Thousands of Aboriginal patients at risk from health service closure, doctors say

Kiara Bloxsome and her six-month-old son Carter, whose family have been patients of the Mount Druitt Aboriginal Medical Service for four generations. “The GPs understand where you come from, because they come from the same background,” Ms Bloxsome said. Photo: Nick Moir’Dear Ministers, you are precipitating a catastrophe’ Aboriginal Medical Service to close over unpaid tax debt
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​The safety of more than 11,000 Aboriginal patients will be put at risk by the closure of a specialist medical service in Sydney’s west, a psychiatrist claims.

Negotiations between state and federal health authorities and staff at the Aboriginal Medical Service Western Sydney (AMSWS) have not yet come up with a way to safely transfer the patients of the service to new treating teams ahead of the service’s closure next month, said Neil Phillips, the AMSWS consulting psychiatrist.

The western Sydney service is in voluntary administration and is racked by debts, and the government has said it will not fund it beyond September 30 because health funding should be used to pay for health care, not to service debts.

Dr Phillips has written an open letter to federal Health Minister Sussan Ley, Minister for Indigenous Affairs Nigel Scullion and Assistant Minister for Health Fiona Nash accusing them of hypocrisy for convening a “round table” on Indigenous mental illness at the same time as closing specialist services for those conditions after years of underfunding for them.

“I’m concerned the decision [to close] is ideological,” Dr Phillips told Fairfax Media. “I have never been more worried for my patients in my entire career, and I have worked in very difficult and remote places. Yet here we are in the centre of Sydney and I don’t know what’s going to happen to them.”

He said many of the service’s patients had very bad experiences with mainstream health services and would not be willing to have their files moved to other clinics. In addition, the western Sydney area did not have enough Aboriginal medical staff employed to meet the demand that would occur when thousands of people suddenly found themselves needing a new healthcare provider on September 30.

“We are talking about 11,000 people needing to be referred somewhere else,” he said. “Over the years it has become very clear that if mainstream services don’t have Aboriginal workers involved, Aboriginal people just don’t go.”

Dr Phillips said the closure could lead to serious psychosis or even death for some of his patients, traumatising them and their families and costing governments more in the long term.

He said it took a long time to build rapport with patients in the service, and many of them would not come in for treatment or take their medication if they were not with a service they trusted.

“Even if you can guarantee nobody will get hurt, which you can’t … if someone ends up in hospital there wouldn’t be much change from ten to fifteen thousand dollars for the government.

“It’s agonising for the families to have someone with uncontrolled psychosis, there’s the issue of domestic violence when someone is experiencing paranoia, and there is the issue of kids observing someone with psychosis in the house – it’s scary.”

A spokeswoman for the federal Department of Health said it was working closely with the NSW Ministry of Health and others to ensure the effective transition of patients, and the government’s “primary concern” was to ensure the patients had access to high-quality, culturally appropriate services.

But she said the service was in “significant debt” and government policy was to use health funding to pay for care, not pay off debt.

“AMSWS has accepted a three-month funding extension up until 30 September to assist with the transfer of clients and services,” she said.

“The government is unable to continue subsidising the service beyond this three months because of the financial difficulties being experienced by the service.

“The Australian government acknowledges that this could be disruptive for patients, many of whom benefit by the community-controlled model of care presently offered by AMSWS, but as this service is now no longer viable, every effort will be made to transition patients to other service providers as quickly as possible.”

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