ALLIED HEALTH SERVICES IN DEEP CRISIS, SAYS REPORT
An "extreme crisis" in allied health services has been blamed for "preventable" foot and lower limb amputations in the Alice Springs hospital, as well as "deformity and suffering" by disabled children in the town.In a scathing report by two Queensland consultants, the running of these functions by Territory Health Services (THS) is described as "unmanaged or undermanaged", "organisationally dysfunctional", afflicted by massive and expensive staff turn-over and offering grossly inadequate professional development opportunities.The Alice News has obtained a copy of the confidential 39-page interim report into "allied health therapy services and associated social works services in Central Australia" by Dr Rosalie Boyce, of the University of Queensland, and Michael Bishop, of the Toowoomba Health Services.The report was commissioned by the NT Government's THS.Dr Boyce and Mr Bishop say: "The inadequacy of allied health professional services has been reported as causing unnecessary pain, disability and even premature death."They describe as alarming the "total inadequacy of allied health professional services available for infants, children and youth in Central Australia."This situation is perceived by the consultants to constitute a serious political risk."White, middle-class Alice Springs based carers of young disabled children very clearly described the deformity and suffering caused to their children from being unable to access allied health professional services."From other interviews and submissions, it is evident that a lack of continuity of care for infants and youth in Alice Springs is so poor that the allied health professionals were described as quickly becoming demoralised and burnt-out."Other evidence had indicated "that the problems are even more immense in remote communities."Within the Alice Springs hospital, allied health professional services are at a lower level than would be expected at any similar sized hospital."The low service levels are partly attributable to poor management of scarce resources, but in the main, reflect inadequate resources for acute services given the number of patients and the case mix."A lack of paediatric [children's] therapy services was again described as a major gap, causing lengthy and unnecessary stays in hospital.Although a dedicated rehabilitation team (particularly speech pathology and occupational therapy) has been established, the demand from other acute areas is so great that current services were described as "ineffective".The consultants say: "Two other service areas identified ... as major areas of deficit were related to allied health professional contributions to aged care and acquired brain injury (challenging behaviour) services."The consultants say they were told that THS is "fighting" with other agencies who would not take patients: "Several accusations were made in relation to a ‘black list' where a number of disabled people or people with chronic illnesses would [not] be accepted within any service."There appeared to be no systematic management of ... waiting lists, records of referral intra or inter professionally, or need in any remote, community or hospital based allied professional health services."This leads to consumers 'falling' through gaps in the system."No systematic collection of meaningful data was being collected by allied health professionals on types, time allocation and costs of services."Practitioners were leaving Central Australia, resulting in "little or no hand over and a great loss of skills, networks and local knowledge".The report places the blame squarely on the management rather than on the professionals themselves."It was not that the ... professionals lacked the requisite skills or commitment to serve the Central Australian community."Rather it was that these staff were worn-down by an often hostile organisational milieu which left them isolated, unsupported and in some cases unmanaged."Professionals, who in some sectors had an average job tenure of just eight months, "have been routinely and knowingly neglected in a manner which defies belief given the scarcity of their number (even when fully staffed) and the known high cost of continuously recruiting replacements".There is a "culture of crisis" in which "excellent" staff are recruited and "instead of benefiting from these 'stars' within a short period of time these ... professionals are exhausted from responding to an unrelenting and overwhelming caseload of high priority clients and an unsupportive and neglectful management".In a few cases the "longed for Central Australian adventure became a career threatening black spot from which some have not been able to recover".Some positions have been left unfilled as a result of "apparently opportunistic decisions", at a "very great cost to the care of the community, in some cases a 100 per cent cut in services".Recruitment costs per position are estimated at between $7000 and $15,000 (with depen-dents).These high staff replacement costs are "essentially diverting funding for patient [and] client care into human resource management costs".The report says allied health care positions are frequently seen as "soft targets able to be easily sacrificed without opposition".At the time of going to press Health Minister Denis Burke had not responded to a request for comment from the Alice News.
