Thursday, May 28, 2015

Launch of Healthpathways

Healthpathways was launched in the ACT and SE NSW by the ACT Health Minister, Simon Corbell MLA. Darlene Cox (HCCA, ED)and Sue Andrews (HCCA President) attended.

A couple of excerpts from the Minister's speech are posted here. It gives you an idea of what healthpathways is about.

If you want to know more you can also check our blog post about healthpathways from last year.


Wednesday, May 20, 2015

Cancer Voices Advocate in NSW Parliament


Kathy Smith was elected at the March 2015 election in New South Wales and is now the member for the Gosford Electorate.

Ms Smith recently gave her inaugural speech in the Legislative Assembly. 

We have provided an excerpt from this speech for those people interested in           the consumer experience of cancer services and the why we advocate for improved access. While Ms Smith is talking about the Central Coast many of the same issues apply to the Capital Region around Canberra. 



Earlier, in 1996, I had been diagnosed with cancer and during treatment I had become aware of an elderly lady who had to travel from Wyong to the Royal Prince Alfred Hospital for radiotherapy treatment each day for six weeks. She travelled by bus and train, and what torture that must have been for her. I was living in Hornsby at the time of my diagnosis and I was fortunate enough to be able to afford private radiotherapy treatment only 10 minutes away from home and my place of work. Silly or not, I was left with a feeling of guilt knowing that this much older lady was having to struggle to travel for treatment while I could be driven for mine without any effort on my part. 

On moving to the Central Coast, I was appalled to find that the only change to the local situation concerning radiotherapy treatment was the establishment of a private facility. However, that facility cost cancer patients thousands of dollars if they were to have treatment locally rather than travelling for public—that is, no cost to patient—treatment. As we were in a low socio-economic area, this was an impossible situation for some and many people were incurring debt to pay for treatment. That debt would mean many years of repayments and many years of depriving themselves in order to make them. Others were forgoing this lifesaving treatment altogether in the hope that the doctors were wrong. 

Being a person who always spoke up for the underdog and who took on the battles of those not able to fight for themselves, it was inevitable that I would do something to draw attention to this dreadful situation and a group of us began campaigning for the provision of public radiotherapy locally in 2006. It was an intense campaign, and it was only me and my very loyal and beautiful friend Kimberly Bates who continued through to the end. We had support from the then members for Wyong and Gosford, David Harris and Marie Andrews. In April 2010, former Prime Minister Kevin Rudd and Premier Kristina Keneally came to Gosford to announce joint State and Federal funding of more than $38 million for the construction of the Central Coast Cancer Centre, which of course included the public radiotherapy facilities for which we had battled so hard. On that day I had been discharged from hospital following the removal of a mouth cancer for less than 24 hours and Mr Rudd must have thought I had a very unusual way of speaking. 

The Prime Minister praised the actions of consumer advocates for bringing the problem to the Government's attention. He pointed out that even though politicians think they know what is needed by the community this knowledge does not always tally with what the public really wants. It had been made very clear to us by senior politicians at both State and Federal levels that without the public action the Central Coast would not have been in the running for public radiotherapy for many years. As I recall, we were number seven on the list, so public advocacy works. Today I am pleased to report that the number of people on the Central Coast receiving lifesaving radiotherapy has increased dramatically—I understand by about 22 per cent. This is not the number of people deciding to be treated locally rather than travelling for treatment; this is an increase in the number of people who previously would not have had any treatment. It is impossible to say how many of these people would have missed out or who would not have survived under the previous arrangements. However, statistics demonstrate what a tremendous investment by the Labor Government in cancer survival this public facility has been. So, fellow members, let us all listen to the public advocates in our area when they come to us with an issue. Many lives may be helped. 

The radiotherapy campaign on the Central Coast also introduced to me broader State and national issues that were in need of cancer consumer advocacy. Cancer directly affects one in three of us, but many more indirectly when our friends and family are impacted by this disease. While I had been campaigning on the Central Coast I had also been working as a consumer advocate with the Cancer Voices movement in Australia. Cancer Voices is the largest truly independent, non-funded cancer consumer organisation in Australia. I became the chair of Cancer Voices NSW as well as an executive committee member of Cancer Voices Australia. During my time with Cancer Voices, many battles were fought and won at both State and Federal levels. There is still much to be done in the cancer area, but I came to realise that the time had come to return to my own backyard and to work to the best of my abilities to continue to improve the lives of people on the Central Coast. There was never any question but that that would be done with the Labor Party.

