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Primary care failing older people in remote areas, royal commission hears


Poor primary care in rural and remote areas is increasing the need for older Australians to access aged care services, the aged care royal commission has heard.

Dr Martin Laverty, chief executive officer of the Royal Flying Doctor Service of Australia, told the aged care royal commission on Tuesday that the service played a role as both an emergency and primary health care provider, principally in remote and very remote Australia.

Dr Laverty told the inquiry primary care plays an important role in keeping older Australians healthy.

“Access to doctors, to nurses, to allied health professionals, to dentists, to geriatricians, and primary care plays an essential role in keeping older Australians, and indeed all Australians, well and healthy,” Dr Laverty told the hearing on Tuesday in Broome.

Dr Laverty said while the RFDS is not an approved aged care provider, aged care and primary care are interdependent.

“The longer you are able to maintain your health through access to adequate primary care the longer you are likely to avoid the necessity of access to the formal aged care setting,” Dr Laverty said.

“Once an older Australian enters an aged care environment, be it residential or community care, access to ongoing primary care is essential to that citizen receiving appropriate care,” he said.

He said primary care is failing older people living in remote Australia.

“My evidence to this commission is that in remote Australia primary care is failing older Australians,” Dr Laverty said.

He said there is are an insufficient number of doctors working in remote Australia compared to metropolitan areas.

“There are half the number of doctors working in remote Australia than they are in city areas and very similarly, when you look at all of the allied health professions, you see roughly between half to one-third the availability of various allied health professions – physiotherapy, pharmacy, occupational therapy – in remote Australia.

“The consequence bears out in the acuity of those older Australians living in remoter areas,” Dr Laverty said.

Preventable hospital admissions

Dr Laverty also told the aged care royal commission the rate of preventable hospital admissions is higher among Aboriginal people compared to non-Aboriginal people.

He said the rate of preventable hospital admissions among Aboriginal people is almost three times higher than the national average.

Dr Laverty compares this figure to the rate of Aboriginal people living in Kimberley, located in northern region of West Australia.

“The national average for non-Aboriginal people is 27 per thousand people. In the Kimberley, the rate for avoidable hospital admissions for Aboriginal people is 75, almost three times the national average,” Dr Laverty said.

He said this figure increases to 117 people per thousand people when comparing avoidable hospital admissions in the Northern Territory.

Asthma, pneumonia, cavities and the need to access dental health care are among avoidable reasons people are admitted to hospital, he said.

“Where you see avoidable hospital admissions increase, you have evidence of the failure of your primary care system.”

“Where your primary care is failing, you are going to have greater call on aged care services for older Australians and when they enter their acuity will be higher such that they will require a higher level of support,” Dr Laverty said.

The hearing continues next week in Perth and will inquire into the nature of person-centred care, advance care planning and palliative care services.

To stay up to date on the latest about the Royal Commission into Aged Care and Quality go to our special coverage. We will also be issuing regular Royal Commission Roundup reports which you’ll receive in addition to your weekly e-newsletters.

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