No quick fixes for problem-plagued WA health system as election looms
Promises to “fix the hospital crisis” are nothing new.
It was a key part of Geoff Gallop’s campaign pitch that secured him power in 2001, but wasn’t achieved.
Alan Carpenter, Colin Barnett, Mark McGowan and now Roger Cook have all presided over the same problems, in varying forms.
Libby Mettam says fixing the state’s health system is her top priority. (ABC News: Keane Bourke)
Now, it’s Libby Mettam’s turn to make the same promise.
“My focus is on fixing our health system,” she’s dutifully repeated, just like her predecessors, throughout the campaign.
A complex system
There are lots of problems in the health system and plenty of explanations for them.
High levels of ramping and long emergency department wait times have been seized on by the opposition.
Issues that are easy to identify and much harder to solve, as the government has responded.
Ambulance ramping is one of the many issues which plague WA’s health system. (ABC News: Rick Rifici)
Part of the reason solutions are so hard to come by was pointed out by one of Mettam’s own candidates this week: one-line slogans cannot capture the complexity of the system they’re talking about.
It’s a behemoth responsible for just under a third of the state budget which is affected by, and affects, almost every part of people’s lives.
“Health is the culmination of many, many government portfolios and many, many parts of our society,” Adam Hort, who’s on long-service leave from his role as the WA Country Health Service’s chief pharmacist to contest the seat of Kalamunda for the Liberals, said on Wednesday.
Adam Hort is the WA Country Health Service’s chief pharmacist. (ABC News: Keane Bourke)
“It’s always going to be complex, just like the human condition is, but I think what we need to be prepared for is innovative, different solutions.“
Suggestions aplenty
Plenty of those have been offered up by both Labor and the Liberals this week.
Labor’s promised to expand programs to divert patients from hospitals, boost women’s health services and help the aged care sector grow to meet demand.
The Liberals’ pledges include more transitional beds, incentives to grow the number of GPs, allowing pharmacists to prescribe more medication and opening up 60 more beds at Joondalup Hospital.
It’s that final promise, being the only new hospital beds outside of emergency departments to be promised so far, which has some leading doctors concerned.
Beds the biggest issue
They worry it doesn’t address a structural problem in WA’s heath system — that we don’t have enough beds.
“It’s over-optimistic to think that our shortage of hospital beds can be fully compensated for by new models of care, by efficiencies, by providing more care in the community,” AMA WA President Michael Page said.
Michael Page said new models of care could not compensate for the lack of hospital beds. (ABC News: Cason Ho)
“There’s no doubt that those things play a role, but it remains true that many types of care have to be provided in a hospital setting.”
That’s down to a fundamental issue, Dr Page explained.
“You can’t take out someone’s gall bladder on the kitchen table. You can’t do heart surgery in someone’s house,”
he said.
“Hospitals bring all of the specialists, all of the allied health teams, to the patient’s bedside under one roof, and enable high complexity types of care to be delivered actually quite efficiently and cheaply when you compare it to the alternative of trying to coordinate things in the community.”
A recent report from the Productivity Commission found WA had the second lowest rate of hospital beds compared to population, ahead of only Victoria.
“Both sides of politics have failed to invest in bed stock in Western Australia,” former federal AMA President, Michael Gannon, said.
Dr Michael Gannon says both sides of politics have failed to put enough beds in place. (ABC News: Keane Bourke)
“We’ve had multiple reviews of bed stock, but ultimately there’s been a failure to put the beds in place.”
Dr Page said a cynical explanation might be the three-to-four year election cycles politicians live in, compared to the 10 to 20 year cycles needed to plan for the health system.
Resolution not impossible
Regardless of the cause, the call from experts is clear.
Much like in housing, the solutions are not quick or simple, but will take time and careful implementation.
As the ongoing debate over where to build the new Women’s and Babies Hospital shows, decisions around building or expanding hospitals are rarely easy, and executing those plans is a whole other story.
Experts say there is no quick fix to the problems affecting WA’s health system. (ABC News: Keane Bourke)
And all of that is without even thinking about a more fundamental issue confronting health systems the world over — advances in medicine creating more opportunities for treatment, often at a higher cost.
“I can’t see a time where demand doesn’t continue to outstrip the willingness of governments to pay, or the willingness of governments to tax their citizens to pay, for services,” Dr Gannon said.
“But that doesn’t mean that we shouldn’t try harder and to get things right.“
That aspiration is achievable.
But if the last quarter-of-a-century has shown anything, it’s that aiming to fix health is an even bigger challenge than Ms Mettam has at the ballot box in three weeks’ time.
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