Monday, May 18, 2015

Excerpt from Legislative Assembly Hansard - Health Priorities 2015

Health—priorities for 2015
Ministerial statement
MR CORBELL (Molonglo—Deputy Chief Minister, Attorney-General, Minister for Health, Minister for the Environment and Minister for Capital Metro) (10.29), by leave: Today I am pleased to speak about the continued investment this Labor government is making in the area of health services in the ACT and the importance we attach to maintaining this investment. The Labor government to date has delivered strong results for the people who use, rely upon and work in our world-class healthcare system, and as the new health minister I am looking forward to making sure that the people of Canberra continue to have access to first-class health care, as also I do for those in the surrounding region.
The Centenary Hospital for Women and Children, walk-in centres in Tuggeranong and Belconnen, community health centres in Gungahlin, Belconnen and Tuggeranong, a new adult mental health unit and the Canberra Region Cancer Centre, as well as numerous investments in equipment and information technology, all demonstrate how this government has made improving our healthcare system a priority. It is important that we continue to make these necessary investments, to make sure that we not only give the sick, injured and unwell the care they need but also have in place preventative policies and services that will help ease the high demand on our healthcare system.
As the relatively new Minister for Health, my focus and my priorities will continue to include ensuring that the health infrastructure program continues to enable Canberrans to get the right care at the right time in the right place; promoting proactive health initiatives and steps to manage the growing level of obesity in our community; and raising awareness of mental health issues and improving access to services for people who need that care.
There is no doubt, Madam Speaker, that the recent cuts in funding in the area of health from the federal Liberal government must be condemned in the strongest terms.
The level of change that is anticipated by the federal budget in coming years will have a significant impact on a small public hospital system and it will be very challenging to manage major reductions in expenditure and services, both within health services and within other publicly provided services. Further, the abolition of funding by the federal government to important preventative health measures is extremely short sighted.
The Australian community strongly supports a universal healthcare model. Access to comprehensive primary health services works. It is not only good for our citizens; it is good for our economy. The entire community benefits from access to affordable health services. The imposition of any disincentives to use primary health care, such as through co-payments for access to GP services, will only increase demand on already busy emergency departments and/or result in less access to primary health care when people need it.
The health infrastructure program commenced by this government is about investing in Canberra's health by changing how and where health services are delivered. The health infrastructure program is the most significant investment in the history of Canberra's healthcare system. Since 2009, this Labor administration has invested, on behalf of the community, $876 million into the health infrastructure program.
There are four pillars to this program: models of care, infrastructure, technology and our workforce. It is a holistic approach to addressing our future healthcare needs and demands. Over the next 12 months, work on the health infrastructure program will continue. Design work will continue for the building 2/3 redevelopment at the Canberra Hospital. In addition, construction will commence on four significant projects: the Canberra Hospital emergency department interim expansion, the new University of Canberra public hospital, the secure mental health unit and the Ngunnawal bush healing farm. These projects will help to meet the needs of our community now and into the future. The projects will also boost and diversify our economy, providing hundreds of jobs for both clinical and construction staff.
I will deal with each of these projects: first of all, the building 2/3 development at the Canberra Hospital. In consideration for the redevelopment of buildings 2 and 3 at Canberra Hospital, key opportunities to manage demand for future health services were identified. These include the expected population growth, along with an ageing population and the rising prevalence of chronic and complex disease.
The opportunity has also been taken to review the existing infrastructure to determine its ability to deliver new models of care, which in turn will impact on community access to quality and safe health services. This project is a serious commitment by this Labor government to the future of our healthcare system.
Late last year, the government announced that it will be investing $23 million in the expansion of the emergency department at Canberra Hospital to help address and respond to the increasing presentation numbers to the ED. The emergency department is the region's major trauma centre. It treats more than 70,000 patients. The last financial year was the highest level of treatment ever recorded.
The expansion and refurbishment of the Canberra Hospital ED will improve the ED's layout, creating efficiencies that will lead to an expected reduction in waiting times. It will also see the integration of transferring children and their parents or carers to a dedicated waiting area and then treatment area for young people.
I turn to the University of Canberra public hospital. This hospital will be the ACT's first subacute hospital and will form an important part of our health system. The UCPH is currently in the development stage, with construction scheduled to begin in late 2015. Construction is scheduled to be completed by late 2017. The University of Canberra public hospital will provide 140 inpatient beds and 75 day places. It will provide services such as rehabilitation, adult mental health and aged care, with both inpatient units and day services available in each area.
