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18/6/19, 12)12 pmTalking Point: How to heal our hospital emergency crisis | The Mercury
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BRUCE LEVETT, Mercury Subscriber only | an hour ago
BRUCE LEVETT: Think long-term, because Tasmanians aregoing to get even sicker
OPINION
Talking Point: How to heal ourhospital emergency crisis
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OPINION RENDEZVIEW LETTER TO THE EDITOR
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18/6/19, 12)12 pmTalking Point: How to heal our hospital emergency crisis | The Mercury
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MAKE IT BETTER: The community is awake to the pending health crisis.
HEALTH Consumers Tasmania welcomesthe invitation from Health Minister MichaelFerguson to take part in tomorrow’s “AccessBlock Solutions” meeting about the RoyalHobart Hospital.
The meeting has been brought forward as a result ofthe Tasmanian Auditor General’s report into theperformance of emergency services in Tasmania’sfour major hospitals.
Access Block refers to an overcrowded emergencydepartment caused by patients staying longer thannecessary in emergency because there aren’t enoughbeds in the main part of the hospital for them to betransferred to.
Access Block is a common factor across manyhospitals in Australia. In a complex industry madeup of many stakeholders, decision-makers andfunders, how can we find solutions to this problem?
Health Consumers Tasmania advocates that alonger-term approach needs to be considered aspart of any solution to the Access Block problembecause many of the contributing factors sit outsidethe Emergency Department. We acknowledge that amore immediate response is also required to thefindings of the Auditor General’s report — “that theTasmanian hospital system is not workingeffectively to meet its growing demand foremergency care”.
Part of the answer can be found in the HealthMinister’s Ministerial Charter July 2018 and I quotethe minister, “a whole of system approach to careplanning and delivery will be maintained, includingstrategies to improve co-ordination and integrationof primary and community care services, with
18/6/19, 12)12 pmTalking Point: How to heal our hospital emergency crisis | The Mercury
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hospital services and supporting individuals to staywell in their homes and communities”.
My conversations with people around Tasmaniashow the public expect safe and quality healthcarewhen they do get sick, and this is seen as non-negotiable, but many people want governments tothink more broadly when it comes to health andhealth care, as the Charter suggests.
Tasmanians are telling me it’s important to “keeppeople supported in their community byunderstanding their needs so they don’t end up inthe acute sector”. That is, hospital.
I am aware of a new service being rolled out by theTasmanian Health Services called the CommunityRapid Response Service that provides doctor andnurse support to patients in their homes when it issafe to do so. This provides an alternative tohospital care and can help in keeping inpatient bedsfree to those who come to hospital via Emergency.
The Department should be congratulated for thispotentially valuable service, but we need moreinnovative solutions like this.
We need to apply this innovative thinking toanother area that requires urgent attention.
The proportion of people in Tasmania who delayvisiting a GP due to cost has risen from 6.9 to 8.7per cent over the five years to 2018-2019. That’sabout 46,000 people in Tasmania who can’t affordto see a GP. As bad as this number is, it has grownby nearly 10,000 Tasmanians over the past fiveyears.
GPs provide a critical first point of contact forpeople who become unwell, but what happens tothose 46,000 Tasmanians who can’t afford to see aGP when they should, or for those who don’t haveeasy access to a GP — as will be the case for those inRisdon Vale when their medical centre closes at the
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end of this month?
I am not an expert, but I understand that they havea greater chance of ending up in Emergency whenthey do have health problems.
We should consider how to support this group inour community so they have equal access to primaryhealthcare so GPs can treat them first. This requiresboth state and federal government co-operation andintervention because the state funds hospitals whilefederal government manages GPs.
A second area where the community tells me asolution to the current hospital crisis can be foundis in health prevention.
Tasmanians have told us that our state needs toconsider a focus on “local health solutions includingservices, prevention and education”.
An analysis of the recent state budget by the HeartFoundation highlights that spending in publichealth services has fallen to 1.4 per cent of thehealth budget and will continue to fall over theforward estimates to 1.15 per cent.
Prevention helps people stay out of hospital for aslong as possible.
Tasmanians don’t understand why so little effortand resources are placed in the areas that, over themedium term, can generate savings to the healthbudget and at the same time, help reduce thesqueeze on our emergency departments.
For a state like Tasmania, where people typicallysmoke more than other Australians, tends to be onaverage more overweight and obese than those wholive on the mainland and therefore, are more proneto chronic conditions like diabetes and heartdisease, this should be a priority for our policy-makers.
The community is awake to the fact that this is the
18/6/19, 12)12 pmTalking Point: How to heal our hospital emergency crisis | The Mercury
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pending health crisis as our next generation movestowards older age, but from a poorer health basecompared to those already there.
This also goes to the hub of the minister’s charterthat commits to support Tasmanians to stay well intheir homes and communities.
Investing in hospitals is important, and weacknowledge that they provide critical support toour communities, but if we continue to ignorefunding to those important areas outside thehospital system, like community services andprevention, then we will only see a Tasmanianhealth system under greater pressure.
And we will be back here again in one, two or fiveyears time, having the same conversations over andover.
Bruce Levett is executive officer of HealthConsumers Tasmania, the peak body forhealth consumer advocacy in Tasmania.
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