MATT SMITH, FEDERAL MEMBER FOR LEICHHARDT: Good morning and welcome to Wuchopperen, and of course, welcome to Minister White. Welcome to Minister White, Assistant Minister for Health, Aged Care, Aboriginal and Torres Strait Islander Health, on her first visit to Far North Queensland. We have put the sun away today because Bec's from Tasmania, and we didn't want to scare her. This is her natural environment, so to speak.
This is a very exciting and important announcement for Wuchopperen and primary healthcare in Cairns. We know that primary healthcare is essentially putting a guardrail at the top of the cliff rather than having an ambulance waiting for you at the bottom. What this project has done has ensured that every single one of these buildings has clean, safe air in it as well as negative pressure rooms to ensure that there are no transfers of diseases once people arrive on site. During COVID, we began to understand that if you go to a doctor's waiting room, you can get more sick, and particularly, with primary healthcare, you're going to have extended consultations. People are going to take their time to understand what's going on and what the solutions may be. So having that clean air and a cool environment, it allows people to focus a bit better.
That allows people who are here for primary health activities a bit more time to sit, relax, be comfortable, and have those longer conversations that concern primary health.
I'm very proud that this has been a $2 million project, 1.5 from the Federal Government and of course Wuchopperen have put in as well to create this for our community. I'll hand it over now to the Assistant Minister who will talk more about this exciting project and what this means for Cairns.
REBECCA WHITE, ASSISTANT MINISTER FOR HEALTH AND AGEING: Thanks, Matt. It's $2 million from the Fed actually.
SMITH: It's $2 million from the Fed? Correction, $2 million from the Fed.
WHITE: Thank you. I'm really thrilled to be here in Cairns standing with Matt Smith, the Federal Member for Leichhardt, but also joining with the CEO of this facility, Joy and her team to celebrate the investment that they've been able to deliver to improve health outcomes for people in this community by making sure we've got access to safe indoor air. We learnt through the pandemic how critical it is to make sure people have access to safe indoor air, and the investment that has been provided by the Federal Government of $2 million in partnership with the Wuchopperen Health Service means that we've been able to upgrade the air conditioning services in these buildings where clinical services are provided to patients to make sure that they can get the care that they need and that we can do that in a safe way.
Partnerships with our Aboriginal Community Controlled Health Organisations is really vital for us to be able to make sure our decisions are community-informed and community-led. We understand that self-determination for First Nations people really can only be driven when they're at the table making those decisions in partnership with government, and I'm really proud of the commitment our government has to support the work of our ACCHOs right across the country and acknowledge the work that's happening here in Wuchopperen as well.
Joy's with us as well, who can talk about some of the specific issues that this clinic might be seeing as we're supporting patients’ access to care. So I'll pass to her and then I'm happy to answer any questions.
JOY SAVAGE, WUCHOPPEREN HEALTH SERVICE CEO: Thank you, Minister.
JOURNALIST: Just your first and last name and your title if that's alright.
SAVAGE: Joy Savage, CEO of Wuchopperen Health Service. And I'm also joined by Dr Nikki Roux, who is our Executive Director of Medical Services. We're delighted to welcome back Matt and, for the first time, welcome the Assistant Health Minister, Rebecca White, for what is an auspicious day for us today to showcase the work of this investment, $2 million, to upgrade the air quality in three of our clinics on this particular site.
Whilst it had a fairly boring name, Air Quality Project, we renamed it Breathe Easy. What it effectively does is it allows our staff, visitors and patients all to have comfort in knowing that the quality of air and ventilation in our clinics is of the highest standard. So in the event, as the Assistant Health Minister has said, when there is a pandemic or an outbreak of airborne infection, that our clinics are some of the safest environments to be in. You can get the care that you need in a relaxed and be confident that you're not going to pick up any other germs whilst on site.
So we're thrilled at that investment and the continued support that we get from the Federal Government and also the state to deliver comprehensive primary healthcare. As our local member has said, primary healthcare is the first line of defence for our community to keep our community well. We have been in this business for 46 years. We're the first Aboriginal community-controlled health service in Far North Queensland. It's an honour to have that position, but we know that there are nine other community-controlled services across Far North Queensland equally doing similar work and serving their communities. And we are so glad that we've been able to have you here today. I have said to the Minister, the air quality is second to none. Indeed, it's as if we're breathing Tasmanian fresh air. Her grade of that was, it's pretty good.