Additionally, UCPH will be a teaching facility, allowing it to extend and enable joint clinical training, teaching and research opportunities between the University of Canberra and ACT Health. Located on the University of Canberra campus, the University of Canberra public hospital will be ideally placed for this strengthening of our collaboration with our key tertiary institutions.
Turning to the secure mental health unit, in 2012 Labor committed to build a secure mental health unit. The purpose of the unit is to provide specialist mental health care in a secure inpatient environment. The facility will respond to the mental health needs of those who are likely to become involved, or who have become involved, with the criminal justice system and those people who cannot be treated in a less restrictive environment.
The 25-bed facility, to be built on the former site of the Quamby Youth Detention Centre at Symonston, will provide individually tailored treatment with programs that seek to maximise individual functioning. The unit is scheduled to begin construction in mid-2015 and is scheduled for completion and operation late 2016.
The unit will be a purpose-built, secure 25-bed mental health facility and it will be an integral part of health services provided by ACT Health. The unit will provide a safe, clinical and therapeutic environment for people with a mental illness who may be characterised as complex, often difficult to treat and who are of serious risk to others. This will also include people with a mental illness who cannot be adequately assessed and treated in a correctional setting. The unit will provide a safe and structured environment with 24-hour clinical support for people with acute or persistent and severe mental illness, and with associated functional and behavioural difficulties requiring secure care.
This $43.5 million project will continue the expansion and improvement of the ACT's mental healthcare system, which has already commenced with the opening of the adult mental health unit at the Canberra Hospital. The secure mental health unit will provide secure inpatient mental health care, treatment and support for those who cannot be safely cared for in a less restrictive environment.
The Ngunnawal bush healing farm is also underway. It will provide culturally appropriate drug and alcohol rehabilitation programs for Aboriginal and Torres Strait Islander people in our community. The bush healing farm is scheduled to begin construction later this year, with completion scheduled for mid-2017. This important new service will help users to improve their overall health and quality of life, which will in turn benefit their families and the broader community.
Madam Speaker, the ACT implements a range of high quality programs in the areas of preventive health. A number of the initiatives adopted by this government have received national recognition by key industry groups. In recent years, the ACT has been awarded recognition for its work in tackling obesity by the Australian and New Zealand Obesity Society, as well as from the AMA and the Australian Council on Smoking and Health for our work in tobacco control.
Preventive health programs work, and there are some notable ones that have been very successful in reducing mortality and the economic losses from preventable causes. Previous successes include car restraint regulations, reducing smoking rates and sun protection campaigns.
The ACT, for example, consistently leads Australia in childhood immunisation, with the latest Australian childhood immunisation register quarterly report showing the ACT has achieved the highest coverage nationally in all three cohorts for all ACT children. The government's immunisation strategy aims to build on our success in this area and to expand the focus of immunisation to whole of life, reducing hospital admissions for vaccine preventable diseases, particularly in high risk groups.
As a government we also have a strong history of achievement in tobacco control and smoke-free environments, and this is reflected in our low rates of tobacco use. Further work is now being done through future directions for tobacco control in the ACT. This future directions document was launched in May 2013 and sets out actions to restrict access to tobacco products and places of tobacco use.
Two consultations were undertaken in 2014 in relation to options for restricting access to tobacco and regulating the sale and use of electronic cigarettes. In 2015 consultation will further occur for restrictions on places where tobacco can be used, such as children's playgrounds, outdoor pools, sporting fields, bus interchanges and in certain areas of multi-unit apartment buildings.
The government has made tackling the rising level of obesity in our community one of our top priorities and for me as minister this is an area of particular emphasis. Approximately 63 per cent of adults and one-in-four year 6 children in the ACT are overweight or obese and these rates are rising. Being overweight or obese puts people at a significantly higher risk of developing preventable illnesses such as diabetes, cardiovascular disease, high blood pressure and even some cancers. These all have subsequent health costs but also a much wider economic impact in areas such as business productivity.
The "Towards zero growth: healthy weight action plan" launched in 2013 is a whole-of-government approach which aims to slow the growing rates of obesity for Canberrans. ACT Health runs a number of programs which align with this plan. Health prevention programs help children build healthy behaviours early in life so that they grow into healthy, productive adults. An example of this is the successful fresh tastes program, which was launched in 2014.
