31 January 2025

Tough budget decisions needed across government to save the hard gains made in health

| Ian Bushnell
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Canberra Hospital building entrance

Demand surged across all areas of the ACT health system. Photo: Michelle Kroll.

Chris Steel hasn’t been sighted for a while. No doubt he is hunkered down with Treasury, wading through the numbers in preparation for his first outing as Treasurer, announcing next Thursday’s Mid-Year Budget Review.

It was left to Health Minister Rachel Stephen-Smith to reveal that a perfect storm had blown away the hospital budget, requiring a top-up of $227 million.

That’s got to come from somewhere, with Ms Stephen-Smith saying hard decisions will be required, and not just in health.

Other directorates and agencies are required to do their bit to support the bolstering of our hospitals and the budget overall.

Mr Steel, still under pressure over what some see as the MyWay+ debacle, will now have to deliver a worsening bottom line and be pressed about where any savings are going to come from. That is, possible cuts to services and programs or project delays.

Welcome to the big league.

READ MORE ACT Government to tip $227 million more into hospitals to meet surging demand

Ms Stephen-Smith says all jurisdictions are facing surging demand for services and cost increases, and the ACT is no different.

She says the extent of the numbers fronting up to our hospitals could not have been anticipated, but it didn’t take long for former Greens Cabinet colleague Shane Rattenbury to accuse Labor of underestimating the health needs of Canberrans in a bid to protect the bottom line.

“There are still significant questions about this news that the government must answer, including needing a deeper understanding of the underlying drivers of these 85,000 extra episodes of care in our health system,” he said.

“We urgently need to rethink how we deliver health services in Canberra. This includes a focus on providing more preventative primary healthcare, including initiatives such as government support for bulk-billing doctors’ clinics.

“The government can’t just slap a $227 million band-aid on this issue. Instead, we need an open and transparent conversation with the community about how to more sustainably manage the health budget going forward while delivering better services.”

Ms Stephen-Smith won’t argue about the need to support primary care and preventative health, or getting to the bottom of the increase in demand.

Candidates are the cost of living crisis, the lack of bulk billing in the ACT, and the ageing population associated with chronic ailments. But some of these chronic issues are not just the preserve of older people, as junk diets and lack of exercise leave many young people obese and facing diabetes and heart disease.

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Health is a notoriously complex and thorny area that can suck up billions and still be a nightmare for treasurers.

What Ms Stephen-Smith wasn’t prepared to do was sacrifice the performance gains in emergency departments reflected in recent data or the inroads into the elective surgery waitlist.

These are the most reportable and headline-worthy of hospital data. These have been bad for as long as I can remember. Any improvement is not going to be thrown away lightly.

Hospital managers are also going to have to find savings and are probably going to face a fight with Visiting Medical Officers over how they are paid.

The question is can the situation be stabilised?

Mr Steel will hope that it can.

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Does this also include the bail out for the multi-million unauthorised DHR overspend that committed the government to spending more without budgetary approval, and the ‘horror show’ that is still under consideration by the Integrity Commission, or are we just forgetting that for now and putting the blame on NSW people?
It seems it’s too easy here just to fudge the books and put a gun to taxpayer’s heads afterwards and this announcement coming when all business cases for this year are finalised seems to warn Canberran’s that there is little left in the pot for other critical services. There is no excuse for a place as affluent as Canberra to be run like this, it will bite in a big big way when there is no money left.
I would rather they chuck a bucket of money at turning themselves into a fit for purpose modern government that doesn’t run itself like a servo shop lurching from one avoidable crisis to the next, and that includes the managerial skillset of the politicians and the head of service. Start now and lets see some improvement by the next election.

“But some of these chronic issues are not just the preserve of older people, as junk diets and lack of exercise leave many young people obese and facing diabetes and heart disease.”

It is ironic when previous Labor/Greens governments have made planning decisions that have seen Woden lose lawn bowling greens, a Pitch & Putt course, a basketball complex, tennis courts and a Ten-Pin Bowling complex. And next on the chopping block is the Phillip Pool. Well done Labor and the Greens you have turned Woden into an area that once had many recreational facilities into an area full of high-rise unit blocks with hardly any recreational facilities just when the population in that area has increased enormously over the past ten years. Congratulations!

