Diabetes services in Northern Tasmania

Mrs Armitage (Launceston) to ask the Honourable the Leader of the Government -

(1) (a) Does the Government agree that there are serious deficiencies in diabetes services in the northern part of the State by not having a permanent full-time endocrinologist at the LGH for more than a decade and waiting times at the LGH and NWRH in the range of 7-16 months; and

(b) if so, what action is proposed to be taken to address the deficiency?

(2) What is the Government’s intention with regard to the current inequity in the specialist endocrinology workforce between the north/north-west and southern region of the State which currently is 0.8 FTE compared with 3.7 FTEs in the southern half of the State?

(3) (a) Is the Government aware that access to private endocrinologists in the north and northwest region is limited; and

(b) if so, is it satisfactory that patients requiring specialist diabetes care must engage with a seriously inadequate service, the vast majority of which is provided by the public sector?

(4) Does the Government agree with the Endocrinology Clinical Advisory Group, chaired by Professor John Burgess of the Royal Hobart Hospital in their response to the Green Paper where only a minimal increase in specialist endocrinology staffing in the north together with the amalgamation of the endocrinology services at the LGH and the NWRH was recommended?

(5) (a) Will the White Paper on the redesign of the Tasmanian health system address inequality of diabetes/endocrine services between the northern and southern regions; and

(b) if so, will the matter of appropriate access to specialist care for patients in the north and northwest regions be addressed in order to limit the impact of their condition and keep them out of hospital by having access to appropriate outpatient specialist care?

Answer from the Leader of Government, Dr Vanessa Goodwin:

(1) (a) The Government recognises that there are significant differences in the ability to access endocrinology services across the state. There are deficiencies in diabetes services in the north and north-west, with fewer specialist endocrinologists compared with the south.

(b) The Government plans to address these deficiencies. To this end, the Endocrinology Clinical Advisory Group - CAG - has been enlisted to develop a contemporary and sustainable model of endocrinology care.

In the north-west, in collaboration with the Diabetes Service, the endocrinology model of care of two general physicians has seen a decrease in waiting times for complex patients with diabetes. Present waiting times at NWRH for an adult patient with diabetes are up to seven months for new patients and up to nine months for a follow-up appointment.

(2) The White Paper on Safe and Sustainable Services Exposure Draft proposes an increased endocrinology service level at the Launceston General Hospital, with services to be provided for patients across the north and north-west.

The Endocrinology CAG will complete an analysis of service need in the north and north-west, while considering the need for applying evidence-based models of endocrine care statewide with the move to a single Tasmanian Health Service.

(3) (a) There is limited access to private endocrinologists in the greater north and the Government appreciates that accessing a private consultant is often difficult.

(b) In contrast to the situation in major urban diabetes centres, those patients living in Tasmania's greater north who have type 2 diabetes and require insulin - a common outcome several years after diagnosis of type 2 diabetes - are currently managed by their general practitioner without specialist referral. Significant resources have been invested in education of general practitioners to support this process, however, further improvement in providing access to specialist care is required.

(4) Until a detailed analysis of service needs is undertaken it is not possible to fully understand what the requirements are to improve access to care. Any decision related to investment needs to be founded on best evidence and based on an appropriate model of endocrine care that considers the impact of a single THS.

(5) The exposure draft of the White Paper states that endocrinology services at the LGH will be increased to a level 5

service from a level 4 service and will include a regional referral role. This service profile change will provide better access to specialist endocrinology services.

(Answers supplied: May 28, 2015)