Fresh tastes works across our primary schools to increase the availability and knowledge of healthy food and drink choices through schools and includes supporting teachers to provide nutrition education, supporting canteens to provide nutritious menus, giving kids hands-on experience in cooking and gardening and encouraging families to provide healthy school lunchboxes.
The ride or walk to school program builds the capacity of schools to promote active travel through providing cycling equipment, teacher training and resources such as road safety training to encourage more kids to ride or walk to school and to convince their parents that it is a good thing. The good habits for life communication program, launched in 2014, helps to address obesity by helping parents to role model healthy habits for their kids through three core behaviours of eating well, moving more and connecting with those around them.
Preventive health for adults is also important. The healthier work service delivers employers increased access to information, support, training and incentives that build their capacity to create healthier work environments, reduce absenteeism and increase productivity. I note that my colleague Mr Gentleman was at a breakfast this morning talking about this program and the importance of it.
The ACT government is engaged on several fronts to support healthy eating at sporting events. Its efforts in this context recognise the synergies between physical activity associated with sport, healthy eating, and addressing overweight and obesity. The healthy food at sport program has been a partnership between ACT Health and the government's sport and recreation services to encourage community sporting clubs to increase healthy food and drink choices in their canteens.
The program will cease in 2015, with the Australian Drug Foundation to implement the good sports initiative, which uses an accreditation scheme for alcohol management practices, tobacco management and healthy food promotion and supply in sporting clubs and organisations.
As part of Labor's 2012 election commitment on tackling obesity, the health promotion grants program has been realigned to have a much stronger focus on obesity, particularly amongst kids, and in programs that support smoking and alcohol reduction and healthy, active ageing. The grants program now offers two types of grants. The larger of the two funding rounds is the healthy Canberra grants. Once a year we prioritise multi-year programs that can demonstrate impact across our entire population. The smaller health promotion innovation fund, which is assessed three times a year, provides grants of up to $15,000 for innovative health promotion projects.
I was pleased to recently announce the opening of the third round of healthy Canberra grants. Thirteen programs have been funded in the previous two rounds, including funding of over $500,000 to the Heart Foundation ACT to deliver the live lighter social marketing campaign, which uses mass media to increase awareness and motivate adults to be more interested in healthy eating, physical activity and a healthy weight range.
The Wirrpanda Foundation was funded over $450,000 for the "Deadly award" winning program Wirra Club which aims to improve Aboriginal and Torres Strait Islander children's health, particularly in relation to overweight and obesity, by improving eating habits and increasing physical activity. Our local ACT Medicare Local received over $500,000 for the connect up for kids program, which targeted the prevention of childhood obesity through the development of a connected, accessible and quality advice pathway for all families of kids aged between three and seven. There are some great examples of how the government is working in partnership with the community to tackle the real, serious and difficult problem of obesity in our community.
On my appointment as Minister for Health late last year, I made it clear that I want to be a strong advocate for improving mental health. Mental illness is still all too often associated with stigma and shame. People with mental illness face challenges in receiving the care and support they need and acceptance in our community. In 2012, as part of this government's election commitments, we undertook to increase community mental health funding by $1 million a year for the life of this Assembly. Half of this funding goes to the government clinical community mental health service and the other half goes to the community sector and their provision of mental health services.
As a government we have also identified other mental health growth areas that will be progressively implemented through each budget. Last year we added a specific budget growth initiative for suicide prevention. In the most recent budget, the community clinical mental health services growth money was dedicated to the expansion of community child and adolescent mental health services.
We are applying this growth money in two areas. The first is in the perinatal and infant mental health consultation service, which provides assessment, diagnosis, treatment and referral recommendations to pregnant and postnatal women up to 12 months postpartum. The expansion and additional staff allow for outreach services that include facilitating emotional wellbeing groups and attachment-focused interventions within the community for mothers in these circumstances.
The second area is an additional clinical position in the eating disorders program which provides services to people of all ages who have complex eating issues. This clinical position focuses on the physical needs of clients, providing nursing, health assessments, ongoing monitoring, education and liaison between GPs and other health professionals.
The community sector mental health growth initiative has provided a community sector forensic mental health initiative and this initiative provides for short-term psychosocial support for people with a mental illness who are exiting the criminal justice system. The service assists people to re-engage with the community and improve and regain independence on their release from custody.
