Cairns CBD: Cape York itinerants raise health concerns in city

A centralised healthcare scheme for Cape residents has been described as a “tragic mess” by an indigenous advocate, who says it can lead to poorer outcomes for vulnerable patients trapped in cycle of alcohol abuse.

A Cairns Hospital patient hooked to a drip walks through the Cairns CBD.

A multimillion-dollar scheme to provide centralised healthcare for Cape residents has been described as a “tragic mess” by an Indigenous advocate which can lead to poorer health outcomes for some vulnerable patients trapped in a cycle of alcohol abuse.

Arriving from communities with alcohol restrictions Cape residents are often lured by cheap and readily available alcohol.

Patients who miss flights back to the Cape can end up on the street to often become entangled in the legal system when committing public nuisance offences which then makes them ineligible for the Return to Country safety net.

The number of Cape York residents taking up the Return to Country scheme has declined significantly since it was first offered in 2012.

When it started the scheme helped repatriate 71 people back to their communities but that had more than halved in 2023 when 34 people were transported to communities.

A year later the number dropped to 27 people being successfully relocated.

A Cairns Hospital patient hooked to a drip walks through the Cairns CBD.

Since January 1 2025, only one person has been transported to their community with another five awaiting transport.

The Return to Country scheme offers low cost airfares for people returning to Cape York on top of already subsidised travel under the Local Fare Scheme.

But the program has been criticised for onerous eligibility requirements including that participants must be homeless for three months and contribute $100 toward airfares.

Mapoon-based Indigenous advocate Jack Wilkie-Jans said taking into account vast distances a centralised healthcare model was not without challenges.

“Medical appointments and the patient travel system are not in sync, if you have to stay and don’t have accommodation they are going to sleep rough,” he said.

“People don’t get on the plane if they decide to get drunk before their dialysis, it’s a flawed system because people have a right to traverse the county.

Jack Wilkie-Jans from originally from Mapoon is a Cairns-based Aboriginal affairs advocate. Picture: Supplied

“The government needs to provide better health outcomes in the community because the main problem is the system is not co-ordinated properly, they cannot organise patients and they don’t understand the (patient’s family) distractions.

“The fact that the Primary Health Network has never really looked at this is a tragic mess, all could be redeemed by a couple of million dollar investment in Cape medical services.”

ONE STOP HEALTH SHOP

In November 2023 a new program called the Care Coordination Service Centre was set up to support patients from remote areas to assess healthcare in Cairns.

Torres and Cape Hospital and Health Service chief executive Rex O’Rourke said the centre was the first of its kind in Queensland.

“The centre is a ‘one-stop shop’ for complex patient support with clinical bookings, travel, accommodation, and associated planning services all co-located under the one roof as a single point of contact for patients to help navigate the health system,” he said.

“A significant proportion of the (Cape and Torres Strait) population identify as vulnerable patients.

“As such, it’s critical that their health care is delivered by the right people with the right skills, at the right place and right time.”

A total of $8.6m was spent through the program on 853 Cape York and Torres Strait patient travel and airfares in 2024.

The cash also helped finance a support person or carer for the patients that also travelled to Cairns in what one police insider described as “drinking buddy”.

“There are now more Cape York itinerants in the Cairns CBD that I have seen since 2019 when we blew the whistle on Queensland Health and shipped them all home,” he said.

It was revealed in 2019 that taxpayers shelled out more than $250,000 in a year for Cape York patients flown to Cairns for medical treatment who missed their flights home.

People walk past a public pay phone covered in graffiti tags on Abbott Street in the Cairns CBD. Picture: Brendan Radke

Asked about the recent cost of missed flights, Torres and Cape Hospital and Health Service this week stated it was not possible to separate out just the value of travel relating to patients and carers using the statewide Patient Travel Subsidy Scheme.

But when return flights are not taken up their costs are not lost as they are credited towards future flight bookings.

FAR NORTH REPUTATIONAL CONCERN

Additional rough sleepers in the CBD are understood to be a factor in a 54 per cent increase in Cairns city liquor offences in the six months to June this year and crime problems the business community fears is damaging Cairns’ international reputation.

A group of itinerants on the footpath outside a business at the corner of Lake and Shields streets in the Cairns CBD. Picture: Supplied

Last month a photo taken on Sheridan St outside the Suan Suan hot pot showed a man asleep in the Cairns CBD surrounded by empty bottles and discarded food.

The photo was taken by Cairns businessman Daniel McKell while out for a meal with visitors from Sydney who emailed the photo to Cairns Mayor Amy Eden with a subject line that read, “CBD needs a clean up”.

“With the limited tourists we have coming to Cairns, this is the view they have when dining out,” he wrote to the mayor.

Queensland Police officers respond to an incident in the Shields Street mall last month. Picture: Brendan Radke

“I was absolutely appalled by our streets and the lack of security presence.

“It is such a shame to hear tourists speak so ill of Cairns and leave such a bad impression as this filters onto the rest of Australia and our potential market.”

Mayor Eden acknowledged she had received the email but said more than $2m annually was spent on cleaning and maintenance alongside a heavy investment in hundreds of CCTV cameras.

She said “complex issues” required an “integrated and co-ordinated response”.

“Enforcement is necessary but we all recognise that it is not sufficient on its own,” she said.

“A whole-of-community response, involving police, health, housing, community services, and council is essential for long-term change.”

BUSINESS HANGING BY A THREAD

Co-owner of the Makin Whoopee gift shop Kirsty Mulley has worked in the CBD for more than 20 years.

She says suburban retail centres sucking shoppers out of the city, the rise of online shopping, a cost of living crisis and the centre of town being unsafe had combined to create a perfect storm for traders.

“Most of us are hanging on by thread,” she said.

“Every single small business in the CBD, apart from maybe some cafes, are either going broke or just fed up and had enough and are contemplating shutting doors because you just can’t keep doing it, it’s exhausting.

“To be honest, I’d say (council efforts) are better than nothing, but it’s not enough for what’s going on.”

Makin' Whoopee co-owner Kirsty Mulley. Picture: Brendan Radke

“They need to up their game and increase what they’re doing

“I go down to Rusty’s about every two weeks and it’s absolutely revolting, and that’s meant to be a tourist attraction.

“It makes me not want to send people there because it’s absolutely feral.

“Our CBD is literally the gateway to the city, this is the first thing people see and the last thing people see.”

As for the growing number of empty shops with for-lease signs currently bolted with heavy chains, Ms Mulley made a concerning prediction.

“Those spaces are never going to be leased, they’re never going to become retail or anything else ever again,” she said.

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Originally published as Cairns CBD: Cape York itinerants raise health concerns in city