CHURCHES MOVE ON WAVE OF YOUTH SUICIDES
Local churches are assisting an Adelaide based suicide counselling organisation to set up a service in Alice Springs, and may seek to reestablish chaplains in the state-run high schools.This follows the death of a high school student last week, the latest in a spate of youth suicides in the town (Alice News, March 25).The Rev Murray Lund, chairman of the local Ministers' Fraternal, says the presence of chaplains in high schools was discontinued about 18 months ago.Pastor Basil Schild says the chaplains would possibly be available on school grounds one lunchtime a week, giving young people "someone to talk to".The Assembly of God, with support from other churches, is moving to expand the telephone counselling service "Teen Challenge" to Alice Springs.Manager Morrie Thompson says under the proposal, a free call telephone number would be available 24 hours a day.During some of the time, calls would be answered by Alice-based counsellors, for whom Teen Challenge would provide "intensive training".At other times the calls would be transferred to Adelaide-based counsellors.However, these counsellors would have access to Alice based counsellors capable of responding to emergencies.Mr Thompson says Teen Challenge would need about $8000 to expand the service to The Alice.An application for funds had been made to the SA government, and corporate sponsors may also be sought from businesses in SA and the NT.The church itself would bear the costs of counsellors' training.Meanwhile the southern region chairman of the Council of Government Schools Organisations (COGSO), Bruce Simmons, says state high schools in Alice Springs have positions for several counsellors.Anzac High, for example, where Mr Simmons is a member of the school council, has a full time home liaison officer, who is "very busy" caring for the needs of not only the students, but also for some adult family members.A police officer is assigned to the school almost full time.The education department employs a part time student counsellor who also has classroom teaching duties.An Aboriginal person employed by the department acts an education worker and resource officer for Aboriginal students and families.A full time registered nurse with counselling training is also available to help in crises.Mr Simmons says these support staff also work with outside agencies, and the principal, assistant principal and senior staff all share responsibility for student management services.Chris Makepeace, Deputy Secretary of Education, says a similar team which meets daily operates at Alice Springs High.He says the department is producing information - still in draft form - for teachers about how to deal with students possibly contemplating suicide."We're going about this very carefully."The last thing we want is that teachers try to deal with such an issue by themselves, rather than using the expert teams at the schools," he says."We're trying to provide an environment where kids are happy, safe and interested in what they're doing."Mr Thompson, of Teen Challenge, says there are usually signs of a person being suicidal."People are subtly sharing how they feel to see whether anyone really cares," he says."The focus of conversation turns inward. 'That's it. I've had enough,' is often the message of someone contemplating suicide," he says.This usually follows periods of emotional intensity, or being burdened by responsibility with little rest.Victims feel physical, emotional and spiritual exhaustion, loss of hope and purpose."The suicidal person is a burden to themselves," says Mr Thompson.They are likely to isolate themselves, give away valuables, cry and display anger."The greatest thing that anyone can do is listen to the suicidal person."By listening you show that someone cares," he says.Setting up a network of support by getting others around the person and "disarming their feeling of being alone" should be the next steps to help, and seeking "recognised counsel".Mr Lund says Lifeline (tel 131114) is one of the counselling services available in Alice Springs, and ministers from all local churches are always available to help.The local clergy has also been vocal on issues ranging from homelessness to mandatory sentencing, "giving a voice to the concerns of those struggling and seeking to influence government decision making," says Mr Lund.Meanwhile X-Treme Underage Nightclub now has a resident band, Cantar, with Andrew Castle and Nigel and Simon Fitzgerald.The next drug and alcohol free night will be this Saturday, April 25, at the Todd Tavern Jam Room, made available free of charge by Tavern owner David Koch, according to X-Treme's secretary, Helen Noonan."It's the safest venue available," she says.A free bus service taking patrons home between 11pm and 1pm "makes parents happy knowing there is no need for their children to be roaming the streets," says Ms Noonan."There will also be a 'chill out' area at the venue where people can sit and chat."Ms Noonan can be contacted on 89 528419.
