Health services

I have nothing but praise for any health service I’ve ever encountered. The hospitals I’ve been in, the doctors I’ve dealt with, the GPs I’ve gone to, they’ve all been wonderful, and I think that Australia is blessed with its health services. I have greatest respect for medical profession. And many of the friends I went through university with have become doctors and I have great respect for them as well. I have never been badly treated, I have never suffered prejudice, I think that I can only say what I’ve already said, that I’ve been well treated, and I appreciate it.

I would think we’re very well covered here, we have good doctors and other medical facilities like physiotherapists and chiropractors and that. This exercise group, virtually in the inner west there’s everything that you could ever wish for, really, without going a great distance which is where – it was an area of Sydney I’d never been to in my growing up and when I came here, and I hadn’t realised just how wonderful an area it was. Everything is here that you need, you’ve got the land, you’ve got the water around you, you’ve got good parks, you’ve got good shopping, good medical, teeth, the lot. Oh yes, I’ve got a particularly good doctor and she explains and she listens, I saw her yesterday and I normally go along with a sheet, which has problem one, problem two, problem three, what I’ve done to correct whatever’s bothering me, and then we walk through it and talk about it.

The hospital in the home was wonderful. Those nurses came every day to give me this jolly antibiotic thing. I had that for about two weeks I think. First of all they started off twice a day and then it was once a day, yeah, they used to come first thing in the morning, I’d have to be up and have the front door open for them to come at seven in the morning and then they came at seven at night, well that was better than me sitting marking time in the hospital wasn’t it you see, it’s a great service, they came, I had the drip in the arm. So look, as I say old age you’ve just got to try and manage it I think and you’ve got to learn to accept, you can’t do anything about it, it’s just that you’ve had the privilege to be here all this time, I reckon every day is a bonus, if you’re well.

The only thing I can say about the health care, I’ve had to deal mainly with my local GP and the hospital, and I couldn’t speak more highly in general of either. The attention that I’ve had from the doctors plus from the hospitals, absolutely magnificent, but here again I find that, you know, people say “Why do you go to [that] hospital? [That] hospital, you know, they’ve had trouble.” but I think with the people that go it’s all a matter of attitude. If you go in expecting that someone is going to be standing alongside of your bed 24 hours a day ready for your call, you’re not going to get it and then you’ll probably be bloody disappointed but you’ve got to remember that, you know, they have more patients, these days there seems to be one to four, you’ve got one nurse four patients, and things like that. Well, a person if they’re attending to one they can’t drop, come to you straight away, might take them a few minutes to get to you but in general with the staff whether it be cleaners, nurses, doctors I find that it’s absolutely the attention you get is good, very good, no trouble whatsoever with them. I couldn’t speak more highly of my experience and my wife will say the same thing.

Shirley: Brian was paralysed and couldn’t move at all and I had to feed him. The nurses didn’t have much time and they’re pretty busy. Sometimes they’d just leave the food there but, of course, he couldn’t touch it and then they’d take it away again and he wouldn’t have had anything to eat. Eventually I went to see the administrator for the care of patients and complained, but every day I’d go in and feed him at least once a day I made sure he got a meal. Then I’d have to clean his teeth and do all the things he couldn’t do for himself, comb his hair and I just had to do it, someone had to do it. And that way I encouraged him to hang in there because the doctors said to me he’s liable to go at any time.

Brian: But I didn’t!

Shirley: And so they didn’t expect him to survive. The nurses…

Brian: They’re very good, they do an excellent job but they’re confined by too much work for one person.

Shirley: Intensive care nurses are very loving. They really looked after Brian. He had one-on-one in intensive care. The nurses would throw butterfly kisses at him, and things like that, tease him, and run their fingers through his hair because he couldn’t hear or know or didn’t, but I’m sure he felt the love and care.

Lois: The people in the hospital are very kind, you know, if they think you’ve been there for a while they say “What about a cup of tea or a cup of coffee and a slice of cake or some biscuits to eat?” They’re very kind, they don’t leave you sitting there all day.

Charles: Except once.

Lois: Oh once, oh yes, that was.

Charles: She had to go in to outpatients and it was before it got to the stage where I had to go too. She went in and she had an appointment at 10 o’clock in the morning, 6 o’clock at night she was still there.

Lois: The waiting room was deserted and I was sitting right down there.

Charles: Finally, one of the nurses came over and said “What are you here for?” and she told them she said “Hold on.” She went away, came back she said “You shouldn’t be here it was someone else they sent you her place and called you in but it’s not your appointment at all.” So she’d been there all day and that was why she was sitting there because they’d made a mistake.

Lois: Oh well, these things happen, my turn…

Charles: That was an interesting one.

Lois: Apart from that, well they’re very very good. You hear people say “[that] hospital, don’t go there” but that’s not right.

