Doctors and patients at a western Sydney Aboriginal health clinic say lives will be at risk if the centre closes down.
Western Sydney has the highest concentration of Aboriginal people in Australia and the Aboriginal Medical Service at Mt Druitt is right at the centre of that, servicing about 11,000 patients.
It works as a one-stop shop, providing everything from GP check-ups to dental, immunisation, pre-natal support, mental health counselling including an in-house psychiatrist, and methadone treatment for drug users.
But earlier this month, the Federal Government put the service into administration after it racked up a $4 million debt, including a $2 million tax bill.
It now has three months to transfer all 11,000 patients to non-Indigenous services like local hospitals and medical centres.
Many of the patients have never sought mainstream medical care and do not trust those services.
We are dealing with a great many people with serious mental illnesses, their lives are at risk.
Dr Neil Phillips
Dr Neil Phillips, the centre’s psychiatrist, holds grave fears for some of those patients.
“I fear that people will go off their medication. We are dealing with a great many people with serious mental illnesses, their lives are at risk,” he said.
“It’s not just lives, it’s the family life, it’s what happens to their children, it’s what happens to their community.
“It’s that some of these people will injure themselves and we’ve already got an appalling death rate from suicide in the Aboriginal community.”
Patient would ‘rather die’ than go mainstream
Robert Connor has been receiving treatment for bipolar disorder at the Aboriginal Medical Service for the past three years.
“I’m not a number there, I’m a person. I have control over my life,” he said.
“I feel I have guidance with them, I have control, whereas in mainstream I don’t have control over anything,” he said.
Mr Connor said he could end up in jail or worse if he was forced to go to back to a mainstream health service.
“I’m not going back, I’d go to jail, because jail is safer than them bastards,” he said.
“My experience with hospital is sleeping the entire time. Psychiatrist’s review when I get there, then I am scheduled, then sleep until I see a new psychiatrist and then just get sent home.
“I’d rather die.”
I’m not going back, I’d go to jail, because jail is safer than them bastards. My experience with hospital is sleeping the entire time… I’d rather die.
Robert Connor
Dr Phillips said Mr Connor was not alone.
“A number of our clients will be fine, I mean they will miss us because we have been doing a good job and we’ve suddenly disrupted their treatment for some mysterious reason but they will be able to seek help in the mainstream,” he said.
“A much, much larger number don’t have confidence in the mainstream or the capacity to communicate their difficulties with people they automatically distrust.”
Government-appointed administrator Michael Jones said the Aboriginal Medical Service got into financial trouble because it was trying to do too much and was unsustainable.
“When programs finished, they just weren’t really disciplined enough to finish,” he said.
“They kept a lot of staff on who were in unfunded positions.”
Government says centre ‘no longer viable’
There is no suggestion of corruption, but the Federal Health Department says the centre has been mismanaged and cannot continue in its present form.
“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 Aboriginal Medical Service Western Sydney,” a department statement said.
“But as this service is now no longer viable, every effort will be made to transition patients to other services, including local GPs and mental health and drug rehabilitation services.”
Mr Jones says they are now working to transfer as many patients as possible into mainstream services.
“There are some other options we are working with that may involve the premises but at the end of the day we have to work quickly because time is of the essence and is not on our side in this matter,” he said.
The Federal Health Department said it eventually would like to find a provider to run a new medical centre, with the help of Aboriginal leadership, but there was no indication on how long that could take.
In the meantime, the New South Wales health system will manage the patients with funding from the Federal Government.
“NSW Health is assisting the administrator in the development of the transition plans,” a NSW Health statement said.
“We are working with the Commonwealth Government, the Western Sydney Local Health District and the Nepean Blue Mountains Local Health District to ensure the Aboriginal people of western Sydney can continue to access culturally appropriate health services into the future.”