OUR HERITAGE ALIVE AND WELL. Comment by JUNE TUZEWSKI
How nice to have life back to normal after attending the Statehood Convention. Our new Parliament House is a beautiful building and full credit to the Government that it is used so extensively by community groups and other organisations for meetings, conferences and receptions. However, it is a somewhat artificial environment and after three weeks of travelling to and from Darwin, and missing home cooking, I've come to the conclusion that I'm not surprised that our politicians are sometimes out of touch with what I call the "real world".Heritage Week, however, is very much about what the real world was like for the people who previously lived here. I find that in learning more about them and their lives, I discover more about myself. Aboriginal culture and heritage has a special place in the Centre, and activities such as those arranged by Frank and Janet Ansell at Pitchi Ritchi contribute to a greater understanding between us all.The story of Pitchi Ritchi's original establishment as a bird sanctuary by the Corbets and its links with William Ricketts, the sculptor, make interesting history in their own right. Mrs Corbet tells the story of how, during the big drought of the early '60s, food was so scarce out bush and the burden on the sanctuary was so great, that an appeal for bird food went out on national radio. The response was instant and dramatic.Parcels of bird food arrived from all over Australia. While pleasing our feathered friends, it created a headache for the local Post Master who sent out an urgent plea to the Corbets to ensure collection of the food daily, as it was creating a mouse plague at the Post Office.The growing band of local writers such as Jose Petrick, Max Cartwright and Rosemary Coppock preserve many facets of life of the early explorers and pioneers of Central Australia which we can all enjoy. Dick Kimber is another local who brings to life the stories of our recent past. And who could pass up a musical evening with Ted Egan or the folk group, Bloodwood, as a very pleasant way of discovering more about the Territory.Many buildings in use today, or sites of current activity, are reminders of our more recent past, but are not always publicly identified as such.Perhaps the time will come when, as in other places, there will be small signs attached to our buildings giving such information as "Jock Nelson, first Mayor of Alice Springs 1971-73, and first Territorian to hold the position of Administrator, lived here... etc."The town's buildings and infrastructure reflect the contribution of many migrants, especially Italians and Germans, who came to the Centre. Buildings we pass everyday have often been used for very different purposes in the past. On the current location of the Alice Springs campus of Batchelor College was the Mt Gillen Chalet, run as part of the Ansett-Pioneer Company. The Hertz Office was once Tuncks' Store. Built as a grocery and general store by Jack Donnellan in about 1940, Ralph Tuncks purchased it seven years later. It was run as a general store, first by himself and later his son, until 1980, when it was sold and run as Ascom electronics store until 1988. In the Araluen area, the site of the Connellan Airways staff quarters, near the original airport, is now used by the Craft Council. One of the old Connellan cottages is currently home to the Steiner School, having at one stage been club rooms for the Central Australian Folk Club. And of course, the old hangar now houses the Aviation Museum and features the history of Eddie Connellan's life work.Many people are aware that the Stuart Arms pub has had a chequered history and been built several times over. But how many are aware that the first Stuart Arms was Alice Springs' first hotel and was built in 1889 by Tryphena and Bill Benstead.Tryphena is believed to be one of the very first white women residents of the town, which was then called Stuart. Bill was much criticised by his mates for bringing his wife to the Alice.Not far from town are areas such as Glen Helen and Ross River, also Arltunga with its fascinating but tragic stories of gold mining. The old Hamilton Downs Homestead, which was donated by the Prior family, and renovated as a community service project over many years by the Apex Club of Central Australia in the early '70s, continues to be widely used by Centralians.Heritage Week has gone from strength to strength over the years, with the number of activities significantly increasing. A time for reflection by the locals and curiosity by the visitors, I believe it contributes to a sense of pride in our community which can be so easily lost in the daily business of our lives. The work of the many volunteers sharing their knowledge, skills and stories deserve our special thanks.