We are also providing important support to provide alternative early intervention options for hospital admission and more discharge options for people with mental illness. The program will provide the least restrictive intervention for people with mental health illnesses, in line with our policies.
I will also speak today about adult mental health, as we do not discuss this matter often enough in this place. Mental Health, Justice Health and Alcohol and Drug Services are developing a comprehensive service model for adult mental health services that encompasses and integrates community based, subacute, acute inpatient and emergency department care.
In September just past we commenced a consultancy to redesign and implement the community-based components of the adult mental health service model of care to improve integrated and contemporary mental health services to the community. The project will provide a detailed model of care for community adult mental health-based services, including, but not limited to, case management, psychological therapies, and assertive and crisis care activities.
One of the big issues we know has been receiving some public focus in recent days and months has been dealing with aggression and violence in relation to mental health care. Our services are committed to implementing sustainable measures to ensure all staff work in a safe system. Safe work practices, risk management and people to coordinate and undertake those safe work practices are the foundations of this system.
The development of an aggression and violence framework which will have aligned action plans across both the adult mental health unit and the Brian Hennessy Rehabilitation Centre is now underway. These action plans for the prevention and reduction of violence and aggression will outline the key actions that have been undertaken in consultation with staff and will be managed through the relevant workplace safety committees. All of these are about providing support for nursing staff in daily operations and ensuring we have systems for the identification, prevention and management of acute agitation and episodes of violence and aggression.
Of course, we have also been active on the legislative front. The Assembly has enacted the government's Mental Health (Treatment and Care) Amendment Bill. This will create our new Mental Health Act, to come into force on 12 November this year. A number of the changes in this new act empower people with mental illness in deciding their own treatment, including considering their capacity to make decisions and ensuring support for that decision-making as well as providing the opportunity to identify a nominated person to represent their views and preferences, and provisions to recognise consent directions made in advance about treatment when their conditions deteriorate.
The new act also advances the statutory options and protections for people who are affected by mental health services and provides for the first time new forensic orders to help ensure access and oversight of treatment for people with mental illness involved in our justice system. We will be undertaking education, training and the provision of plain English explainers to help mental health consumers, carers and their service providers understand what this new law means for them when it comes into effect later this year.
The government is also identifying and responding to an issue that has been on my agenda for some time—providing support for those who are caught up in the emotional, difficult and often traumatic circumstances of a coronial investigation. The government has committed funding for a new coronial counselling service. This fills a big gap in services. The coronial counselling service will provide therapeutic counselling to people who have been bereaved by the death of a loved one that is being investigated by the coroner. The coronial counselling service will offer counselling for the whole period that the coronial investigation is underway. All too often with an unexpected death, family and friends are left isolated and alone during the difficult circumstances of a coronial investigation. This new counselling service is something I think we can be particularly proud of because it helps fill a gap in a very important area of service delivery.
Equally, the government has committed ongoing funding for the "let's talk for suicide prevention" campaign. The aim of this campaign is to say to people that it is okay to talk about suicide, both to seek help and to offer help to others. In 2015 the focus of the campaign is around World Suicide Prevention Day on 10 September this year, and it will be on groups at higher risk of suicide in our community. ACT Health will support community organisations working with these groups to run suicide prevention education, and in 2015 we will also partner with the Education and Training Directorate to run a competition for high school students to develop new suicide prevention messages for print, radio, TV and web broadcast. I hope we are able to use the winning entries in future years' campaigns.
Nationally, on 1 July last year the ACT commenced the trial of the NDIS. We know what the scheme will do—provide people with disabilities, including psychosocial disabilities—the opportunity to purchase services that are tailored to their needs. Very small numbers of people with psychosocial disability have been assessed for this scheme in the ACT, but we will continue to monitor what it means for them as the scheme is rolled out. We will also monitor the implementation to make sure that no person currently receiving a government-funded mental health support service is disadvantaged by the implementation of the NDIS.