So I have Dr Nikki with me as well. So if there are any infection control particular questions that you would like to ask, we can have our doctor respond to those. Thank you.
NICOLETTE ROUX, EXECUTIVE DIRECTOR OF MEDICAL SERVICES, WUCHOPPEREN HEALTH SERVICE: Thanks, Joy. Hello.
JOURNALIST: Just your first and last name, sorry, and your title.
ROUX: Dr Nicolette Roux, Executive Director of Medical Services.
I just wanted to say something just around coming through the pandemic as a community-controlled health service. I was proud to be here, I’ve been here 11 years, but through the pandemic, what we learnt was tremendous around infection control, clean air, and how important that is. But what we did as a community health organisation was that we stood up to serve all of community during the pandemic. We had a respiratory clinic here that was Department of Health-funded and we opened our doors to everyone. In that experience, we learned a lot about clean air. And as a clinician, I know it does hamper your patient time in clinic if you’ve got to separate the patient from other areas – so if they’ve got an infectious condition like COVID in this example, now what we can do is we can make sure our staff have the correct personal protective equipment on and they can actually see the patient in the room. And we feel reassured that they can leave the room and the chances of them passing that onto someone else coming back into the same room is now much less than it would’ve been before the clean air project.
JOURNALIST: What was the situation like before?
ROUX: Well, the situation before the clean air was that we would have to probably see most of our patients outside. And for a very long time we had the respiratory clinic running, so any patient with potential COVID symptoms or other infectious symptoms would have to be moved into our respiratory clinic. And when that was then stopped, we had to see patients outside to try and protect our staff, but also our community that are inside our clinic. So we'd have to probably see them outside in a private space, which isn't ideal, especially up in Far North Queensland where it's quite hot or very rainy at times, and so now we see our patients inside. When we moved even further after COVID or the pandemic passed, we used to have to segregate one room in our clinic that we would see all our infectious cases in with HEPA filters et cetera, so we would not be able to see them in our consult rooms.
JOURNALIST: How long did the facility operate not fit for purpose? Because it clearly sounds like it couldn't really operate day-to-day business?
ROUX: Look, during the pandemic and so in the initial stages when the borders opened, we probably converted to telehealth only for quite some time, and so it was very minimal what patient contact we had in person. We never turned anyone away, so we were still seeing our [indistinct] here, but we obviously had to pick up our proportions and had to change to telehealth, which is what a lot of services had to do.
JOURNALIST: What kind of impact did it have having to either do telehealth or be outside in these kinds of situations where you might have rain or you might have machinery going on in the background? What kind of impact does that have on those kinds of patient interactions or whether people are coming?
ROUX: Well, of course, you don't have a bed that you can lie someone on. So, of course, if someone was critically or concerningly unwell, we would move them inside and take additional precautions. But you can’t lie someone down and fully examine them. You try and keep privacy at the utmost of your attention. But, you know, having an open-air clinic is not ideal, especially when someone wants to share their health history with you and have potential spectators and that, so you just try and limit that as much as you can. So it wasn't ideal having to see people outside. And also inside before the clean air, we would have to see the patients within 10 to 15 minutes to try and limit our exposure.
JOURNALIST: How long have you guys been pushing for the clean air?
ROUX: Probably since the start of the COVID pandemic. So when we started learning about what a respiratory clinic required, and in fact the type of fresh air and exhaust that you need - exhaust mechanisms, excuse my lack of technical terminology, it was at the start of the pandemic that we started realising, because we'd have to look at the clinical risks around infection.
JOURNALIST: How did you realise, with more people getting sick, these diseases spreading?
ROUX: Well we knew that the numbers of cases in Cairns had gone up. And, of course, pending the borders opening, we were already putting plans in place to try and limit the effect of this in our community. So no, it wasn't based on a high number of cases that then led us into that. We actually were preparing. It was all preventative, our planning in that regard.
JOURNALIST: And was it a decision that the clinic made to pursue this kind of filtration? Or was it following a review into the whole system and some recommendations?
