“With the deaths of children that have occurred in the hospital, it is amazing that these issues have not been addressed by the minister much sooner,” writes political columnist MICHAEL MOORE.
AVOIDABLE deaths in our hospitals are tragic. They are even more tragic when such deaths occur in children. After four such deaths in the last few years it is appropriate to have a shake-up of pediatric services across the ACT.
The government has tabled a scathing report on the treatment of children across the health system. Dropping the report in the same week that the media was focused on legalisation of small amounts of illicit drugs for personal use, however, was cynical in the extreme.
“The Paediatrics Organisational and Service Plan” begins with a positive note covering “pediatric medicine (including sub-specialties), pediatric surgery, and community child health at Canberra Health Services. It sets out the scope of services to be provided, the operating principles for delivery of those services, and the actions required to get there”.
However, it then goes on to identify the problems it is attempting to address. The problems are widespread and reflect serious failures by the government. It is no wonder that Health Minister, Rachel Stephen-Smith was hoping it would not get too much coverage.
Shadow Health Minister Leanne Castley launched a biting attack arguing that “despite the minister continually stating everything is working as it should, this report clearly shows pediatric care in the ACT is not up to scratch and doesn’t even come close to what our children deserve”.
Ms Castley said: “This Labor-Greens government has dropped the ball and our children have borne the brunt,” adding “the Canberra Liberals have continually called out inadequate pediatric care in the ACT as have nurses, pediatricians and families.”
The report sets out the problems and how the government will go about addressing them. The most significant is inadequate staffing. This falls directly on the shoulders of all of the ministers in cabinet. As Jon Stanhope and Khalid Ahmed have pointed out in the pages of “CityNews”, over recent years the health budget has been subjected to significant cuts in real terms.
Without appropriate funding it is impossible to ensure adequate staffing. The pressure on staff across the pediatric (and other areas of health) have been enormous. Despite herculean efforts, with inadequate staff, things do go wrong. This is why the report bases its “planning horizons” on three fundamentals: “stabilise, strengthen and expand”.
High acuity and deteriorating patients have not had “appropriate care settings and formalised protocols”. This has been combined with “workforce training and education challenges”. With the deaths of children that have occurred in the hospital, it is amazing that these issues have not been addressed by the minister much sooner.
Additionally, the inability to manage the service effectively has been exacerbated by “insufficient business support and intelligence”. To address this “a number of revisions to financial and performance reporting are recommended, including development of an internal performance dashboard for each section”.
The relationship with NSW health services has also come under fire. There is a recommendation to “develop a specialised services agreement with SCHN (Sydney Children’s Hospital Network) for tertiary/quaternary services in conjunction with neonatology and ACT Health”. Later, a recommendation includes working more closely with the “outreach services”.
These services include: nephrology; rehabilitation, physicians; neurosurgery; oncology; orthopaedics and dermatology. Additionally, recognition of inadequate staffing is identified by setting an immediate priority “to strengthen/implement: neurology; cardiology; rheumatology; endocrinology and video-consultations”.
One of the concerns cited was regarding “culture and governance, including silo working, and perceived excessive bureaucracy”. The solution identified in the report is the adoption of “interprofessional teams” to be incorporated in each section of pediatric health care delivery. What about “excessive bureaucracy”?
This approach seems to be in conflict with “insufficient business support and intelligence”. Cutting back on the bureaucracy is unlikely as indicated by “ensuring that the necessary resources, infrastructure and training are available, as well as a mix of skills, competencies and personalities amongst team members”.
This plan identifies the problems that need to be addressed. It is long overdue. However, it is here at last. The report appears to be a serious commitment to improve pediatric care across the ACT health system.
The good news is that “The Paediatrics Organisational and Service Plan” provides a blueprint and commitment for addressing the range of issues raised. The bad news is that the federal government’s most recent Budget has effectively cut $2.4 billion from the public hospital system across Australia.
Michael Moore is a former member of the ACT Legislative Assembly and an independent minister for health. He has been a political columnist with “CityNews” since 2006.
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