ACT Government fails to improve healthcare for chronic conditions, audit finds

Dominic Giannini 18 September 2020 9
Rachel Stephen-Smith

Health Minister Rachel Stephen-Smith said the Government agrees with all of the report’s recommendations. Photo: Region Media.

Between 2013 and 2019, ACT Health failed to improve the healthcare of people who suffer from chronic conditions, a scathing report from the ACT Auditor-General has found.

Despite multiple strategies and commitments from the Directorate in the last decade, the ACT Government made no headway establishing or implementing strategies, the Chronic Disease Management Unit (CDMU) or using partnerships with other organisations to improve the health system, according to Auditor-General Michael Harris.

“These four commitments have not been effective in expressing improvement priorities, or in driving or demonstrating improvements to the care of people living with serious and continuing illness in the ACT,” Mr Harris said.

“The ACT Health Directorate has not established an effective strategic direction for the improvement of care through these commitments.”

ACT Health had not made any recommendations to respond to the 2017 National Strategic Framework for Chronic Conditions as of August this year, the audit found.

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The Directorate was also criticised for not having ACT-specific strategies and failing to address the Territory’s specific circumstances.

However, the audit did acknowledge that the government’s Healthy Canberra: ACT Preventive Health Plan 2020-2025 will address many of the shortcomings in implementing the ACT Chronic Conditions Strategy between 2013 to 2019.

But it found that none of the four commitments added significant value to the ACT community.

“ACT Health Directorate officials’ and partners’ time and effort in developing strategies, plans and governance arrangements, and in monitoring and reporting on progress represents a significant lost opportunity for improving health outcomes,” the report said.

ACT Health was found to be less engaged and responsive to their partners than expected, while services at the Chronic Disease Management Unit were underutilised.

The Auditor-General recommended that the Directorate create an ACT-specific response to the national framework, develop more partnerships with organisations that are capable of improving the healthcare of people with chronic illnesses, and improve the transparency and accountability of the CDMU.

Reform of the CDMU by clarifying the purpose and benefit of its programs and services – especially the Chronic Care Program – was also recommended.

Health Minister Rachel Stephen-Smith said the Government agrees with all of the report’s recommendations and that work is already underway to improve services.

“Canberra Health Services and ACT Health have implemented a range of initiatives to expand and improve health services for people with chronic conditions, including some of the most vulnerable members of our community,” she said.

“The Canberra Health Services Strategic Plan identifies improving care for people with chronic conditions as a key strategic priority. Canberra Health Services is partnering with community healthcare networks and consumers to co-design an integrated care program for people living with chronic conditions.

“This work recognises the importance of integrated and co-ordinated care for people, with GPs, allied health professionals and specialists working alongside each other for the best possible patient outcome.”

The government noted that the Auditor-General did not look at service delivery in the report, citing Commonwealth, private and ACT Government providers who deliver chronic disease management services in the ACT.

A joint working group has also been established to oversee the strategy for chronic condition management across the ACT health system, with a senior committee overseeing the Territory’s response to the National Strategic Framework for Chronic Conditions.

The government said stronger oversight and governance of the Canberra Health Services’ Chronic Care Program has also been implemented.

The Auditor-General’s report can be found here.

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9 Responses to ACT Government fails to improve healthcare for chronic conditions, audit finds
HiddenDragon HiddenDragon 7:49 pm 29 Sep 20

With the increasing complexity and sophistication of health care services, the question has to be asked whether smaller jurisdictions (even when relatively affluent) can establish and maintain the full range of services which are provided by the large jurisdictions – and which they, too, struggle at times to offer at levels satisfactory to consumers.

In this, and other areas of service delivery, there may need to be much greater sharing across jurisdictions (without necessarily centralising services at the federal level) – particularly with government revenues constrained for many years to come by the economic impacts of the virus.

Daniel Duncan Daniel Duncan 8:12 pm 21 Sep 20

Another reason to vote Barr and his crony's out.

bj_ACT bj_ACT 10:48 am 21 Sep 20

We continue to get scathing Auditor General reports on Health, Education, Property deals and Public Transport. It’s a continual decline across important government services and functions.

Andrew Barr talks a great game and he certainly delivers on the little niceties. But he is getting worse on the core elements of government and small pockets are failing badly. Especially in parts of canberra outside the inner north.

Meg Thow Meg Thow 8:46 pm 20 Sep 20

Vote them out Canberra. Highest taxes- lowest services...

Vanessa Jones Vanessa Jones 11:32 am 20 Sep 20

How long is the wait now, to see a specialist in an ACT public hospital? When Katy Gallagher was the health minister, the wait was 7 months. Are people supposed to sit in bed ill for 7 months, waiting?

    Bianca Rossetti Bianca Rossetti 3:17 pm 29 Sep 20

    Sadly it to access the chronic pain clinic it is over a year wait!!

Nicole McGuire Nicole McGuire 10:58 am 20 Sep 20

And the govt is proposing to further reduce services offered to patients with chronic illnesses by closing the Medical Day Unit. Yes having Rheumatolgy and gastroenterology patients and other treated alongside cancer patients and they’re reviewing the protocols for administering biologics. That is reducing the number of observations and the post infusion monitoring times.

A_Cog A_Cog 10:52 am 20 Sep 20

The ACT Labor Government’s terrible performance running core services like Health is what SHOULD matter in elections, but in this non-election, its hardly getting a mention.
The Productivity Commission does an annual report on how the states and territories perform across all areas of government – its called the Report on Government Services (ROGS). The PC reports help citizens compare apples with apples, and see through the spin that poorly performing governments spout.
What we have in the ACT is the worst/second worst performer across a bunch of core services – health is just one. Wait times, surgery times, infection rates, complications. Does anyone remember the bullying scandal at the ONE hospital the ACT has to manage? All the executives “retiring” in 2018 and 2019 when the incompetence got airtime? That’s all been forgotten in COVID.

Because of their values and empathy, Labor is supposed to be good/great at health, education, corrections, homelessness, mental health, drugs and addiction, public housing, childcare, aged care, public transport. Pick any of those issues, look up the ROGS, and prepare to be shocked.

I’m beyond shocked and dismayed that a supposed Labor party has been in for 20 years, and they remain so bad at caring for people.

Angela M J Brown Angela M J Brown 10:35 am 20 Sep 20

What a surprise. As a person with multiple complex conditions, everyone works in silos and I have to keep track of what each one prescribes and remind the prescriber that I am on certain medications. My GP has to manage it all, with often no communication from specialists or the health system here. My recent experience in TCH says volumes about why we die because of mismanagement and no follow up ever.

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