ROUX: Yeah, so I wasn't involved in the grant application. However, what I do know is that it was a Capital Grants funding opportunity that came by, and we decided as an organisation to apply for our clean air project based on our infection control. Did you want to speak?
SAVAGE: There is a lot of learnings that went on during COVID, and I think it was actually a multitude of people. I don't think we had to scream and yell for this. I think as we learned, as we understood the importance of the infrastructure and how that plays into a pandemic – no one had experienced anything like it for 100 years – that it became clear. And the Commonwealth recognised that that was something that could actually enhance how services could be delivered in a health setting, and we seized the opportunity to apply for and were fortunate enough to be granted. I'm sure there are other services as well around the country who may have followed suit, either from our original application and successful grant. But I think we all now realise, even in a primary care setting – we’ve certainly known for a long time in an acute care setting, as in hospitals – but even in a primary healthcare setting, how the infrastructure, how the air quality, how the ventilation, fresh air, particularly here in the north with the moisture, can play an added protective weight in containing infection. So it's a significant infrastructure infection control measure that adds to all of the other things we know about practice.
JOURNALIST: Just for a bit of perspective, would these systems already exist in hospitals around the state?
SAVAGE: In the main, yes, they would. And they certainly have negative air pressure rooms and so on. I'm not sure of the extent of other primary care services that have it, but we're very pleased that we do.
JOURNALIST: And you could operate without this – is that not a health concern?
SAVAGE: Well, of course you could. But it is always the ambition of any healthcare provider to have the latest facilities available to you to both aid the provision of service and importantly to keep visitors and patients and clients who access these facilities in an environment that is certainly not going to cause any harm or add any risk to their health.
JOURNALIST: Some questions for the Minister.
WHITE: Yeah, sure. Of course.
JOURNALIST: Do you have an idea of how many facilities, either in Queensland or particularly in the Far North, have or don't have this kind of air quality infrastructure where they can have infectious people consultations inside without that risk to other patients and staff?
WHITE: So this was a Capital Grant program that was offered for Aboriginal community control organisations to make an application to, and it was up to them to determine how they wanted to make an application to meet their local needs. And that's always been a really key part of the design of this program. It's up to the community to decide what sort of funding they need to spend to improve services for their local community. So the figures that you're after would be held by both the State Government, as they are the primary deliverer of some of those services, along with the Federal Government,
JOURNALIST: So it's not regulated whether you have ventilation?
WHITE: In acute health settings, there would be a requirement to make sure that you've got negative pressure rooms and that you do make sure you've got appropriate ventilation to support patients in that environment, because you're talking about critically unwell people in some instances. In primary healthcare settings, to my knowledge there are no specific standards that need to be met. But what we've seen here in Wuchopperen is that the local community has identified this is a concern for them, and they've taken action to make an application to a Capital Grants program and been successful to make sure they can deliver safe indoor air quality for their staff, but also for the patients and families who rely on this service.
JOURNALIST: But you have any idea of whether any of the - there's a lot of Indigenous Controlled Health Organisations throughout Cape York and up into the Torres Strait - do you have any idea how, if any of them, have this kind of security?
WHITE: There's 10 in Queensland to knowledge, and I can provide advice back to you but, off the top of my head, no, I don't.
JOURNALIST: I mean this - having air where patients can be seen inside, given especially how large Wuchopperen is - it seems like a fairly a basic thing that most people would expect. That they would be able to come and be seen by a clinician, in person in the privacy of a room where there's no risk to other patients and staff. Why has it taken so long for this kind of facility to be extended to this service?
WHITE: Well, there was never any restriction around patients being able to be seen inside. It was just how you manage that in a safe way. And the doctor's spoken about limiting the amount of time that you spend with patients and making sure you see them in separate rooms to protect against other patients and staff being exposed to potential viruses being shared in an airborne way.
Obviously, in the northern part of Australia where you're dealing with humidity and hot weather and a fairly unpredictable climate at times, you want to make sure you can do that indoors as safely as possible. And that's where this investment I think deserves our congratulations for Wuchopperen in identifying this as a priority for this community.