Hospital care and casualty units are not the next gauge option! This idea is not a viable option. People could die, needlessly in the waiting room, while politicians zoom overhead in private jets.

Looking for funding, or an answer to the cost of living crisis, try taxing people who wouldn’t even get out of bed for less than what it would cost to run a hospital!

And since when have preventative screening and the right kind of early intervention been not the first priority?

Preventative medicine isn’t just a financially savvy answer to the budget problem, this types of things SAVE LIVES!

I strongly believe that all this economic “news” we are offered is for anyone’s benefit but for those who earn 7 or more figures a year.

These people hold money for status, while the rest of us consider who to take affordable health care away from? We are squabbling over scraps.

And this inflation stuff isn’t real. It’s just a construct inflicted on those of us who aren’t in the top 1 or 2%, who own half or so of Australia’s wealth.

These people have no compassion. Where’s all the money they squander even sits? In some kind of investment, no doubt.

The rich take money out of the economy to save and have holidays overseas. So why can’t we just print more? Inflation, no. It would devalue the top richest people in Australia.

Why has that terrible woman Gina going to stand up, off of her nest of money and sense of self importance to help us out.

You never know n ow Gina, you could need hospital too. And if they are understaffed that could mean a punched ticket.

HiddenDragon9:56 pm 01 Feb 25

Labor promised hundreds of extra health workers in the 2024 election campaign – they just forgot to include funding for that in the ACT Budget and that omission was not picked up in the pre-election budget update –

https://www.treasury.act.gov.au/__data/assets/pdf_file/0006/2572971/2024-Pre-Election-Budget-Update.pdf

What they’re doing now, with a disingenuous veneer of “imagine our surprise”, is what the majority of Canberrans voted for, and almost certainly would still have voted for if the fiscal facts of life had been revealed before election day.

There will be much more of this to come over the next four years, and today’s news about a freeze on non-essential hiring, while apparently a rude shock to some, is actually a sign that this government is finally starting to face up to reality and the difficult choices that involves.

Much of the increased demand is the result of previously denied, delayed or unmet demand leading to a need for more urgent and more extensive health treatment down the track.

Additionally there’s been an increase in e-bike and e-scooter injuries as well as more car crashes. All predictable for anyone who had been paying attention.

Incidental Tourist12:46 am 01 Feb 25

If ACT Health directorate recently wasted $66 millions paying wrong invoices, why they can’t just slap $227 million band-aid of taxpayer’s money to patch their suddenly appeared financial black hole?

Tom Worthington3:41 pm 31 Jan 25

Promotion & expansion of the walk in centres would be useful. I only recently realised I could attend the centers. I had assumed they were for specific groups. Since discovering anyone could use them I have become a fan.On my last visit, the nurse checked my blood pressure & immediately called an ambulance. Without the center I would not have received any treatment, with possibly fatal results.

Glad you were able to get treatment and are OK Tom. The walk-in centres are great.

It would be great if they were more accessible for those without cars. Then you could truly walk in when unwell.

Interest wording on RSS announcement yesterday where she said the 85k rise what Canberra Health Services had since the same period in the 2023 financial year.
This would make it July to December 2022, so 2 years ago and that period is before Canberra Health Services took over Calvary.
Not an attack on that decision or process, but wonder if CHS is more expensive to operate Northside Hospital than Calvary was???

They took over Calvary public – the public patients were already paid for by the ACT and counted in the figures for Canberra Health Services.

It would be helpful if the author included the amount of the ACT budget deficit & the annual interest payment.

Find savings? LOL
Nah, they will just raise rates yo cover their irresponsible spending again.

I’m stunned that I can actually agree with you on something

Who would have thought importing 1 million+ third worlders into our country would have impacted essential services. Whoever allowed this to happen needs to be criminally charged, for real, no cap.

That’s a bit harsh Mike, I’m a supporter of immigration but we have to let the right people in. We also have a quota of asylum seekers. Its a bit harsh to put every immigrant into third worlders.

If it was not for hard working immigrants Australia would not be as developed as what it is.

Why is a failed primary school teacher Treasurer of the ACT?

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