THE OLD TIN SHED THE BULLDOZERS DIDN'T GET. Report by KIERAN FINNANE
People's first impressions of Alice Springs usually include Heavitree Gap, the shape of Mount Gillen, the Todd River.Photographer Mike Gillam was struck by all these things but to his list of 25 years ago he added the variegated iron roof of a shed, just visible through a dense screen of athel pines, with the rocky mound of Teppa Hill rising gently behind it.At the time there were probably 100 others like it. Now, most of them are gone, but this one, by a combination of circumstance, vision and exceptional risk-taking, skills and hard work, has survived.It was still housing Maskell's Welding workshop when Mike walked onto the block with a busted radiator."I got yarning with Keith," recalls Mike. "He said he wanted to sell up before the shed fell down around his ears!"Mike, with a long-nurtured magpie's eye for "junk", particularly for pieces with a story to tell, walked around the shed."I was intrigued but it looked so tragic, I didn't think at that point that it would be a smart thing to get involved with."He and his wife Maria Giacon had already made a decision to sell their house in Old Eastside. The block there wasn't big enough to add a workshop and studio for Mike's work. They had been looking for a light industrial or commercial block for about a year, guided by a list of preconditions."One of the things at the top of our list was the presence of a heritage building that was unlikely to survive without attention, a building which people didn't necessarily recognise to be of value."The shed certainly fitted the bill.The corner supports had been entirely eaten away by termites and many of the other structural timbers were also under attack. Part of the north-facing wall was lying on the ground and part of it was propped up by a broomstick. When Maria picked up the broom, the rest of the wall came down.They asked builder Hans Gram to look at the shed. He told them that at least it wouldn't cost anything to knock it over, he could just lean on it. When they asked for his opinion about possible restoration, he shook his head and said "no way".Hans himself recalls getting a terrible feeling in his stomach: "The structure nowhere near conforms to the building specifications of today. It simply didn't seem to be worth spending time and money on."Friends and neighbours, who could only see the massive termite activity and endless work required, told the couple that their hopes were sheer madness.MADNESSBut madness won the day and Mike and Maria moved in, accepting that they might end up with nothing more than the stone chimney at the back of the shed. A solid blockwork house exists in the northern corner of the block. This is where they eat and sleep, but many a waking hour , especially in the first six months, was spent labouring to save the shed from collapse."We owe a huge debt of gratitude to Hans," says Mike. "He got in quickly and stabilised the corners, but we still had a roof flapping, that whole eastern wall was leaning right out, the northern wall was off, so the building was 'paper bagging', and the ceiling had a six inch slump in it."They jacked up the ceiling and Hans made a steel superstructure using stirrups and adjusters every 30 centimetres to wind it back up four inches. "Hans spent about a week in the roof. He's an incredibly hard worker, thinker and problem solver. He's put a huge amount of himself into this building - you couldn't pay him enough for what he's done here."What persuaded Hans to become involved?"The critical thing was that Mike gave me time to think. I realised after a while that if it had lasted for 50 years built as it was, it could keep on going if it was restored in the same way."I also realised that this was one of very few remaining examples of what were once typical buildings in Alice Springs, from a period when materials were stretched to the limit."Our remaining heritage buildings are mostly the ones built with money, which were in the minority."For Hans, the restoration became a lesson in the heritage of his own trade: "It was so interesting to see the little things done to make it work. For instance, in some of the later mulga uprights, a hole had been drilled in the bottom to take an empty cartridge shell, which was used as a key to hold the upright in place until the concrete footing had dried."Nonetheless, the work could be frustrating, because the key to success was in it not being visible: "You'd get to the end of the week, stand back and wonder what you'd done," says Hans.Would he take on a job like it again: "If the owner was as game as Mike, I would. We need our heritage in all its type. We owe it to ourselves and the future."NEXT WEEK: Taking an eye opening walk through "the shed".
TERRITORY MANDATORY SENTENCING TO FACE HIGH COURT CHALLENGE. Report by KIERAN FINNANE.