The Government is not in process of stipulating how these grants should be spent by communities. We are offering these grants to communities to decide for themselves, how they want to make application so that they can best meet the needs of their local community. And that's what co-design in First Nations Health looks like. It's about working collaboratively with people at the table who are making decisions about what their local communities need.
JOURNALIST: With the lessons learned from COVID and the efforts that went into controlling respiratory illnesses at the time - and the doctor mentioned - do you think there will be an expectation that more primary health centres do adopt this technology? And will there be an investment for those centres?
WHITE: There's absolutely no doubt that we've learned an enormous amount since COVID about how viruses are transferred and the importance of safe indoor air quality. And that's not just in health settings but also in our education settings. We've seen a lot of improvements made to ensure that our young people in school settings have access to safe indoor air quality too.
So, I am confident that the more we learn about how respiratory diseases operate, particularly infectious diseases like COVID, the more opportunities there will be for organisations like this one and others across the country to make upgrades to ensure that people can be safe when they're indoors. We have learnt an enormous amount about the value of safe indoor air over the last few years, and I commend the research that's happened both in Australia and globally to inform our understanding.
JOURNALIST: Are there further grants for other clinics to apply for?
WHITE: Well, through this portfolio, yes. So, we do have a capital project where we - this is round two of funding that was provided to the Aboriginal Community Controlled Health Organisations, to make an application, to decide what they might need to do in their health facilities to co-invest with Government to make upgrades. There will be further capital grants and programs provided by the Federal Government to support our Aboriginal Community Controlled Health Organisations to make upgrades to infrastructure. And there are a number that are currently being rolled out across the country.
JOURNALIST: Just to confirm, there's a $2 million Federal Government investment, what was the Wuchopperen contribution?
WHITE: It was two different programs. So, that 1.5 came from that bucket that sits within the portfolio responsibility that I have. There was an extra $500,000 provided through a different stream of Federal Government.
SAVAGE: So, we took the opportunity to, while the ceilings were down and ventilation systems had been put in, to upgrade our fire alarm system as well. And I think our contribution was, all up, an additional 600,000. My finance person's at the back kind of doing the fingers, so good on you [laughs].
JOURNALIST: When was it all completed?
SAVAGE: It was all completed, I believe, on 26 June I think.
JOURNALIST: When did it start?
SAVAGE: The project started in earnest on 1 July, so it took a whole year. We, essentially, had to decant and transition our staff to other facilities and adjust the service model, service operating model. We did our Rainforest building first, which is the one here behind us. We did Coral Cave, which is the one behind you here. And then finally the Reef Building, which is actually the first building on site so it's much older, more complex works that needed to go into this building. And we seized the opportunity to just upgrade our fire alarm system and refresh the building while we had moved staff around to deliver services.
JOURNALIST: And when you said three clinics, is that three buildings or three rooms within those?
SAVAGE: No, three buildings. We have eight buildings on the site. The three are our clinical areas.
JOURNALIST: Just to clarify, ventilation systems is just a fancy term for air. It’s just simple air cons, is it?
SAVAGE: No, it's not. No, it’s not a simple air con at all.
JOURNALIST: Okay.
SAVAGE: It's air conditioning with filtration, UV, fresh air. So, some air cons just take a little bit of fresh air. This is a very high-grade ventilation system, air conditioning and ventilation that pushes fresh air through. And we're also able to have, as both Dr Nicky has said and the Health Minister, negative pressure rooms as well.
JOURNALIST: Okay. Many people may not know what they are, what they're for, why they're important. Can you just give us a brief explanation?
ROUX: Well, what it does is it helps the air that's in the room, get removed, pretty much. So, it gets pushed out or exhausted out through negative pressure. And then the fresh air, as a result - and I'm not an engineer by any means - is then able to come in by that mechanism. So, old air out, fresh air comes in.
JOURNALIST: What sort of situation would someone need to go into the negative air rooms, instead one of the normal ventilated that you now have?
ROUX: Well in tertiary centres like our hospital here you'd have a negative pressure room for someone with an infectious disease. Because you don't really want that affecting other ward areas. But however, in our community setting in primary health care it would be any potentially infectious case that would go in there. So, it would be, you know, we had a measles notification recently from an overseas traveller. And so likewise, if we had any of the vaccine preventable infectious diseases that come in, we would treat it the same way.