For many years now it has been known that rural hospitals located near shared state/territory borders in Outback Australia have faced an unresolved medical dilemma when it comes to arranging critical care aeromedical transfers in a timely manner. During my 15 yr career with RFDS this was well known amongst the small aeromedical community. The locations that would recurringly come up in conversation were and still are towns such as Broken Hill and Karratha which are near shared borders between states/territory. For example Broken Hill is actually closer to Adelaide in South Australia than Sydney in NSW but is officially on the NSW side of the shared border. For doctors/nurses/paramedics dealing with this issue on the ground in such remote towns, they have borne witness to tragic outcomes as a result of this when trying to organise urgent critical care transfers. Maddeningly the roots of this problem lie in state politics and lack of coordination between health departments . The following two tragic deaths highlight the problem. Alex Braes died in 2017 and Austin Facer in 2019, both from Broken Hill and both were treated at Broken Hill Hospital . It is important to note that the coroner either did not find or was unable to find that delayed aeromedical transfer contributed to these deaths. However the recurring delays present significant stress to families of deceased and the hospital staff involved. The ever present anxiety is that eventually ( if not already) there will be another tragic death in which delayed transfer did contribute.
The coroner clearly recommends that interstate agreements urgently be established to resolve the issue of requesting and confirming cross border transfers for critically unwell patients.