The High Court is set to hear argument that the Northern Territory's mandatory sentencing laws are unconstitutional.In an appeal against a well-publicised mandatory sentence of 14 days' gaol imposed on a Kalkaringi woman, Margaret Wynbyne, for unlawful entry and stealing a single can of beer, legal arguments will deal with the interrelationship of the judicial and executive arms of government.Senior counsel in the case, Colin McDonald QC, briefed by the Katherine Aboriginal Legal Aid Service, will argue that mandatory sentencing "infringes the judicial power of the Northern Territory, because the essence of the judicial power is to decide criminal punishment."It is not for the executive to preordain it, other than the maximum penalty, in advance."Mr McDonald says that it could be very difficult for a mandatory sentencing law to succeed at Commonwealth level because the Australian Constitution, in Chapter Three, "entrenches judicial power". When judicial power is entrenched in a constitution, it cannot be altered or interfered with by the government of the day; the courts are fully independent to resolve a dispute fairly and impartially. "Until the 'three strikes' law in Western Australia, governments had left sentencing to the judges. The judicial power had survived on conventions, but now those conventions have been breached in WA and clearly in the NT."However, we're seeking to argue before the High Court that the judicial power is more than a convention here, that the Commonwealth judicial power permeates the NT Supreme Court."This argument was unsuccessful in the appeals heard by the Supreme Court and the Full Court of the NT.As well as the Crown, the Attorneys-General of the NT and WA argued against the appeal: that judges' powers in the NT are not entrenched, that the NT courts are ultimately just statutory courts and do not have the type of entrenchment that the High Court and Commonwealth Courts do under the Australian Constitution.The Katherine Aboriginal Legal Aid Service, acting for Margaret Wynbyne, had initially challenged the constitutionality of the mandatory sentencing provision of Section 78 A of the Sentencing Act, before the Katherine Court of Summary Jurisdiction .This argument was dismissed by the magistrate, who however stated that he would not have imposed a gaol term had he not been constrained to do so by the mandatory sentencing law. "The injustice of the case was extraordinary," says Mr McDonald."This lady had no prior convictions, she had a two year old daughter, she had character evidence that she was a very fine and upstanding woman and had not been in trouble before, she had employment, had excellent prospects and was unlikely to ever offend again."She comes from Kalkaringi, about 800 kilometres south of Darwin. She would have had to go into the Darwin prison for 14 days, heavens knows what was to happen to her daughter, and then go 800 kilometres back, all for a $2.50 can of beer."This sort of factual scenario takes us back to the days of transportation in the early 1800s when Britain was getting rid of its very small time criminals and packing them off to the colonies."Mr McDonald sees the case as a good example of why the vesting of judicial power is important in the Northern Territory's constitution. "History shows that if you don't have judicial power entrenched, the likelihood is that you will have significant injustice," he says. "In future generations it could even lead to tyranny."Ultimately, mandatory sentencing deviates from a principle which has served Australia and people elsewhere well over a long period of time and that is, that the punishment should fit the crime."You don't preordain a punishment for all manner of offences because circumstances differ and vary."By ignoring this our punishment regime can end up reflecting a very strange moral view, says Mr McDonald, citing an example where in a domestic altercation a person is assaulted and a piece of property damaged: "For the assault, the person is convicted, placed on a bond and fined, but for the broken window or whatever, even though compensation may be fully paid, they get 14 days in gaol!"We also need to ask, he says, whether indiscriminate incarceration for property offences is really in the best interest of the whole community:"It is not uncommon for some of the best families around the country to have a son or daughter, but more likely a son, who has a few years of turbulence and rebellion and gets involved in two offences. "If that son then goes into gaol with all its potential poisoning effects, is that really wise and in the community interest?"The world tells us every day that people aren't the same, and offences differ in all sorts of factual scenarios. "Another example is with criminal damage: why should someone who's trashed a car get the same punishment as someone who has simply dented a hub cap? Under this scenario, you rightly get someone who comes out of gaol and feels they have been treated most unjustly."On the other hand, what happens if a young person goes into gaol, and becomes so frustrated that he commits suicide in custody? That causes grief for everybody, including the prison authorities, to say nothing of the loss of a young life and of the loss to the parents. "The catch cry is 'don't cuddle up to criminals'. Nobody wants to 'cuddle up to criminals', that's not the issue. The issue is how do you protect society effectively and intelligently?"If silly sentences bring the law into disrepute, then that's dangerous."The best way to protect society from crime in the long term is to increase the likelihood of criminals getting caught, it's the biggest deterrent of them all, and to do that you have to improve the resources and efficiency of the police force, then watch the detection rate to increase. Wherever this is done, offence rates plummet."Our police do an excellent job in detecting major crime, we have high rates of clear-up in those areas. Now we need to increase police resources to deal with those frustrating crimes of break-ins, theft and damage to property."Meanwhile, mandatory sentencing laws in the NT and WA, have been condemned by the Australian Bar Association. The peak body of legal expertise, one of two in the country, voted unanimously in favour of a motion put to it by the NT Bar Association and supported by its counterparts in Western Australia and Victoria.Says Mr McDonald, president of the NT Bar Association: "Like any other body we have a capacity to put our views to the public, to make submissions to the Attorney-General, but we do so on an informed basis, as the people dealing with these cases from day to day."
