Deb Jones says her experience as a Royal Darwin Hospital (RDH) patient was one of the worst of her life.
In severe pain from a chronic health condition, the disability pensioner was last month wheeled into a cubicle in the hospital’s emergency department.
It was there that she would spend the next two days, unable to sleep, sharing a one-person room with another patient.
“[The other patient] couldn’t get out of her bed to go to the toilet, so every time she had to go to the toilet, I had to leave the room,” Ms Jones said.
“I was hooked up to machines, I’d had a blood transfusion, I’d had an iron infusion, and all that had to be disconnected so I could leave the room.”
Ms Jones said her single cubicle was one of many holding two patients.
“Every room … was double-bunked, there was no segregation,” she said.
“It’s horrible, because you’re having this personal conversation about your personal health [with a doctor], and someone else is listening.
“It’s just a total invasion of privacy.”
‘Bursting at the seams’
RDH is the Northern Territory’s biggest and busiest hospital.
The chief executive of the NT Health Department, Marco Briceno, said RDH was currently operating in “emergency management-type conditions”, leading to experiences such as Ms Jones’s.
“You could even call it disaster services,” he said.
It’s a situation the NT secretary of the Australian Salaried Medical Officers’ Federation, John Zorbas, said had become too familiar for staff.
“The truth is we’ve normalised disaster,” he said.
“[In] the emergency department, you’ll often see … two people in one [cubicle] — a practice called double-bunking – [and] long wait times for surgeries.”
“Everything is just bursting at the seams.”
NT Health has overspent its budget every financial year since 2016-17, including an almost $200 million blowout in 2023-24, leading to Chief Minister Eva Lawler putting executives on notice.
The hospital has also experienced high staff turnover rates for years.
“We’re seeing more and more people who just aren’t able to get the job satisfaction and deliver the patient care that they want to, in the system that they’re currently working in,” Dr Zorbas said.
RDH’s inability to function properly can be seen in its recent history of code yellows.
A code yellow is called when an internal emergency impacts a hospital’s service delivery.
RDH called its first code yellow — ever — in 2018.
Last financial year, there were 18.
Aged care patients blocking access
Dr Briceno said the main reason behind the code yellows at RDH was an inability of services to meet increasing levels of demand — otherwise known as access block.
“We then have to rationalise services [and] compromise on … priorities,” he said.
The first thing compromised on is usually elective surgery.
In 2022-23, the NT had the longest overdue elective surgery wait time of any jurisdiction, at 391 days, with only 69 per cent of patients admitted within a clinically recommended time.
The hospital’s service ability is restricted, in part, because up to 70 beds are permanently taken by people unable to access residential aged care, most of which live in RDH’s Palmerston campus.
“If those [aged care] patients could be receiving care [in a residential aged care facility], those extra 50, or 60, or 70 [hospital] beds could be utilised for what they are intended for,” Dr Briceno said.
The underfunding of aged care in the NT, Dr Zorbas said, was the biggest factor impacting overcrowding and access block at RDH.
“When 15 per cent of your acute beds are not being used for acute care, that leads to a situation where you can’t actually provide business as usual,” he said.
“[A new aged care facility] needs to come yesterday.”
A licence for a facility with 110 extra NT aged care beds was allocated by the Commonwealth in 2021, but has not yet been built.
In the 2024-25 budget, the NT government allocated $12 million for a proposed new 120-bed aged care centre in Palmerston.
It has also committed to building a new 32-bed multi-purpose ward at RDH.
Primary health care struggling to relieve pressure
On top of issues with aged care, health experts say RDH is struggling to meet demand because Territorians are sicker than people in other jurisdictions and have more preventable conditions.
Dr Zorbas said better resourcing of community-controlled health organisations could ease the burden on RDH.
Rob McPhee, the chief executive of Darwin-based Indigenous health service Danila Dilba, said his organisation was underfunded by $60 million a year.
“That’s a conservative estimate of the sort of funding that we need to close the gap we’re currently facing,” he said.
“Seventy to 95 per cent of clients … have some form of chronic disease.
“At the moment, it takes two to three weeks for a client to get an appointment with one of our GPs.”
Mr McPhee said if primary health care was better funded, then hospitals, including RDH, wouldn’t be under so much pressure.
“The system is designed [so] that when you first become unwell or you don’t feel great, you go to your doctor, and Aboriginal medical services are part of that first step,” he said.
“If we’re not funded properly, and it’s three weeks to get an appointment with a doctor, it just goes to show that we’re then not picking up on those issues early.
“Inevitably, they’ll become sicker, they’ll present to our clinics, and there’s not much we can do, because they need to present a hospital because [it’s] an urgent issue.”
Dr Zorbas said with people in the territory desperately needing the best possible care, solutions needed to be enacted “today”.
“I think we’re running out of time to fix this problem,” he said.