“At the end of 2018-19, there were 132 public hospital beds fewer than the number projected in the ACT Health Capital Asset Development plan of 2008 as the minimum required to meet the needs of the ACT community,” writes columnist JON STANHOPE.
IN January my colleague Dr Khalid Ahmed and I posted a blog to the Policy Space at the University of Canberra in which we explored the causes of the extremely poor performance of the ACT’s public hospitals.
Our interest in doing so was sparked by claims by the Minister for Health, Rachel Stephen-Smith, that the increasingly poor outcomes were a consequence, in her words, of “not only increased presentations but more complex patients”.
On our analysis of the publicly available data, we found no evidence to support either of these claims and concluded that an assessment made at the time by the ACT AMA president Dr Antonio Di Dio, that the Minister’s claims were merely a distraction, were valid, and that the decline in the performance of Canberra’s public hospitals was a result of inadequate staffing, too few beds and the failure to invest in the physical upgrading and enhancement of health infrastructure.
We noted that as early as 2008 the then Minister for Health, Katy Gallagher had, with the full support of the ACT cabinet, developed a detailed plan to meet the future health needs of the territory.
The plan was known as the ACT Health Capital Asset Development Plan (CADP) and it was developed as part of an exhaustive examination of the future health needs of Canberra based on an analysis of population growth, the ageing of the community and all other factors relevant to an increase in demand for health services and inflation in health costs. It was estimated at the time that there would be a 50 per cent increase in admissions over the decade to 2022.
The ACT government was, therefore, well aware, over a decade ago, of the expected increase in demand and was cognisant of the capacity limitations of the health system to meet that demand.
As a consequence, in 2010 Gallagher committed, as part of a range of initiatives, to provide an additional 400 public hospital beds by 2022.
In our paper Dr Ahmed and I noted that on the data then available from the Australian Institute of Health and Welfare (AIHW) that up until 2015-16 the level of demand for public hospital beds was closely aligned to the annual increase in bed numbers consistent with the CADP.
However, the AIHW has recently published further data on bed numbers in the ACT and across Australia and it is now clear that a decision was taken by Labor and the Greens in 2015, following the departure of Gallagher to the Senate and the elevation of Andrew Barr to Chief Minister, to abandon not just the commitment to increase bed numbers but to the CADP as a whole.
However, more alarming is that not only did the ALP and the Greens decide to call a halt to the scheduled increase in beds but they actually began to close existing beds.
The chart above, constructed from data included in the latest AIHW report, reveals not only a significant reduction in public hospital beds between 2016-17 and 2017-2018 but that, as at the end of 2018-19, there were 132 public hospital beds fewer than the number projected through the detailed analysis commissioned by Gallagher, and incorporated in the CADP, as the minimum required to meet the needs of the ACT community.
The 2008-09 Budget allocated $300 million as a first tranche of $1 billion that the then government had committed to the implementation of the CAPD. The Budget also included $63.8 million for feasibility and forward design for a number of projects including the full redevelopment of the Canberra Hospital site.
I recently made an FOI request of ACT Health for a copy of the CADP. I was hoping to better understand the extent to which the current government had departed from the construction timeline which ACT Health believed, a decade ago, was required to ensure that the people of Canberra who depended on public health services, i.e. the poor and powerless, pensioners the working class, battlers and others who once trusted the ALP for support, had the level and range of health services that ALP governments traditionally prioritised.
I received the following response: