The Northern Territory government has been exploring dialysis treatment options in the remote town of Batchelor, despite assurances it would not shift medically vulnerable YiSSA residents away from their services.
It is less than a week before the expected closure of Darwin's largest short-stay accommodation centre, the Aboriginal-run YiSSA facility, on October 11.
The accommodation has been relied on by vulnerable Territorians, including dialysis patients, homeless residents and families fleeing violence.
The NT government rejected a $3.5 million shared-purchase offer from the federal government to keep the centre open and announced it was instead shifting some of YiSSA's residents to Batchelor, a town 100 kilometres from Darwin.
Correspondence provided to the ABC reveals a senior NT Health bureaucrat reached out to renal health service Purple House last week about the possibility of using its "Purple Truck" for treating dialysis patients in Batchelor.
The bureaucrat asked for written confirmation "that Purple House does not currently have the capacity to provide mobile haemodialysis services for individuals relocating to Batchelor who may require treatment in the coming weeks, following the closure of YiSSA".
"Having this confirmed in writing would be helpful in informing our planning for alternative arrangements," the bureaucrat said.
The email chain included Purple House chief executive Sarah Brown and one of her staff members.
"The truck is currently in Alice Springs and limitations re staffing, and the oncoming build up and wet season will make providing service from the truck over the next four- six months very difficult.
"Our priority in staffing is to maintain our existing permanent sites."
The Purple House staff member then explained why moving dialysis patients to the Batchelor facility was "not advisable on several levels".
The reasons outlined include a lack of access to dialysis, reliable return transport to Darwin, proximity to aged care, disability services and the Darwin and Palmerston hospitals "as dialysis patients are unfortunately frequent flyers to acute care".
It would create "further dislocation and destabilisation to an already extremely vulnerable patient group that require a high level of medical and social services support", the email said.
The NT Health bureaucrat thanked Purple House for its advice: "This information will help inform our planning and advice to executive leadership," the bureaucrat said.
Minister had ruled out Batchelor move
During a press conference announcing the decision to relocate YiSSA residents to Batchelor, Children and Families Minister Robyn Cahill said NT Health was working to find dialysis patients accommodation close to services in Darwin.
In response to a direct question about whether dialysis patients would be moved to accommodation in Batchelor, Ms Cahill replied "No".
Despite several requests from the ABC, the NT government has not confirmed whether there are now plans to accommodate dialysis patients at the Batchelor site or how many dialysis patients resided at YiSSA and required alternative accommodation.
In a statement to the ABC last week, a spokesperson for the NT government said "where residents require dialysis or other ongoing treatment, the service providers will work with NT Health to ensure appropriate transport and accommodation arrangements are in place so people can continue to attend their medical appointments".
"The government has been working with residents to support them into suitable alternative accommodation, and no resident who needs medical care will be left without a way to reach it," they said.
Government urged to keep YiSSA open
Since the announcement of the YiSSA closure, support workers for dialysis patients have spoken about fears some patients could miss treatments and become unwell after being forced into "unsafe" overcrowded homes or onto the streets.
Last month, the board of the Aboriginal-run Purple House wrote to NT Chief Minister Lia Finocchiaro and all other NT government ministers, urging them to reconsider their negotiations with the federal government over YiSSA.
"Investing in services such as YiSSA enables Aboriginal people from remote communities to receive the care they need with dignity, safety and cultural support," the board members wrote in the letter seen by the ABC.
"The closure of this service would create significant barriers to healthcare for some of the Northern Territory's most vulnerable residents and place additional pressure on hospitals, community organisations and other accommodation providers."
In a letter responding to the Purple House board, Ms Cahill wrote that negotiations regarding the site had not been straightforward and the federal government had insisted on a "movable feast" of conditions.
Ms Cahill said they ranged from a "requirement for the Northern Territory government to relinquish ownership of the infrastructure to a third party to committing to engage in a long-term agreement with a specified third party, with no capacity for discussion or negotiation".