Finally, I turn to our performance in the areas of the Report on Government Services. This report was released earlier this month, and I am pleased the report shows that, across a whole range of our health services, we are continuing to make good progress in providing quality healthcare services. While we continue to tackle challenges such as the increasing demand for emergency and elective surgery services, the report is a timely reminder of the complexity and the diversity of the health services Canberrans seek on a daily basis.
Firstly, our residents continue to enjoy the highest average life expectancy of anywhere in Australia: 81.7 years for males and 85 years for females. The territory continues to register excellent results in childhood vaccinations, with 93 per cent of all kids aged 12 to 15 months fully vaccinated—the highest rate reported nationally. We have seen the second consecutive growth period in participation rates for women aged 40 and over undertaking breast screening, increasing from 30.6 per cent during 2011-12 to 32.3 per cent during 2012-13.
The practice incentive program regarding diabetes incentives was reported for the first time, and it shows a large proportion of these practices within the ACT registered for the PIP diabetes initiative. The ACT figure of 57.7 per cent is well above the national average. It is great to see our GPs taking on this program.
ACT public hospitals have made very significant improvements in improving patients' access to elective surgery within the clinically recommended time frames. We now have the lowest wait times for elective surgery since 2003 and we have met eight of the nine elective surgery targets for 2013. While there is still more work to be done, this is a very encouraging trend.
The ACT has maintained 100 per cent accreditation of all its public hospital beds, demonstrating our ongoing commitment by our staff to deliver a quality public healthcare system. We have the highest proportion of community follow-up for patients with a mental illness, following their discharge from hospital—73.9 per cent of mental health patients are followed up within seven days of leaving hospital, against a national average of only 60 per cent.
We have seen in the report highlights of the ACT as an exemplar for managing the use of seclusion during acute episodes of mental health inpatient care. Through alternative strategies and engagement with mental health consumers, the ACT has been able to significantly reduce our seclusion rates. Current data from the most recent reporting year shows the ACT has a seclusion rate of 0.9 events per 1,000 bed days compared to a national average of nearly 10 seclusion events per 1,000 bed days. The fact that we are using alternative strategies to ensure people do not have to be placed in seclusion is a good thing.
Our public hospitals have seen 125,890 emergency department presentations in the last reporting year. This is the highest number of annual presentations in the ACT on record, 12 per cent higher than those recorded just three years ago. The proportion of emergency time presentations with a length of stay of four hours or less during 2013-14 was 61.8 per cent. This rate is lower than the national average, but we have seen significant improvement—4.5 per cent improvement to the performance on this performance measure for the 2012-13 year. That is a good outcome; it shows our EDs are working hard to improve timely access to care.
There is further work to be done in reducing the number of patients waiting to be seen within the appropriate triage categories. This will remain a focus for me and the government in the coming year, and we will be pursuing a range of initiatives. I have mentioned the additional beds in our emergency department, the engagement of more doctors and nurses, and further reviews of our models of care. We have also committed $23 million to provide 12 new beds in the Canberra Hospital ED, and this is a very important reform.
Turning to commonwealth reforms, the most recent federal budget figures indicate that funding from the commonwealth to the ACT for public hospital services will be approximately $240 million less than anticipated by the government over the next four years—a quarter of a billion dollars less coming from the federal Liberal government to our public hospital services. This significant shortfall is a real problem.
The major reason for this reduction in expenditure is related to the abrogation by the commonwealth of its commitments under the national health reform agreement to provide funding guarantees up to the levels that would have been provided had the previous healthcare arrangements remained in place. We are now in a situation where we have to report against these new targets under the national healthcare reform agreement, but we do not get any funding from the commonwealth to recognise the shift to those new performance arrangements, contrary to the commitments previously given.
The basis of the NHRA and the commitment to funding guarantees was based on the commonwealth's recognition of its obligation to fund a greater proportion of public hospital services than was the case in the previous agreement. No statements about increases in public hospital funding across the nation by the current Liberal federal government explain the real funding cut to the ACT due to this arbitrary cessation of funding guarantees.
The Abbott government has unilaterally walked away from key commitments contained in the national health reform agreement which was signed in good faith in 2011. The ACT's position in relation to the NHRA will need to be reconsidered, given the commonwealth's abrogation of its commitments to guarantee that no jurisdiction would be worse off. Commonwealth health department officials at the Senate on 2 June last year clarified that there would be $55 billion less funding nationally for hospitals over the next decade. This is $55 billion less from the federal government, and there has been no consideration by the Liberals of what this means for our public hospitals. The simple fact is that for the ACT there will be $210 million less than the growth the ACT has calculated for our hospital systems. We need to manage this, to protect services but also hold the federal Liberal government to account for their failure to support health.
