The Australian Government remains committed to engaging with the Norfolk Island community on the delivery of health and aged care services and has finalised the 2019 Norfolk Island Health Service Plan (the 2019 Plan).
The final 2019 Plan that I am releasing today on the Department's website, includes the views and experiences expressed by the community during KPMG's consultation meetings of December 2018, February 2019 and March 2020.
The Department and I appreciate the time and effort of individuals, organisations and the community in preparing submissions and attending consultation meetings.
Key themes expressed during consultation include:
- The Norfolk Island context: an appreciation that the unique culture, heritage and isolated geography was recognised in the 2019 Draft Plan;
- Ageing in place: difficulty in the ability to age in place and palliate and die on Norfolk Island due to the lack of care continuity in the primary healthcare setting and the expense of returning people to Norfolk Island should they pass away on the mainland. This would allow for cultural and heritage connections to be retained;
- Travelling for planned care: there is a significant cost, dislocation and stress associated with travel or planned and emergency care related travel to the mainland. Improvements are required to the networked service, including integration with mainland health and education service providers.
- Operating in a networked context: Stakeholders commented that there was a need for the community's needs to be safely met and that this would be achieved through the integration of health, community, aged care and emergency services.
- Continuity of care: there was a need for greater continuity of care to support the delivery of quality, patient centred care and to encourage community members, particularly the elderly, to engage with the health services on Norfolk Island.
- Opportunity for training generalist clinicians: the requirement for a partnership with a mainland health service provider to improve the delivery of health services in the new facility;
- Clinical and corporate governance: support for the governance processes and the proposed clinical advisory panel.
- Birthing: The cultural importance of having children born on Norfolk Island, to mothers identified as being in a in a low risk birthing category.
- Surgical services : Some stakeholders commented that a Level 2 surgical service would be inadequate due to Norfolk Island's remoteness and potential delays to flights.
The key findings and recommendations from the 2019 Plan include:
- enhancing the governance frameworks for the on-island health facility to ensure services and infrastructure are responsive to local health needs and changes in practice. The report identifies maternity services, surgery and aged care as key areas of community interest in this regard.
- Establish a clinical advisory panel, including community representatives, to provide independent advice about the need, and evidence for, the provision of specific services on Norfolk Island.
- developing the Terms of Reference for the panel in consultation with the community. They would focus on changes in demand for services (based on local data), and changes in accepted practices for service types that are commonly difficult to deliver in remote areas (such as birthing and surgery).
- Maintain a ‘Level 1’ Maternity service to provide antenatal and postnatal care for women with no identified risk factors, and investigate the continuity of care before and after birth for women birthing on the mainland, and family support services leading up to the birth.
- Provide a ‘Level 2’ General surgery service to facilitate the delivery of low-risk surgical procedures on Norfolk Island for an ageing population.
With respect to both maternity and surgery, a key challenge in all rural and remote communities is the ability to attract and retain a qualified workforce. This workforce is critical to ensure a safe and quality service. The report recognises that, while both of these services are of cultural and social importance to the community, there are a number of factors that impact the Island's ability to establish a safe planned birthing service. This includes the volume of births each year, the availability of suitably qualified health professionals and the time that would be needed to travel to a higher clinical capability in the event of a difficult birth.
It is important to remember the clinical advisory panel will continue to monitor the needs of the Island and what is feasible to improve services into the future. This Governance model is intended to provide flexibility as needs change over time and as new technology and health care options become available. The Multipurpose Health Services Facility design will also provide flexibility for future needs.
The 2019 Plan, Community consultation feedback report and KPMG's Norfolk Island Health Services Plan: Consultation Report can be found at: www.regional.gov.au.
Anyone with questions or requiring any additional information can contact the Office of the Administrator on firstname.lastname@example.org or phone 22152 or send an email to the Department at: NIhealthserviceplan@infrastructure.gov.au.
Administrator of Norfolk Island
16 July 2020