Interesting times ' evolution of dialysis in Australia's Northern Territory (1980-2014)

Gillian Gorham, Sandawana William Majoni, Paul Lawton, Sarah Brown, Bigani Dube, Tara Conlon, Cherian Sajiv, Pamela Wood, Selina Signal, Alan Cass

    Research output: Contribution to journalReview articleResearchpeer-review

    Abstract

    Background: Treatments for kidney disease have been available in Australia for more than 50 years. Despite this, and the Northern Territory (NT) having Australia's highest rates of kidney disease, the range of models of dialysis care in the NT has been limited until quite recently.

    Objective: The paper provides a brief history of the development of dialysis services in the NT and examines the contexts in which unique models of dialysis care have emerged. Data reviewed included published and unpublished documents and reports, relevant Departmental and ANZDATA information and interviews with past and present staff.

    Discussion: The early development of renal services in the NT was characterised by a desire to limit expenditure, despite repeated disease projections that indicated rapidly escalating demand. An integrated policy response was not forthcoming to address the magnitude, persistence and growth in the burden of kidney disease. Repeated periods of capacity crisis requiring Ministerial intervention have dominated the historical landscape. In the meantime, Aboriginal patients, communities and clinicians have advocated, with some success, for services that are closer to home and more responsive to patients' health, social and cultural needs.

    Conclusion: There has been considerable expansion of dialysis services across the NT, with several unique models of dialysis care developing over the last 15 years. While there are now some community-led services, the NT Government continues to provide the bulk of staffed services. It is yet to be seen if the new MBS item for remote dialysis services will be another game-changer.

    Original languageEnglish
    Pages (from-to)108-116
    Number of pages9
    JournalRenal Society of Australasia Journal
    Volume14
    Issue number3
    Publication statusPublished - 1 Nov 2018

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    Northern Territory
    Dialysis
    Kidney Diseases
    Social Welfare
    Health Expenditures
    Interviews
    Kidney
    Health
    Growth

    Cite this

    Gorham, Gillian ; Majoni, Sandawana William ; Lawton, Paul ; Brown, Sarah ; Dube, Bigani ; Conlon, Tara ; Sajiv, Cherian ; Wood, Pamela ; Signal, Selina ; Cass, Alan. / Interesting times ' evolution of dialysis in Australia's Northern Territory (1980-2014). In: Renal Society of Australasia Journal. 2018 ; Vol. 14, No. 3. pp. 108-116.
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    title = "Interesting times ' evolution of dialysis in Australia's Northern Territory (1980-2014)",
    abstract = "Background: Treatments for kidney disease have been available in Australia for more than 50 years. Despite this, and the Northern Territory (NT) having Australia's highest rates of kidney disease, the range of models of dialysis care in the NT has been limited until quite recently. Objective: The paper provides a brief history of the development of dialysis services in the NT and examines the contexts in which unique models of dialysis care have emerged. Data reviewed included published and unpublished documents and reports, relevant Departmental and ANZDATA information and interviews with past and present staff. Discussion: The early development of renal services in the NT was characterised by a desire to limit expenditure, despite repeated disease projections that indicated rapidly escalating demand. An integrated policy response was not forthcoming to address the magnitude, persistence and growth in the burden of kidney disease. Repeated periods of capacity crisis requiring Ministerial intervention have dominated the historical landscape. In the meantime, Aboriginal patients, communities and clinicians have advocated, with some success, for services that are closer to home and more responsive to patients' health, social and cultural needs. Conclusion: There has been considerable expansion of dialysis services across the NT, with several unique models of dialysis care developing over the last 15 years. While there are now some community-led services, the NT Government continues to provide the bulk of staffed services. It is yet to be seen if the new MBS item for remote dialysis services will be another game-changer.",
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    Gorham, G, Majoni, SW, Lawton, P, Brown, S, Dube, B, Conlon, T, Sajiv, C, Wood, P, Signal, S & Cass, A 2018, 'Interesting times ' evolution of dialysis in Australia's Northern Territory (1980-2014)', Renal Society of Australasia Journal, vol. 14, no. 3, pp. 108-116.

    Interesting times ' evolution of dialysis in Australia's Northern Territory (1980-2014). / Gorham, Gillian; Majoni, Sandawana William; Lawton, Paul; Brown, Sarah; Dube, Bigani; Conlon, Tara; Sajiv, Cherian; Wood, Pamela; Signal, Selina; Cass, Alan.

    In: Renal Society of Australasia Journal, Vol. 14, No. 3, 01.11.2018, p. 108-116.

    Research output: Contribution to journalReview articleResearchpeer-review

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    T1 - Interesting times ' evolution of dialysis in Australia's Northern Territory (1980-2014)

    AU - Gorham, Gillian

    AU - Majoni, Sandawana William

    AU - Lawton, Paul

    AU - Brown, Sarah

    AU - Dube, Bigani

    AU - Conlon, Tara

    AU - Sajiv, Cherian

    AU - Wood, Pamela

    AU - Signal, Selina

    AU - Cass, Alan

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    N2 - Background: Treatments for kidney disease have been available in Australia for more than 50 years. Despite this, and the Northern Territory (NT) having Australia's highest rates of kidney disease, the range of models of dialysis care in the NT has been limited until quite recently. Objective: The paper provides a brief history of the development of dialysis services in the NT and examines the contexts in which unique models of dialysis care have emerged. Data reviewed included published and unpublished documents and reports, relevant Departmental and ANZDATA information and interviews with past and present staff. Discussion: The early development of renal services in the NT was characterised by a desire to limit expenditure, despite repeated disease projections that indicated rapidly escalating demand. An integrated policy response was not forthcoming to address the magnitude, persistence and growth in the burden of kidney disease. Repeated periods of capacity crisis requiring Ministerial intervention have dominated the historical landscape. In the meantime, Aboriginal patients, communities and clinicians have advocated, with some success, for services that are closer to home and more responsive to patients' health, social and cultural needs. Conclusion: There has been considerable expansion of dialysis services across the NT, with several unique models of dialysis care developing over the last 15 years. While there are now some community-led services, the NT Government continues to provide the bulk of staffed services. It is yet to be seen if the new MBS item for remote dialysis services will be another game-changer.

    AB - Background: Treatments for kidney disease have been available in Australia for more than 50 years. Despite this, and the Northern Territory (NT) having Australia's highest rates of kidney disease, the range of models of dialysis care in the NT has been limited until quite recently. Objective: The paper provides a brief history of the development of dialysis services in the NT and examines the contexts in which unique models of dialysis care have emerged. Data reviewed included published and unpublished documents and reports, relevant Departmental and ANZDATA information and interviews with past and present staff. Discussion: The early development of renal services in the NT was characterised by a desire to limit expenditure, despite repeated disease projections that indicated rapidly escalating demand. An integrated policy response was not forthcoming to address the magnitude, persistence and growth in the burden of kidney disease. Repeated periods of capacity crisis requiring Ministerial intervention have dominated the historical landscape. In the meantime, Aboriginal patients, communities and clinicians have advocated, with some success, for services that are closer to home and more responsive to patients' health, social and cultural needs. Conclusion: There has been considerable expansion of dialysis services across the NT, with several unique models of dialysis care developing over the last 15 years. While there are now some community-led services, the NT Government continues to provide the bulk of staffed services. It is yet to be seen if the new MBS item for remote dialysis services will be another game-changer.

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