All this talk of efficiency and productivity. Where is the patient experience in all this?
It’s been a big week for productivity, efficiency, funding models, roundtables and government announcements.
Has it been a good week for healthcare, though? A good week for patients? The jury is well out, readers.
Of course there was the Productivity Commission’s final interim report – Delivering quality care more efficiently.
Overall, it was a good set of recommendations – more investment in prevention, more collaborative commissioning between PHNs, LHDs and ACCHOs, and a national framework for giving workers more mobility across sectors.
The first is a no-brainer – the phrase “prevention is better than cure” has been around since the mid-13th century, if the AI bot on my Google machine is anything to go by. God knows the Public Health Association of Australia has been banging on about it for years.
The second is already happening. In Queensland PHNs have to co-commission with LHDs thanks to the Queensland Commonwealth partnership, and the fact is other PHNs around the country have long ago figured out that they can’t do things – at least not for long, or consistently – without the help of other agencies, including state government ones.
The third makes sense because it saves on paperwork.
(Just as a side note here – sorry to keep going on about this, dear readers at the Department of Health, Disability and Ageing – but that Boston Consulting Group review of the PHN business model that you say hasn’t been sent to PHNs, and that you keep hiding away in your top drawer? It has totally been sent to PHNs. We know it. They know it. You know it. Come on, bite the bullet and release the bloody thing so we can all move on, while hopefully improving things on the way.)
I can tell you some things the PC’s report didn’t talk about. General practice, for one. And the workforce shortage, for another.
This week also saw a couple of hearings into the NSW bill calling for the splitting up of the Hunter New England LHD, a huge district stretching from Newcastle up to the Queensland border.
Day one of the hearings heard from health professionals who want the district split in half with the northern section to be administered in Armidale or Tamworth.
The biggest complaint there was that the urban-centric administration in Newcastle wasn’t doing enough to sort out workforce shortages that have seen places like Wee Waa Hospital have to close its ED between 5.30pm and 8am. Even when it’s open, there’s never a doctor onsite.
Day two of the hearings heard from health professionals who don’t want the district split in half.
Why? Because it will complicate an already complicated situation. And what’s more, no matter where the district is administered from, there will always be a need to refer patients down to Newcastle.
“As a GP, your patients can’t have all of their services delivered in the New England region, by virtue of our population size,” said Dr Michelle Guppy, from the New England Division of General Practice.
“Tamworth Hospital is never going to be able to deliver open heart surgery or other sorts of major medical services, and so there’s always going to be a need to refer out from this region.
“And at the moment, we have clear [referral] pathways down to Newcastle, because we’re one health service.
“Splitting the health service would add a layer of complexity for general practice referrals.”
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Heather Franke, from the Gunnedah branch of the NSW Nurses and Midwives’ Association, said splitting the district would “not solve the biggest issue for rural parts of the LHD – workforce shortages”.
The Productivity Commission can talk about how the care economy workforce has doubled over the 20 years to 2020 – it did – but that’s not much good if demand has outstripped that supply – it has.
Increased mobility, or more workforce regulation, or a more efficient workforce – it doesn’t feel like any of that solves the wicked truth at the heart of what ails the Australian healthcare system.
There aren’t enough of the right kind of health workers in the right places at the right time.
The other event dominating debate this week has been the upcoming economic roundtable next Tuesday, Wednesday and Thursday.
A quick look down the list of 24 invitees – as published by the Australian Financial Review – suggests there is not going to be a lot of joy, or even worth, in the roundtable for those in the healthcare industry.
There’s not one person even vaguely related to the sector at the three-day yakfest. Bankers, investors, Woodside – for god’s sake – treasurers (but not all of them), public servants (but not Blair Comley), trade unionists – which I suppose constitutes some representation for healthcare workers – and small business organisations.
Does Mark Butler even get to go?
I’m off to Melbourne for the AIDH’s big HIC2025 conference. Have a good weekend all.