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Bad medicine: regional health services in poor shape (Geelong Advertiser, opinion)
16 April 2008
Next month's State Budget will reveal the Brumby Government's strength of commitment to rural and regional health care in Victoria.
Next month's State Budget will reveal the Brumby Government's strength of commitment to rural and regional health care in Victoria.
The State’s ailing public hospital system is firmly in the political spotlight, with capacity crises, over-stressed hospitals with low staff morale, and COAG wrestling to get a handle on health care financing.
Health services in rural and regional Victoria are stretched to the limit but a cure may be in sight as the Rudd Government takes a greater share of responsibility to fix the system, and under co-operative federalism, seeks to work with the Brumby Government on improvements.
Doctors are certainly ready and waiting to help governments to improve patient care. AMA Victoria has put a rural rescue plan to the Brumby Government, a $116 million package over four years designed to reverse the decline in doctor numbers and to provide added support for medicine in regional Victoria.
The problems are growing severe. Victoria’s population boom has not just occurred in Melbourne — regional Victoria is growing at a rapid rate too.
The pressure is being felt in general practice shortages. Over the ten years to 2006, the net gain in GP numbers in Victoria was one solitary doctor. Only one extra GP, while Victoria’s population grew by 518,000 people. Country Victoria has experienced a real decline in access to general practice.
Our hospitals are also feeling the pinch. Geelong Hospital’s emergency department presentations rose 4 per cent last year. Emergency department patients admitted to Geelong Hospital waited longer for a bed than the year before. Just over half of emergency department patients not admitted to hospital were seen within the clinically appropriate time of four hours. Unsurprisingly, patient satisfaction with the hospital declined.
Regional and rural Victoria is watching with interest as a premier and a prime minister begin to juggle money and review agreements. An additional $500 million was committed from the Federal Government last month across the nation, but in Victoria alone we need another $715 million from the Commonwealth to regain funding balance. We need more beds to ease the capacity crises across the state.
However, money alone is not the answer. The recent public health medical staff review commissioned by former State health minister Bronwyn Pike, and inherited by Daniel Andrews, found Victoria's public hospitals to be under significant stress with low morale.
This was no surprise to doctors, nurses and other health care workers who deal with the problems every day. With bed shortages and longer waiting lists, more patients than ever are seeking care from old and over-stressed hospitals.
Victorians who live in our regional centres or on the land are experiencing hard enough times with the drought and rising interest rates – the least they should expect is a sound and reliable system to service their health needs.
The Ministerial Review found that rural Victoria was having the greatest problems in recruiting specialists and procedurally competent general practitioners. Across general practice, vacancies listing with the Rural Workforce Agency Victoria have climbed by 50 per cent in just two years.
The picture is pretty grim. Not enough doctors, high stress, low morale and declining service standards. We need a circuit breaker. That’s why AMA Victoria has asked the Brumby Government to commit to a $116 million rural rescue package.
The rural rescue package — available at www.amavic.com.au — contains 12 key elements, including supporting overseas trained doctors, improved training opportunities, and support for specialists and general practitioners. It is a comprehensive package designed to provide relief for rural doctors and to promote the opportunities to recruit more doctors.
AMA Victoria’s proposal represents less than one quarter of one per cent of the Department of Human Services budget over the next four years. On behalf of rural doctors and rural communities, I urge Mr Brumby to commit to a rescue of rural medicine across Victoria.
Dr Doug Travis is President of AMA Victoria
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