An article by ABC News and Australian Story – Read full article here

The Queensland Government has rejected a proposal to help fund an innovative mobile cardiology clinic that treats hundreds of people in regional Queensland.

Known as “the heart bus”, the mobile clinic is the brainchild of Rolf Gomes, an electrical engineer-turned-cardiologist.

It was launched by Dr Gomes’ company, Heart of Australia, in October 2014, and in its first six months of operation, nine patients were referred for open heart surgery.

“These are the type of procedures that, left unattended, you could potentially die,” Dr Gomes told Australian Story.

The Heart of Australia mobile clinic travels some 8,000 kilometres each month, servicing 12 regional communities.

“We’ve now seen in excess of 2,000 patients and these are people who might never have seen a cardiologist,” Dr Gomes said.

People living in the country are 44 per cent more likely to die of heart disease than people living in the city, and in some remote areas the figure can rise as high as 63 per cent. There are a number of other medical outreach services for people living in the bush, including some specialty services such as cardiology, but Dr Gomes said this was not enough.

“You can’t look at the city-country gap and say the way to address that is to maintain the status quo, because whatever already exists, clearly we need to be doing more,” he said.

‘I wondered, why couldn’t I find a cardiologist in town?’

It was as a young trainee doctor on rural rotations that Dr Gomes was first struck by the lack of medical services available to people living in the bush.

“I wondered, why couldn’t I find a cardiologist in town? Why couldn’t I find an orthopaedic person?” he said.

His own family had experienced failures of the medical system first-hand in their hometown of Calcutta, India, where a misdiagnosis at the local hospital contributed to the death of Dr Gomes’ five-year-old brother, Clive.

 

“I sometimes try and put the pieces together as to what could have been done,” he said.

His parents immigrated to Melbourne with their four remaining children a few years later, when Dr Gomes was 10 years old. He graduated from university as an electrical engineer in 1996 before returning to study medicine, a profession he felt was “more about people than computers”.

The heart, with its valves and pumps and electrics, was a perfect fit for the former engineer. He began practicing as a sole cardiologist in Brisbane, but the gap between city and country services continued to niggle.

“I’d walk into my city practice and wonder why I couldn’t take the diagnostic testing equipment to rural and regional areas on the back of a truck,” he said.

His engineering background gave him the skills to design a mobile diagnostic and testing clinic. He estimated it would cost $1 million to build the truck, then another $1 million to keep it on the road for a year, and he struggled to find funding.

“He was talking about having federal government, state government, local government, industry, hospitals, the local community, the GPs all coming together for this concept around this cardiology truck,” general manager of St Andrew’s War Memorial Hospital, Andrew Barron, said.

“My first reaction was, ‘Wow, that’s a fantastic idea but tell him he’s dreaming’.”

Something finally clicked when coal seam gas mining company Arrow Energy came on board as principal sponsor — other companies followed suit, and St Andrew’s hospital helped with the fit-out. With the truck near completion, Dr Gomes and his wife took out a second mortgage on their house for $800,000. The Federal and Queensland governments each contributed $250,000, boosting the funding by half-a-million dollars, for the project to finally get off the ground.

‘Heart of Australia is not going anywhere’

Dr Gomes said the Heart of Australia mobile clinic was an ambitious pilot that proved specialist services city people often took for granted could be delivered to remote regions.

He recently submitted a proposal to partner with the Queensland Government to expand to other regional towns and to include more specialty services such as respiratory physicians, gastroenterologists and urologists — but this has been rejected.

Queensland Health has issued a statement saying it “values the important services that private cardiologists provide” but that it already provides “cardiac services in over 40 rural and remote communities”.

“Heart of Australia provides cardiac services in 12 rural and remote areas — nine of which Queensland Health already services,” the statement said.

The department also said that in addition to outreach services, “patients can also access widespread telehealth facilities to enable consultation with specialists in larger centres”.

Dr Barron, whose hospital continues to support Dr Gomes, said he believed further assessment was needed.

“I think what we need to see now is some independent health economics work done to measure the impact that the Heart of Australia is having,” he said.

Dr Gomes has not given up the fight.

“I’m quite happy for people to be doing research and white papers and blue papers, but let’s make sure people aren’t dying in the meantime,” he said.

“The Heart of Australia is not going anywhere. This is not the end of our discussion with government. This is the start of the fight.”

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