Medical scientists say the shutdown of Australia’s only nuclear medicine generator is endangering patients in rural and regional areas who need urgent diagnostic tests and who are being forced to fly to major cities to receive them.

“This situation is unprecedented in the history of nuclear medicine in Australia,” nuclear medicine practitioner Peter Tually told Guardian Australia.

“We have a problem providing care to many rural Australians, in particular those with cancer and heart disease, following the shutdown of the nuclear reactor’s production facility for medical isotopes 10 days ago.”

The Australian Nuclear Science and Technology Organisation (Ansto) runs the generator at Lucas Heights in New South Wales, about 25km south of Sydney. The generator usually produces about 10,000 doses a week of Technetium-99m (Tc-99m), which is then supplied to medical facilities around Australia as well as in New Zealand and other countries in the Asia Pacific. It is used in medical diagnostic tests to detect numerous heart, lung and musculoskeletal conditions, as well as cancers.

But Ansto was forced to close the generator 10 days ago due to a mechanical fault. While it has been shut down for a variety of reasons before, and there are contingency plans to handle such situations, the generator has never been out of operation for so long. Antso said the issue would take “some weeks” to repair but could not give Guardian Australia an exact timeframe.

Back-up supplies are usually imported from South Africa in such situations, but that plant has been temporarily shut down for maintenance. Australia then sourced Tc-99m from the United States, but a plane delivering a second wave of generators has been held up due to mechanical issues.

Last weekend, Australia received Tc-99m generators from the US, which were distributed on Monday to 24 hospitals in metropolitan areas, 12 regional and rural medical facilities and five Global Medical Solutions Australia sites across Australia. But this equates to less than 40% of normal weekly supply.

The plane delivering the second wave of generators is now expected to arrive on Thursday morning.

“If there are no further delays, this means the generators will be delivered to medical facilities on Friday,” an Ansto spokesman said. “Ansto appreciates the airline delay will make things challenging for our customers in Australia and the region, and is seeking to keep all parties up to date on the progress.”

But Tually, who is director of Kalgoorlie Medical Imaging in Western Australia, said communication from Ansto to rural and regional medical practitioners had been poor and that frustration was building. He said while Ansto was doing all it could to repair the generator, it was failing to properly ration the available Tc-99m and deliver it to areas most in need.

“There needs to be greater assistance given by the government to Ansto to deal with this,” he said. “Antso are more than qualified at the nuclear physics level and we have a good relationship with them, but they do not have the clinical expertise to determine where available supplies need to most urgently be sent.”

While patients at large tertiary hospitals in major cities might have back-up diagnostic tests available, for example through CT scans for echocardiography, towns such as Kalgoorlie have no such back-up tests.

“Those alternative tests may not be the best but they are enough to manage patients in the short term,” Tually said. “In Kalgoorlie we don’t have that richness of alternative services. Kalgoorlie is the most remote site on the planet in terms of its distance from the reactor and there is no CT scanner or echocardiography here. Heart disease and cancers are the biggest killers, and delaying diagnosis is a very bad thing.

“I’ve had to fly a patient to Perth and my colleagues in regional towns around the country are facing the same issue. Patients are having to leave loved ones to fly to Perth or Sydney.

“We’ve never had this shortage happen to this extent before ... previous shortages have lasted a couple of days, max.”

But an Antso spokesman said the available supplies of Tc-99m were being allocated according to protocols.

“Generator supplies are being delivered according to need, as advised by clinicians and hospitals,” he said. “In addition, a third batch of generators was produced in the US yesterday and is scheduled for delivery to customers in Australia early next week.”

Guardian Australia has contacted the office of the minister for rural health, Senator Bridget McKenzie, for comment.

