Wednesday, May 7, 2008

ACT Budget - what does it mean for health consumers?

Last night I went to ACTCOSS to consider the budget in terms of health services. What follows is an overview of what I discovered.

Finally we start to get some details around the Capital Asset Development Program (CADP). The ACT Government 'Building the Future' program has allocated $300 million for the first stage of what we believe will be a $1 billion redevelopment of ACT health facilities. This will include:

  • $90 m – a women and children's hospital on the site of The Canberra Hospital
  • $23.6 m – an adult mental health acute in-patient unit on the Woden site
  • $18 m – a new community health centre at Gungahlin
  • $9.4 m - 16 new beds ICU/HDU/CCU facility at Calvary Hospital
  • $2.4 m - 24 additional beds at the Canberra Hospital
  • $5 - redevelopment of community health centres

The ACT Government commitment to infrastructure needs to be supported. It demonstrates that they are planning for the future rather than only reacting to immediate events. We know that there has been significant work within ACT Health in projecting future needs of the community. Admissions to hospital are increasing annually and with the aging of the baby boomers planners are anticipating a peak in demand for services 2016. This budget is a starting point.

It is essential that these infrastructure developments are progressed hand in hand with the health service planning that ACT Health is engaged in. There needs to be flexibility built into the design of buildings to accommodate changes in practice that lead to improvements in services.

Last September, when HCCA submitted our priorities for the ACT Budget we identified access to primary care as the most important. Interestingly, the scoping study for Primary Care Walk-In Centres is the only initiative that directly relates to primary care in this budget. This may involve enhanced nursing roles, such as nurse practitioners. There is an overwhelming need within the ACT to address access issues to primary health care. There is a direct relationship between access to GPs and presentation rates at the ED. We need to consider expansions of roles of a range of health professionals and the use of nurse practitioners, physician assistants and the role of the practice nurse. This may be addressed to some degree in the Workforce Initiatives. The GP work in Canberra Campaign will hopefully result in increased numbers of GPs more accessible services for consumers. I hope, with the rescoping of the Australian Health Care Agreements, primary care will complement our local public health services.

There appears to be a gap in terms of dental services in this budget. ACT Health has improved waiting times; for example, the waiting time for those consumers accessing non-emergency dental services has decreased from an average of 16 months to 10 months. And those consumers who are eligible and have an urgent need are seen within 24 hours. There was scope to fund an adjustment to the eligibility criteria to accommodate many of the people who are currently ineligible and who are unable to access private dental services because the cost is prohibitive.

There is a focus on providing ‘more beds’ but this is not just the solution. We would like to see emphasis on doing things differently, developing innovative models of care across a range of settings, expanding the roles of health professionals to move away from the default position of supplying services in the acute setting.

In summary, a good starting point. Russell will provide further insight with his analysis of the budget.

I look forward to the dialogue with ACT Health about how consumers cna be engaged in shaping these initiatives.

Darlene Cox
Executive Director


Deb N said...

Excellent work Darlene. This timely analysis and the blog as a whole are invaluable. Re: the budget. I'm still concerned that so much money goes into 'beds and bricks' and not enough in preventative and primary care - though the primary care centres are a excellent thing to see. Let's get behind them, see them build and so keep people out of expensive hospitals as far as possible. Thanks Deb

Darlene said...

Thanks for your comment Deb
I agree with your point about the need for more emphasis on preventive care. I'm hopeful that with the re-scoping of the health care agreements we may see funding arrangements change to accommodate the need for preventive care.