Val: Yeah, we have been lucky. Just little things I don’t like, for example we go to a clinic where there are quite a few doctors and we’ve nominated one of them who took us but to see her, we have to ring up at eight o’clock in the morning to make an appointment and everyone has to do that so that when you ring, it’s always engaged and when you finally get there, there’s no way that day, it’s got to be the next day so you’ve really got to be almost dying to get in.

Austin: That’s a bit hard darling. If you’re really ill, you can ring up anybody in that mob and they’ll see you.

Val: That’s right, you don’t see your doctor.

Austin: No.

The most infuriating thing I find is that it’s impossible to get an appointment with our doctor. And I mean I have got – it’s well controlled – but I have got high blood pressure, but it’s well controlled and I’m not on a lot of medication for it. And even when I go to get a new script, he doesn’t even take my blood pressure, which I really wonder about, but anyway. Yes, you could get an appointment. If you rang up at half past eight in the morning, but you had to ring for an urgent appointment, and that has really riled me for some years because I think, you know, yes I might be sick but it’s not really that urgent and if I’ve got to ring-up and take one of those appointments, where does this leave other people who it’s really urgent? And that’s the only way you could get in to see him.

You can’t separate emotional from physical. Because, the physicality of a disease, or of an illness impacts on your feeling about how you’re coping or how you see yourself. And when you’re ill, predominantly you see yourself as vulnerable, and, the questions are about, when they’re serious illnesses, and you’re like me, who’s been very independent, what the medical profession actually asks you to do is to give our entire body over to them to sort out the problems, and that requires a fair bit of trust. If there is no existing relationship, perhaps they’re a specialist who’s come through your life for a very short period of time, you haven’t had a chance to establish any trust. So, the anxiety and the concern about whether this is survivable or what are going to be the long term impacts on illness and disease, impact on your mental health.

But when individual sits down in front of them, they’re going to be just as confused as the patient is until they find what the linkages are. The more intelligence you can get from the patient, the more successful the doctor is. Until the doctor recognises that fact and recognises that a relationship can’t be created in a ten minute span of time, you probably will build up that relationship, maybe over 12 months. I actually think that the system that we have, particularly in the general practice area where you have clinics with multiple doctors, and you have maybe a practice manager and nurses out the front who control the appointments, and some of the- so, the issue of modern practices where you have practice managers and nurses who are managing the appointment books, some of the issues are that, particularly a senior, may get an entirely different doctor every time they go to that practice. So, the success of that clinic in looking after that patient is going to be the doctor’s notes. The question that I would ask is does that create the relationship necessary to extract information from the client sitting in front of them. I think that it’s like trying to do medicine, which is an extremely important and valuable service to the community, it’s like trying to be a doctor with one arm tied behind your back.

One day I just kind of yelled at a nurse – well I didn’t yell – “For goodness sake, I’m still at work. I’m not an imbecile,” but I found that once you’re over 65; and some doctors, not all, but even my own specialist. Every time I saw him, it was like, “Be careful, don’t fall over.” It was like I was being; and did I bring somebody with me? Did I bring somebody with me? Does everyone over 65 have to have somebody with them because they’re not able to communicate? There were a couple of things I found were quite, yeah; I didn’t like them at all. They were quite daunting, how you were treated because of your age. I was in two hospitals, two different ones and it was the same in both. The second time around at the same hospital, when I had the second one done they were a bit different because they realised, when the girl came in the morning and said, “We need to get you up for a shower,” I said, “I’ve already been up.” She said, “What, have you had a shower?” I went, “Yes.” She said, “Well, how did you do that?” I said, “Well, I got out of bed and pushed the walking frame across to the shower and had a shower.” “Oh, oh.” So there’s a misconception. People should be treated for what they are, not what their age is. That’s the secret. I mean, someone at 65 is probably old. Some people at 65 aren’t old and some people at 50 are old, but it is a perception, especially in the medical profession, I’ve found, that you’re looked at as “age”, not “person”. Even on Monday, I had to see a doctor with this chest, because it got a little bit too much, and I’d never seen him before and he’s reading through my record and he started to laugh. I said to him, “Is there something funny up there?” He said, “No. I’ve never seen a healthy report of someone you’re age.” So that was sort of like, you know, they don’t expect people to be healthy. They expect you to be starting here “And you’re on no drugs whatsoever?” I went, “No,” and, “You don’t have sugar or cholesterol or any of those things?” I went, “No.” So there is that misconception that we’re all the same. You get to 65 and you all become tarred with the one brush, basically. That’s the way I see it. I’ve heard that from a few other older people as well.

How did that make you feel?

