“If you are one of the 40 per cent or so of Canberrans who don’t have private health insurance and given the government’s clear disdain for you and your healthcare needs, do you wonder why you would ever vote for the Labor or Greens parties ever again?” writes JON STANHOPE.
MY colleague Dr Khalid Ahmed and I have recently published on the “Policy Space” blog at the University of Canberra a paper titled “ACT Public Hospitals Hit by Predicted Health Tsunami”.
In it we explore the validity of the valiant attempts by ACT Health Minister Rachel Stephen-Smith to explain away the increasingly poor outcomes being achieved by ACT public hospitals as simply a consequence of increased and unprecedented presentations and more complex patients.
Dr Ahmed and I looked closely at the latest publicly available data on patient complexity and unexpected or unplanned for growth in population and, hence, in demand.
Our analysis, of the government’s own data, reveals that a high level comparison of relative stay and average cost weight indicate that, as a whole, the ACT’s hospital system does not experience any higher level of complexity than the states.
We also note that in any event it is hardly a valid excuse for failing to treat patients, in the urgent and emergency categories, in a clinically appropriate time.
We also compared the annual rate of population growth, as reported by the ABS, during the period 2011-12 to 2017-18 with that of the years 2008-09 to 2011-12. The data reveals that population growth in the ACT over the six years to 2018 was in fact relatively lower than it was in the preceding four years.
There is simply no evidence, that we could find, to support the minister’s assertions that the poor performance of our public hospitals is related to complexity or an unexpected and unplanned for surge in demand.
The so called unprecedented and, hence, unplanned for growth in demand for health care which Minister Stephen-Smith blames for our public hospitals’ ailing reputations was anticipated and planned for as early as 2008 by then Minister for Health Katy Gallagher.
Gallagher not only developed, with the full support of then-cabinet and government, a detailed plan to meet the ACT’s future health needs but also secured an initial $300 million through the 2008-09 Budget as the first tranche of a $1 billion program of investment in hospital and health infrastructure.
In a media release on June 15, 2008, Ms Gallagher said: “Detailed modelling work by ACT Health has confirmed that with one of the fastest ageing populations in the country, the ACT community is facing a ‘health tsunami’ in the next decade, unless detailed and brave investment is made now.”
Ms Gallagher further announced that: “The 2008-09 Budget included a $300 million investment in health infrastructure including a Women’s and Children’s hospital and a new suite of mental health facilities”.
She further noted that this was only the first stage of the plan for meeting the “future needs of the community”.
In February, 2011, Ms Gallagher released a paper titled “Expanding hospital services in the ACT: an additional 400 Hospital Beds.” That paper included the following statement: “The existing ACT public health care system is at capacity and needs to expand to meet future health demand created by an ageing and growing population, changing technology and consumer expectations… The pressure on acute beds will continue with projections estimating a 50 per cent increase in admissions up to 2022.”
The $300 million first tranche of the $1 billion Capital Asset Development Plan (CADP) provided funding for the planning and design work for a range of projects in the second tranche including the full redevelopment of the Canberra Hospital site and the delivery of an additional 400 hospital beds.
However, it is clear following Katy Gallagher’s resignation as Chief Minister in late 2014 and her move to the Senate that decisions were taken by incoming Chief Minister Andrew Barr and his Labor and Greens colleagues to not only abandon the commitment to deliver the additional 400 public hospital beds but to also dramatically reduce funding for health, in real terms, which actually resulted in beds that had been delivered being closed.
Dr Ahmed and I estimate that as a result of these decisions there was, as at June 2018, a shortfall of 126 beds against the target determined through the rigorous CADP planning processes undertaken under the supervision of Gallagher and committed to in every Budget between 2008-09 and 2014-15.
The CADP redevelopment plan was based on a master plan that provided for the full redevelopment of the Canberra Hospital site.
However, the identified projects, including the master plan for the site were also abandoned by Labor and the Greens after Gallagher departed. They decided instead to proceed with a significantly watered down proposal known as the Surgical Procedures, Interventional Radiology and Emergency Centre (SPIRE) for the Canberra Hospital.
SPIRE will include only 148 beds, about one third of the number planned for, a decade ago, under the CADP. On the basis of current growth estimates, by the time SPIRE is eventually completed in 2024, assuming it is not deferred yet again, an additional two projects of similar scope to the SPIRE project will need to be completed to meet the forecast demand.
If you are one of the 40 per cent or so of Canberrans who do not have private health insurance, particularly if you simply cannot afford it, do you ever wonder, in light of the current government’s clear disdain for you and your health care needs, why you would ever vote for the Labor or Greens parties ever again?
Jon Stanhope was chief minister from 2001 to 2011 and represented Ginninderra for the Labor Party from 1998. He is the only chief minister to have governed with a majority in the Assembly.