Staff describe endless chase for funding for people in need in Murray Mallee General Practice area
Health worker Lisa Courtney dreams of setting up a garden, cafe and op shop so former addicts can gain life skills. But there’s one giant hamster wheel in the way.
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Lisa Courtney is, yet again, trying to figure out where the next dollar is coming from. This is not unusual. In fact, scratching around for cash is very much part of her daily life.
Courtney is clinical services manager for the Murray Mallee General Practice Network, based in Murray Bridge. It provides a range of services, including programs to help people overcome addiction to ice and other drugs as well as mental health support services. But it needs funding to run them and as The Advertiser reported on Monday that it could be forced to cut services by the end of the month if promised federal funding of $1m over the next two years does not arrive.
Courtney’s frustration is evident. Not just with the latest battle to have this funding delivered (which was promised in the last federal budget), but with the whole hand-to-mouth existence common to many in this sector.
She describes the constant hamster wheel of applying for grants, tendering to provide services, chasing funding, looking for donations, to find the money to help some of the most vulnerable people in the community.
“When we spend all this time chasing AOD (alcohol and other drugs) funding, it is never-ending and time-consuming,’’ she says. And it can be frequently unsuccessful.
“Even the most successful of grant writers are only successful 50 per cent of the time; it’s a bit of a lottery,’’ she says.
But, as it turns out, even when you are successful, dragging promised money out of the federal government can be tough.
Courtney supplied a timeline of the work required to win that funding from the previous Liberal government. It started with a meeting with the local federal MP Tony Pasin on March 1, 2021 to give a presentation of the service needed in the area. By June, Pasin was asking for more documentation to pass on to then-health minister Greg Hunt to show the need for such services in the Murray Mallee. More updates and costings were sought in August and September. In December, they were given some interim funding to take them through to the budget. The on March 28 this year, they were advised they had been successful in winning $1.008m over two years. Which was good, but less than they asked for. A press release came out on April 11 confirming the decision. Then Labor came to power in the May election.
Emails and phone calls were exchanged with the health department to say the election had delayed the process but contracts were being prepared and all was fine. Last month, the department advised the practice should use any “underspend’’ it had from previous funding.
And still, they wait.
There is no doubt there is a demand for the service in the region. The Murray Mallee covers 23,000sq km and has a population of around 37,000. Murray Bridge itself has done much to lift its image in recent times, but is still one of the state’s poorer areas.
“This population has a high level of trauma and a high level of complex trauma and that means you need a higher level of service and more of it,’’ Courtney says.
But, Courtney says, what funding that does come in is not based on need, but based on the population of the area.
Courtney also believes regional areas inevitably suffer in comparison with cities. Murray Bridge is both too close and too far away from Adelaide. There is a struggle to attract and keep staff. She says she knows of other service providers who have been unable to fill positions, even when the money has been available.
Courtney says there is a lack of drug and alcohol counsellors in the area, a lack of rehab beds, but that it’s difficult for those who need those services to travel to Adelaide. There is no public transport and the state government’s patient assistant transport scheme, which helps pay transport costs for medical appointments, only kicks in at 100km from the city. Murray Bridge is around 75km from Adelaide.
Not that Courtney is giving up. She has another idea that she believes will benefit the clients that come to the network. The idea is to build a self-sustaining café, garden and op-shop that will employ those trying to start a new life but have inevitably patchy employment histories. They will learn new skills, build some self-esteem, learn how to interact with other employees and bosses. Courtney refers to them as “micro-employment’’ skills, that many former addicts never learned.
She says she needs around $300,000 to start it up. Again, she has started the process of writing grant applications, chasing funding, looking at fundraising ideas. Already she has been knocked back on a few. But she’ll hang in there, believing in the essential worth and logic of the idea. That it is a way to prevent the curse of intergenerational unemployment and change society. That is why she keeps going.
“It’s exhausting. But you have to be as creative as you can be in a regional area to get the best bang for your buck,’’ she says.
‘Very real threat to nurses’: Drug-fuelled violence escalates in EDs
- Brad Crouch
Frontline nurses dealing with drug-fuelled patients are seeing cases of abuse on the rise as arrivals with drug-induced psychosis fill emergency departments and add to ambulance ramping.
SA Health’s Safety Learning System, where staff log potentially dangerous incidents in an effort to avoid a repeat, shows an alarming rise in abuse reports.
Australian Nursing and Midwifery Federation state secretary Elizabeth Dabars said nurses and midwives were concerned about the behavioural impact of methamphetamine in their workplace.
“We believe more needs to be done to protect health care staff from rising violence,” Ms Dabars said.
“We know from Safety Learning System statistics that incidences of physical, mental and verbal abuse against health care staff have soared in South Australia by almost 50 per cent in the last five years.”
Ms Dabars said federation members are dealing with increased numbers of drug and alcohol-afflicted patients throughout the health system.
“One member informs us that prior to leaving her emergency department in 2012 to work with SAPOL, as a senior registered nurse she very rarely went ‘hands-on’ in helping to physically restrain violent patients, as the hospital Code Black team provided an adequate response to such incidents,” Ms Dabars said.
“The registered nurse said that during her subsequent three years with SAPOL as a police
officer she only went ‘hands-on’ five times on the road.
“However, when she returned to the ED in 2016 she was forced to help physically restrain
patients five times in her first week back due to the increase in violence presenting and drug
use in the community – as well as the fact that the Code Black teams were often responding to violent incidents elsewhere in the hospital.”
Ms Dabars noted methamphetamine-related presentations to hospitals added to problems of bed blockage and poor patient flow through the system, with many mental health patients housed in EDs, sometimes for days, due to a lack of more appropriate accommodation.
“We have received anecdotal reports of increased methamphetamine use and the terrible effect it has on people’s lives and the negative effect it also has on the health system more broadly due to the additional burden on the system due to the physical and behavioural impact,” she said.
“Members report drug and alcohol-affected patients causing significant damage and presenting
a very real threat to nurses, midwives, other patients and visitors.
“Drug-induced psychosis is a significant problem. People who experience mental health issues
have a greater risk of using drugs to help them cope, and those who use drugs are more at
risk of developing mental health issues. So, they are linked problems.”
The state government has committed to implementing the federation’s 10-point plan to end violence and aggression, which includes improved security, risk identification, ensuring workplace design goes to prevent violence and that people are educated on how to handle the
issues.
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