TOWN WITHOUT SOLACE. Book review by KIERAN FINNANE.
On the Edge of Red
by Jo Dutton
People living in Alice Springs, especially those who have come here from other places, will read Jo Dutton's On the Edge of Red differently from readers elsewhere, looking in it for a special sense of recognition and relevance.One of the important tasks of artists is to hold up a mirror to their audience, and, in the Alice context, it seems appropriate to focus on this aspect of the novel. So, what image does Dutton give us of this place?We see the town through the eyes of Lara. She has a drama about "belonging", more acute than many, to play out. She spent miserable early childhood years moving around the north-west of Western Australia with, as she later understands, a broken-hearted family. Her mother dies and her drunkard of a father surrenders her to welfare.The kindness of her adoptive parents doesn't manage to heal these wounds, and as they start to open up in adulthood she sets out on her journey to the Centre, where, in the words of her lover Sim, she will be "surrounded by other outsiders", a "belonging even [she] could allow [herself]." What Sim perhaps couldn't understand from the distance of Perth, is that there are also "insiders" here, in various states of dislocation and woundedness, and that the town presents to Lara a multi-layered metaphor for her own state. She is surrounded by the pain of dislocation, as if in a hall of mirrors.She sees it , or the barriers put up against it, from the first weeks of her arrival.About her colleagues at the land council she tells Sim that "everyone seems very closed."Racism is "the first thing you notice here. There's no shame in it at all ... They never give black people the right change."The buildings look "into each other, denying the landscape around them ... Conquer, deny and desecrate could well have been the building code motto."The rules about the races mixing are "not pinned to walls for all the world to read" but "insiders could translate 'no singlets allowed' into 'no black people admitted'."The town is also divided into "tourist and traveller , non-government worker and government employee, business interests and Aboriginal organisations." Initially, the only comfort Lara finds is in the landscape: "I feel right at home," she says when she first goes swimming in a waterhole.With time she also finds it in a few relationships.These examples are all from the first five chapters of the book. Does the rest of the book record a change?Internally, for Lara, yes. She goes through some very hard times, including the still birth of her first child, a meeting with the father who abandoned her and what she sees as an act of betrayal, however well-intentioned, by Sim. She teeters on the brink of sanity. Significantly, the person who brings her back from the edge is not someone from her own culture, but Mabel, an Aboriginal grandmother. Mabel has her own story of a lost baby, a fair-skinned granddaughter who was stolen from her care - and she is able to help Lara properly grieve for her dead baby.However, far from integrating Lara with her environment, Mabel's healing prepares Lara to leave it. Externally, for Alice, things remain the same or worse. After her baby dies, Lara reflects: "There was nothing in town for her. Except in rare moments, town left her feeling empty and flat. Life in there was always going to have something missing." Dutton is to be commended for having the courage to tell it as hard as she sees it. While the novel will become an important cultural document of a particular stage in the evolution of Alice Springs, it must be hoped that for future Laras, Mabels and their families, the town becomes a kinder and more humanly pleasing place.There are many other things that could be said, but space demands only mention of the fine descriptions of landscape, and some very good writing about Sim's and Lara's relationship, and particularly about their sexual pleasure with one another. To get to publication of this her debut novel, Dutton has had to keep faith with herself for a long time and now that faith is deservedly rewarded.
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