Angry, actually. Not being seen for who I was but being seen for what I was, as in age; as a number. To treat them as a person first, not as an old person but as a person first. Continually not calling them, “love,” and “darling,” and “sweetie,” like they do. I think that’s demeaning personally. It’s a personal thing with me because I saw it happen to my mum in the nursing home and I know how much she hated it. I also think that they need to understand that they’re not just old, they’re a person with memories and a life and not talk down to them. I think that’s the thing. That’s the word. Not talk down to them because it does happen. By the time I’d got through to my second hip, my specialist was a very different man than he was when I had my first one done. By the time I got to the second one, he never asked did I bring anybody with me or he wasn’t as over-protective. I think that they’re doing their job but if you’re looking at a piece of paper and you think, “Oh 70, right, okay,” well you have a mental picture of a 70 year old’s capabilities and I think that’s something that has to change. People have got to be taken for who they are and not their age.

Val: The private, the hospital itself, I’m talking about the medical service. The hospital itself, we’ve always been to this private hospital. Or you’ve been down to Adelaide once where they didn’t do the operation here and that was all arranged very well.

Austin: I was looked after wonderfully by half a dozen lovely nurses who called me “Darling” and said “Love” and kept fussing over me and I lapped it up, wonderful. “Do you want a cup of tea, Love?”, “Can I move you here, Love?”

Val: But the local private hospital gave us good attention for the things we’ve been there for and our GP service is quite good too.

Austin: It’s pretty good. We’ve got good doctors I think.

S – One-on-one of course is the best possible situation but to find out more about what the patient needs is much needed. In the other ward they usually don’t go down to that ward until they’re pretty able to care for themselves to some degree, but Brian couldn’t even get out of bed to go to the toilet, and the matron was saying, “Look you’re down here, you should be up on your feet by now. You should be able to go to the bathroom by yourself”, and she didn’t look to see just what condition he was in, and she was really lording it over him and he’s cringing back.
B – That was only one incident.
S – Yeah I know, but it really upset me because I thought he’s come out of intensive care, here he is down in the ward and he can’t even walk! Anyway.
B – She had the wrong information that’s all.
S – Well it’s not right.
B – That’s another thing with the hospital and the care especially with aged people is lack of communication, especially in diets.
S – Especially diets.
B – They do have a good system with diets and they have dieticians that will come and see and evaluate and do everything. The last time I was in hospital I was fed through a tube for almost four months so I didn’t have a meal. When they got me off the intravenous feeding and to be able to eat myself, sometimes the communication between the dietician and the kitchen and the communication between the doctors and the nurses sometimes broke down. I wrote a little paper when I was leaving the hospital the last time to what could be improved with their services. One of the main things was communication between the patients and the care staff, whatever role they were keeping. So that’s a big thing.29:23
Q – Did you feel that that was taken on board?
B – Yes, yes, yes I do.
Q – So you felt you were heard in the system?
B – Yes I did, and they really valued that actually, the people in administration and the head of the nursing staff, they really valued that. So I believe it was taken on board and hopefully in the future there’ll be a better system. So I’ve had quite a bit of experience in hospitals!
S – More than he needed.
B – A lot more than I needed, but fortunately now I’m quite – not back to fully fitness of course but I still have two bags, fistula bags to drain the excess fluid from my bowels, they’re going to heal up on their own, that’s what the specialists have told me. So I’m waiting, and waiting for that day to happen so I can go back to playing golf and fishing.

A: When I’ve gone to my local doctor which is rare, because luckily I’ve got good health otherwise, yeah he sort of sends me off to different things.
Q: So have you discussed it [memory issues] with him?
A: Yes, yeah and it’s advisable for me to take somebody with me when I go because a few months ago when I went to the doctor and came home my daughter rang and said “What did he say?” and I said “Oh I don’t know, I’ve forgotten”. See, I forgot. So from now on she always comes to the doctor with me and he knows that. I’d forgotten most of what he said when I got home. It sort of goes in and out. Things like that.

A: Yeah but that tells me in there, somewhere in there to ring them up Thursday to verify it, which I did. The nurse I spoke to said it’s been cancelled til the 29th, and they said “Oh hang on a minute”, she said “I’ll ring you back in a minute”. So her minute was about three quarters of an hour, she said you don’t have the operation, the anaesthetist said “No”.
Q: What do you want to happen Jack?
A: Now today the one I rang and spoke to today said the anaesthetist said “Yes”, so I don’t know what they’re doing. Well I’m not sure actually I mean if I have it it’s going to kill me sooner or later, I know this. Then again if I haven’t I could still be dead anyhow, so I was convinced to have the operation, now I’m just not quite sure what I’m going to do.

