPH .6954 cents Average !'ix.ea costs ;51.1;-:;()() divided by 1::~~:. c hom·2 1;er· :nonth ,illO. 5955 per hour. ~11C.5Y55 divided by lEl.18 ~.P.H • 6103 cent/mfl · . '- Therei-ore uverage coBt per- mile = • fr~-; ,-1. hlO;:; = $1. 3057 Thi~; equal to ,t.2"30. 58 J;;erhr. tlb2. .H. rv1. irs 1;ercentage of t.,Jt,,J.l costs 25.97% The invoicing, rl.ig}:t ti:11c.,, cost..LLe :.::,:~ i.:8:lic:.:il ·_,ci:2.ils u_ppertain- ing to tr-:e ;·light::, wec·e c~)1q,leteJy 1· -~ j_:,Ll.:.'.:. ::;pot chec.t<:s on rnontr,c, not ro viewed c .rn ~·:i r·i,,,!d t L,) ,:i1; ov,::; I':! liability PAGE 7. ·1•0 obtain ~l r:omplete r·evic;v: ot· the v<,,' o:: t-<.. P. D. S operations to the r,orthern Territory JJepartm:;;nt of' Heal th :1 re view or their total aper- ations was rruide. The contract arrangements [:Lown above riePe given oy ti-1.e Department of' Heal th, Darwin. They were reviewed during i..·<~1Jruary l';.;.8~ .. ~.x1d have remuined stationary :;ince that date. rhat, in SJ.i te of increaset, in many cor;t :·£let.ors. ~he contract arrangements are divided i~tJ two parts. A. 0tatic charges H. ttourly charges. 0tatic charges Im,, LU' anc e p~,11 .... Lvrno·o per ,'/ear LJepr·_:c iati on ;:;b[,500 Air navigation charges ;i ~125 Pilot tmlary ,57 ~~000 T Vl'AL ~1716:25 ~o be paid per month ,.5].<:1,300 Hourly costs J.<'Uel ,6~0000 1v1a intenanc e ,6Z,6COO .l!;ngines t86000 TOTAL r1ourly clrnrges. emial t:J t,cased ~-m 12cc \o .rs fl., i ?AGE 8. uU: AL ------ v l ··· 1 6'.J lC;\: of' A. e1rr1ountE. per· z~::ir to p ~ I -'- t.._, of flown --····- 'J. ver.age , ,_,! l _; )C_, ., ')'l = 1 ~ i ei· year \_, µ ... , .. \, .; \ .L" ;5'19530 ;636692 Oper2tic~uJ LlOSts. _il52CCO ;;:S583C8 l \ ,.... }wrter stuncruy pj lot u workers vxnpensation Ho1ic1:Jy pay v 1 r: ~ 3 r: 8 fJ-UO <.) ;.'572CCC ,.,' r7 n ,·, c.. of 1JS:CCCC pi Ot:. ...,-1._: cost of h'.. w. D. a operut.o::·,: to i-.ort}'.er·n Tc~··r-i tor:; uc,v0rnJ:1ent ~4-0,3617 Theret'ore t·ederal Govecnm.cnt sub2 i dy c i_uals GEl\l'l'HAL AU:.:i'l'HALL\J.\I H::<~1,1 c OPTEH::i Heview ~cr·lad coverc and J anc11 :'., 1G82. .p-, . t 1.VO l J J t,; : l'I O. l n •"") P l\/1...... e ;:. ~ 1. Average cost Ller mile by the ·1·enderfo Board reveul the f ollov, l ccr~tr~ pe.1· rni le. t.,;hortair t' 6 8 tJ d1 G(·,N ·1·ennanta1r P 68 u P~•..... I pv'l ....G'-s, '-' v'l '·0 .. , •.., y.; • t 'i!~_J ;_:;.. { • ·, 'l i--. "":. =-! .,·: ,. d' .. · .. • ~ • I /. 'i - ,, . '!" '! \. -'! ;;,..• - , I •• t . . ·- ·-:- ,:.:. \l.i ,;.··-• \"I ·:, r;-~ ~::.: ;. ! £:: j ...... -· ~t<~ ,• . , -·~.. :·i~~tf-";J,. ,1) ,_.>-\ _.'t;::'~/~tt'i1~;_;1;l;.;}:f,/~~~t·ttbl~l~i,i·:;~;: ~\}}: ii{~i; ~. 82/809 :)r K. Fle:ming, Dr K. r::irke; Mr L. Kerc~:s:.1.:or; Mr H. Wat::.s, :-1r P. Dosset· ?.E: AMS COMMITTEE OF R~:VIEW Subsequent to the Committee's last meeting I received the following inforrnati'.Jn from the }Jorthern Ter-ritory Tourist Cominission. l\VERl\CE Dfl.ILY TOURIST POPULATION JI.';' f-1/\IN NON-URBAN TOURIST AREAS: * Avers Rock (Uluru :,Jational Park) 1980/81 217 * Mataranka 19 81 219 * Finke Gorge National Park 1981 60 * Ormiston Gorge National Park 1981 137 * Kakadu 1980 233 DESERT SAFARIS * This is extremely difficult to even roughly assess, however, W'i th the co-operation of the larger companies operating into ~hecie areas, I have arrived at an aggregate figure of approximately 10,000 for 1981. The peak times for this movement would certainly be restricted to the months of June/ Sentembsr. However, it should be stressed that the data is not definitive and is subj2ct to variation. I/. rl).&(~L. ~ ... /"' >,,.:, .. ~ I"\\..... l. ~,,.~ ~ _7~:~erson -~~.1.i::::c.dry to Committee 10 November 1982