20 December 2020

Government's fate may hang on finally getting health right

| Ian Bushnell
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Rachel Stephen-Smith

Health Minister Rachel Stephen-Smith: much rests with her delivering Labor’s health promises. Photo: File.

Last week was another milestone for the ACT’s ailing health system, with yet more bad performance reports for its emergency departments and elective surgery waiting times, and the release of draft plans for the Canberra Hospital expansion that we all hope will remedy a chronic situation.

The local AMA continues to assert that chronic underfunding and a lack of capacity is at the heart of the problems. The number of beds at Canberra Hospital just hasn’t kept pace with the city’s population, it says.

So the expansion plans are welcome as a sign that we are edging towards a start next year on a project that has been a long time coming.

READ MORE Canberra still has the longest emergency waiting times in Australia

Health Minister Rachel Stephen-Smith has reminded us that it is only one piece in the overall puzzle, and acknowledges that there is more work to do in the ED to improve the situation there.

Other pieces include the bigger Centenary Hospital for Women and Children, and the new mental health ward under way, and longer-term projects such as a northside hospital and elective surgery centre.

The expansion is set down to be completed in 2024, an election year, and a start on the northside hospital is not expected until the middle of the decade.

So Labor is likely to face more bad headlines in the meantime and while it can argue the system is on the mend it can’t afford to suffer the delays or changes in direction that have marked the lead-up to where we are now.

Voters may have been forgiving enough to give Labor the benefit of the doubt in the past, particularly with not much of an alternative on offer, but come 2024 and there are failures to deliver, a rejuvenated Opposition may be back in the game.

Canberra Hospital expansion

The Canberra Hospital expansion is a key piece of the ACT’s health puzzle. Image: ACT Government.

The health projects will also be competing for funds with other infrastructure plans including light rail and the Woden CIT. There are many who believe that funding was diverted from the health system for light rail and the expansion, as conceived under Katy Gallagher, scaled back from its original scope.

That is all water under the bridge now but Ms Stephen-Smith will need to muscle up in the Cabinet room to ensure that the funding is there so the health infrastructure strategy she has committed to is delivered and not kicked down the road as the Canberra region population continues to grow.

READ MORE Nurses air staffing concerns following ambulance bypass

The other big issue with Canberra Hospital is the overhaul of its poor culture and management practices. When asked about it, the hospital chiefs rattle off a long list of initiatives underway to turn the ship around but the results so far appear mixed and they will need to maintain momentum if things are to really improve.

They will also need to be open and transparent about the process, with the community having so much investment in the hospital and so many willing to let opposition politicians and journalists know about any lack of progress or the latest ”scandal”.

Trying to keep the lid on a situation will inevitably blow up in the faces of management and government.

Health, with its intractable problems, can be a graveyard for ministers.

Ms Stephen-Smith deserves our goodwill so Canberra gets the health system the national capital deserves, but voters next time may not be so forgiving if her promises prove beyond her.

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HiddenDragon7:51 pm 21 Dec 20

The inexorable growth in health costs, at a rate well beyond CPI and other measures of inflation, means that there will eventually need to be a serious re-jig of how the costs of Australia’s public health system are shared between the federal and state/territory governments. That wouldn’t solve all of the problems with ACT Health, but it should certainly help.

In the meantime, co-operation between ACT Health and NSW Health – which seems to have been an ingredient in our response to the virus – could (if this is not already happening) be extended somewhat more widely to produce savings which could be re-directed to service delivery. A federal system has benefits, but one of the hazards is the tendency for sub-national bureaucracies to devote too much of their funding to duplicating policy and program development work which has already been done in other jurisdictions – often due to parochialism and the empire-building instinct being dressed up as unique, or at least “special and different” circumstances which are then claimed to justify re-invention of the wheel, so to speak – with all the consequent costs and delays.

ChrisinTurner6:46 pm 21 Dec 20

It is hard to believe that a Labor/Green government is working so hard to get everyone to use the Private Health system, preferably by travelling to Sydney. They are diverting funds away from Health into toy trains, filling in Lake Burley Griffin to build apartments and other stupid and expensive projects. They hide away from the voters, as much as possible, by not having electorate offices where we might be able to meet and argue with them. They go to shopping centres unannounced and call that consultation. They are hell-bent on getting developers to remove as many trees as possible. What a disaster!

Capital Retro3:03 pm 21 Dec 20

A Labor Politician was visiting a remote area of the ACT and asked the locals what the government could do for them.
“We have two big needs,” said the people.
“First, we have a hospital but not enough doctors and nurses.”
The politician whipped out his mobile phone, spoke for a while and then said,
“I have sorted that out. More doctors and nurses will arrive at the hospital tomorrow. What is your other need?”
The locals replied,
“We have no mobile phone reception in our area…..”

Capital Retro2:56 pm 21 Dec 20

The comment by Stu McRae is spot on.

With Labor now continuously in power in the ACT for almost 20 years, any voter under 35 years old would not know what the performance of another government is when it comes to “delivering” health services so that group believes that what we have been getting for the past 20 odd years is normal.

Those of us who are old enough to remember what the service was like – not perfect but streets ahead of what it has become now, are the main group complaining.

Labor know this and they also know nothing has to be done to change it because it will never become a sole election issue.

How the hospitals may have been when the Libs were last in power is no indication of how they would deliver now.

Though interesting many of the issues health faces in particular the culture are a direct result of the closure of the old Canberra hospital and merging of the two different cultures vis RCH and Woden Valley Hospital.

And closure of the old RCH has its origins in self government.

Capital Retro4:49 pm 21 Dec 20

Why don’t you just call me a liar JC?

I am telling you it was different, “not perfect but better than now”. It’s got nothing to do with “culture” either.

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