Doctors' groups take temperature on appetite for health care reform

Rural health services are under pressure (Getty)

Rural health services are under pressure Source: Getty / Mark Evans

Leaders from around 50 medical groups have gathered in Canberra to tackle some of the thorniest issues facing Australia's heath system. The Australian Medical Association is among the organisations to attend. The AMA argues that logjams in public hospitals, rural communities struggling to access care and the shuttering of private hospitals and services shows the health of Australia's care system is waning.


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TRANSCRIPT

"Today we've announced the holding companies of Healthscope Operations have entered into receivership."

That was Tino La Spina, the CEO of Healthscope, a company that runs 37 private hospitals in every Australian state and territory.

Health Minister Mark Butler reassured the community that it would be business as usual at Healthscope hospitals while a new buyer was found.

"One in seven or one in eight private hospital procedures are undertaken at a Healthscope hospital, and that's why we have been so determined, and I know my state and territory colleagues share this view, so determined to make sure that if there is a sale of Healthscope hospitals, which it's now clear there will be that it's undertaken in an orderly stable way that protects the operations of those hospitals and through that the interests of patients and the very hard working 19,000 staff members."

These reassurances have done little to allay wider concerns about the private health system, however, and the role it plays in sharing and alleviating demand in the public system.

The federal health department's own data says that Australia’s private hospitals cover more than 40 percent of all hospital admissions and deliver approximately 70 percent of surgeries considered to be elective.

Meanwhile, the public system itself has been under increasing pressure - and the public face of that has been emergency departments.

A report released by the Australasian College for Emergency Medicine in January said roughly 30 percent of people who needed to be admitted were still waiting eight hours after getting to an ED.

This week, College head Dr Steven Gourley has said it was clear that presentations are growing every year - largely due to patients who have nowhere else to go.

"The demand is very, very high and we're struggling to meet that demand. We're looking forward to some constructive discussions about how we might meet that demand as we move into the future, and provide the care that we know our patients desperately need - and deserve."

Dr Gourley has been part of a gathering in Canberra this week with around a hundred other medical leaders, from dozens of groups, talking about how to solve these issues.

President of the Australian Medical Association, Dr Danielle McMullen, was there too.

"We all know our health care system is under strain, whether it's the logjam in our public hospitals, the workforce shortages right across the country but particularly in rural and remote Australia, and the closures that we're seeing even in private hospital services."

Dr McMullen says an independent health workforce agency would go a long way to addressing these types of problems.

"We don't have the data, the strategy, the plan, for how many doctors we need, what kind we need, and where we need them to work. It's been about a decade now of that information vacuum and so we're really seeing the cracks starting to show."

Dr Raymond Lewindowsky is the president of the Rural Doctors Association.

He says issues with access to private hospitals, and access to health services overall, is an especially vexed problem in the bush.

Dr Lewindowsky says rural and regional patients are especially susceptible to inequities in the health system - and they are too often overlooked when funding is decided on.

"In funding we need reform. In staffing, there just aren't the numbers in the bush. But that is for reasons that are predictable, and solvable... There are ways around that. We actually do have solutions to it, and it's going to be great to put forward some of the solutions and talk about it and be able to present it."

Health has figured prominently as each state and territory hands down its respective annual budget.

Queensland Treasurer David Janetzki has announced the state government will spend $33 billion on public health in the next financial year.

ACT Treasurer Chris Steel has argued that the territory's deficit is due to the government's revenue stream falling behind what's needed in part to meet the growing demand for health services of its ageing population.

STATEMENT VO: "All of us are facing this massive fiscal challenge from the growth in demand and cost on our hospital systems. That is something that we want to address with the Commonwealth sitting down and getting underway with negotiations on a new five-year National Health Reform Agreement."

In New South Wales, the Minns Labor Government is preparing to hand down its third budget this week.

Both Health Minister Ryan Park and Treasurer Daniel Mookhey acknowledge a strong demand for public hospitals - and issues with rural health.

A 2024 rural health inquiry found that in New South Wales alone, a number of rural maternity units, including at Bathurst, Lithgow and Kempsey, were on the brink of closing down due to staff shortages and limited resources.

Women have also reported experiences of waiting for weeks to see a GP or nurse to help with post-birth complications or general support.

The Treasurer has told a gathering at the South Eastern Sydney Local Health District that a key focus of their budget papers is funding for rural maternity services.

"We will always look to provide more money into our health system. Our health system does a magnificent job every day for the people of New South Wales. Our health care professionals do a  fantastic job. We want to equip them with the resources they need to provide the care that the community is asking for.”

But Dr Lewindowsky says these kinds of budget decisions in the state and federal sphere too often leave rural health without everything it needs.

He says policymakers should be looking at rural health in a completely different way.

"It's not set up well. Unfortunately right now it's often thought of a subset of urban - but the problems, the issues, and the way that health care is delivered there is very different, and that's why we need a separate strategy."

Meanwhile, Dr McMullen says everyone hopes for real progress on how to address rising demand and inequities in the system.

"We all need to come together and urgently address these issues. These are affecting Australians every day and therefore they're affecting doctors. We're a profession trained to care, and the issues that hurt our patients hurt us too."


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Doctors' groups take temperature on appetite for health care reform | SBS News