No, if I want to see a specialist, they will say when would you like it, I said what’s public, they say probably 12 months, eight months. I said I’m private. He said next week; that’s the difference. You want next week, fix you up Earl? No problems. Do you want to go private [public]? Wait. I don’t want to wait. I want it there and then. I pay a high premium, but I don’t have to pay for anything, there are no gaps, no gap, and I get 10 free ones a year, physiotherapy – no charge; they’re around $60. I get the physiotherapy to get the mucus off my lungs; that brings them up, yeah that’s free because I pay a high premium yeah. I pay for it but I get results.

A: There’s a bit of a hassle up here [Northern Territory], like trying to get into see any specialists, and what I – just as an aside what I am looking at at the moment, I run out of breath quickly and the registrar at the cardiac [clinic] told me that my ingoing ventricle of the heart is okay, but the other one’s pumping slowly, the outgoing. A friend of mine’s got that condition and he’s just had a pacemaker installed, but for me to pursue that matter down the line it would take a long long time, it puts you off trying to get something done. Yeah to see anybody, like I’ve got tired of the public system and I’ve gone to the private, I’m seeing a back doctor next month, I’ve had to wait about three months for him to come up from Adelaide. Then if he does recommend something for me it will probably be months and months before that’s implemented. It’s just – you just feel like you’re living in a backwater because you can’t get any professional services, they take so long.
Q: And that’s specifically an NT or a Darwin issue do you think?
A: Yes they have trouble attracting the doctors and then there’s quite a few specialists come up here for short-term, you know quickies, a couple of days or something once a month. But it’s very hard to get in to see them, and you just get tired of the fact that you’ve got something wrong with you and you have to wait darn near 12 months before it’s fixed up. So that’s my main issue with health services up here.

A: It’s what they call the PATS system. It’s the Patient Assisted Travel Scheme and if you can’t get treatment up here, mostly for cardiac and for oncology services, they send you south. It’s probably a little bit difficult. In my case, they were going to send me to Adelaide and I don’t know anybody in Adelaide so I chose to go back to Albury where I came from originally all those years ago because I had somewhere to stay for three and a half months and that was a lot better than being isolated in a place that I didn’t know anybody. That’s alleviated now because of the new Oncology Unit. I can’t comment on the cardiac thing. I think probably I’d still have to go south for major heart surgery.11:52
Q: I think we’re quite unique in Australia, in that there is quite a lot of travel for specialist services.
A: Yes, particularly in remote areas like this.
Q: Can you reflect on what that feels like to be moved around in times of crisis and to not have that support network that you would normally have with family and friends? In your case, you chose somewhere alternative.
A: Well when my wife went south, I went with her, both for her surgery and for her radiation. The chemo was done up here. That was okay but, really, if you choose to live in an isolated area, then the old tyranny of distance is very applicable. I mean, nobody twists your arm to live in a place like this. It’s our own volition and I think we’ve got to accept that you can’t have everything that they’ve got in big cities and I’m more than happy with the services we got both from my wife’s point of view and from mine.

Q: It sounds like there needs to be a meshing of services so there’s not just the Balanda [White people] bringing in the aged care service it’s doing that in a Yolngu way?
A: To make that older person happy and to feel that she’s getting both ways of support and then she’ll get, even though, for example, if I get sick here no one’s looking after me and they are taking me away, all we need to do is to talk to the family members and say “Look we have to provide her a house or something you must go and visit her, singing, visit her, make her comfortable, support her and say that I’ve got culture here, you’ve got still culture here, we’ve got to bring you out to sing song or we can bring your painting and you tell us and you’ll write story.” Something like that will make us- you know.
Q: It sounds like quite an easy thing to do and a logical thing where you have the medical care and the Yolngu way of caring for older people but that’s on country?
AYes, Yes. Sometimes when you are there and you want to see Bungul dancing, you can ask your children, your grandchildren to come and dance for you. And story to tell about their grandmother’s country and they’ll enjoy that, and enjoy the older person. They will enjoy the way they share each other’s story.

We were brought in from our homelands and they brought us here from homeland, we were all focussing on one shop, one hospital, because there was service here in Galiwin’ku. That’s how I felt that when I’m living in town for a long time I, sometimes as I get older and I get not enough exercise, not enough getting good stories, I do but there’s a lot of influences. Like Yolngu don’t, we don’t listen to each other, and we try to teach ourselves or tell other Yolngu about the health, we ignore each other; we ignore people talking about it.

In the area of aged care, where you have it commonly stated that right at the moment we’re about 150,000 carers short, to deal with today’s problems, let alone a further aging population, and the strategic nature of that information that is well known across the board, I don’t see strategies to deal with it. There are some great things going on in the sense that the Productivity Commission’s review of caring for older Australians resulted in a recommendation to the government, and the living longer, living better legislation that went through a couple of weeks ago starts to put in place a framework for reform in aged care.