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Brumby blueprint a good start
24 June 2008
AMA Victoria today welcomed Premier John Brumby’s health reform plan to address key health concerns including public hospital funding shortfalls, growing waiting lists and increasing need for preventative health programs.
“The Premier has some good ideas for health care across Australia,” AMA Victoria President Dr Doug Travis said. “He understands the capacity problems plaguing the Victorian health system and realises that we need reform.
“His ten-point plan would be a great start to improving health care in the country.”
Dr Travis gave a summary of AMA Victoria’s response to the ten points:
An extra $1 billion in the new Australian Health Care Agreement. “Sounds good for Victoria,” Dr Travis said. “How much will the other states get?”
Dr Travis said that Commonwealth funding for public hospitals has now fallen more than $700 million a year behind the Victorian Government’s investment. “We need more beds, we need more nurses, we need more doctors,” Dr Travis said.
Activity based funding for hospitals across Australia. “This is a good idea. Whatever the flaws, the Victorian system of casemix funding provides reward for effort,” Dr Travis said. “Victorian hospitals are the most efficient in the country, and our continued productivity growth has only been stymied by overcrowding. An extra $1 billion per year would ease that overcrowding and allow for greater efficiencies.”
GP clinics in hospitals. “Currently, rules about funding set down by the Commonwealth limit how care is provided. That’s the wrong approach,” Dr Travis said. “Best care models should be funded rather than the funding dictate the care.”
Dr Travis noted that category five emergency department presentations had fallen by more than nine per cent last year. “I don’t buy the argument that emergency departments are clogged up by patients who should be at the GP,” he said. “The massive growth in emergency presentations is from people who really need to be at a hospital.”
Dr Travis also noted that GP clinics in hospitals would not create more doctors — more GP training places were needed.
Healthy living partnerships. Dr Travis said that healthy living partnerships sounded a good idea, and he looked forward to more details.
WorkHealth Initiative. “Workplaces are the next frontier for health care,” Dr Travis said. “This world-first program is likely to make a real difference and I encourage other states to follow Victoria’s lead.”
Superclinics. Dr Travis agreed with the Premier that superclinics should be in the highest priority areas and be better aligned with state-based and other community services. Superclinics should not adversely affect existing services.
National rollout of e-health. “The Premier is right to highlight IT infrastructure as a necessary ingredient for health care reform,” Dr Travis said. “A national e-health rollout is important, but we also need to look in our own backyard. Our hospital IT infrastructure is woeful. HealthSMART is behind schedule and over budget.”
Expanding MBS to allied health. “As long as general practice remains the centre of care, GPs would love the opportunity to have more funded allied health services available to their patients,” Dr Travis said. “AMA Victoria held a meeting last week with 13 different health professions, who all agreed that the current Medicare arrangements did not offer enough flexibility to use allied health care appropriately.”
“We need the best possible care for our patients, delivered by the best people for the job. Where the job is team co-ordination, then the best person for the job is a GP.”
Access to dental services. Dr Travis agreed that dental health care needed more public support, particularly for those in need.
Increased elective surgery capacity. “We need to increase capacity,” Dr Travis said, “but the challenge is to build long term solutions rather than short term fixes.
“Hospitals across Victoria this month are shutting down elective surgery due to funding constraints, or not enough nurses, or running out of money. A fair proportion of elective surgery capacity in Victoria is sitting idle as we speak. Let’s increase the funding for public hospitals to do more surgery in existing public facilities before looking for other solutions.
“We need to build up the capacity of our public hospitals. We need more nurses, more doctors and more beds.”
Dr Travis said Governments need to work with the medical professional and the community to reform Australia’s health system.
“The Premier’s blueprint provides a path forward. It’s a good start. Let’s work together to build a health system that provides the best possible care to all Victorians.”
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