The federal budget also included announcements regarding changes to a range of other agreements. The national partnership agreement on preventative health was abolished four years earlier than expected. This represents a loss of around 47 per cent of ACT health funding for health promotion and prevention. The national partnership agreement on preventative health was aimed at stimulating action in preventing chronic disease and funded some really important programs, like the healthy children initiative, aimed at reducing the level of obesity in kids aged zero to 18 years; the healthy workers initiative to promote healthy lifestyles in workplaces; the healthy communities initiative to reduce the prevalence of overweight and obesity; and infrastructure to support the measurement of risk factors in our health population. All this money is lost.
In addition, we have had to deal with a range of other impacts, and we have responded. We have invested more money in sport and recreation services, facilities and upgrades and more investment in our healthy weight action plan, but we should be doing this in partnership with the commonwealth government. Improving people's lifestyles and reducing the impact of lifestyle-related disease saves everybody money—the ACT taxpayer, the federal budget, the ACT budget—through fewer people having to go to hospital.
The cessation of the national partnership agreement on improving public hospital services also warrants mention. This cessation of reward funding involved programs for the national elective surgery target, the national emergency department target and new subacute beds. This national partnership provided $56 million over all four years, and it has been lost in areas where we need it most—that is, elective surgery and access to our emergency departments. There have also been cuts in Indigenous early childhood development, although elements of this have been continued. We have seen funding deferred on adult public dental services.
These cuts come as the broader health system has been thrown into turmoil with the announcement of the $7 co-payment for visits to GPs as well as increases to co-payments for PBS medicines, pathology and diagnostic imaging. This Labor ACT government strongly disagrees with and rejects the notion that there should be co-payments for general practitioner services. This is bad policy that affects those least able to pay for their health care.
The removal of restrictions on state and territory governments from charging patients presenting to hospital emergency departments for GP-like attendances will not be actioned by the ACT. It breaks the Medicare principle of universality, of free public hospital care, and would be administratively complex and costly to administer.
Governments at a commonwealth and territory level have been working for a generation to improve access to health care for our community. We know general practice provides the benefit of establishing a long-term relationship with a healthcare provider, which is integral to achieving good health over the length of people's lives. We are sure that efficiencies can be made, but they need to be designed in a way that is fair. The co-payment is not fair. The co-payment will not raise the level of funding to meet growing demands for health care. Instead, it will add to healthcare costs for consumers. It will reduce early intervention for those who cannot afford the out-of-pocket expenses to see a doctor.
It is worth highlighting that Australians pay and make a contribution when they go to their doctor—it is called Medicare. Contributions we all make based on how much we earn through our taxes and through the Medicare levy provide a progressive funding base for funding essential health services.
We hear the rhetoric from Joe Hockey that some people should make a contribution. Well, they do, through Medicare. Despite the rhetoric from the current commonwealth government, there is no crisis. We have low debt levels nationally and the cost to government for health care is below the OECD average. We have one of the most efficient funding bases for health care anywhere in the world.
It is important that the healthcare system provides for all Canberrans, regardless of who they are, where they live or how much they earn. A priority critical to managing demand on the healthcare system is to implement policies that help prevent illness, injury and disease. Reducing our high level of obesity, helping people to be more active and having a physically and mentally healthy Canberra are key to reducing the high level of demand that already impacts on all areas of our health system.
I thank members for the opportunity to present this comprehensive outline of our program for health services. This is one of the largest areas of the ACT budget. It is one of the most complex, but it is also one of the most important for our community. As health minister, my focus will continue to be on improving access, tackling lifestyle-related disease, illness and obesity, and improving the framework and support services for those with mental illness. These, amongst areas in health, will continue to be a key priority for this Labor government. I present the following paper:
Health priorities for 2015—Ministerial statement, 12 February 2015.
I move:
That the Assembly takes note of the paper.

ACT Health - Partnering with Consumers

Last week ACT Health underwent accreditation against the new national standards.

I was invited to speak at the opening meeting with the surveyors. My speaking notes are posted here for the information. Throughout the week we had the opportunity to speak with the surveyors in more details about the work of the Health Directorate and staff at Canberra Hospital and Health Services about how they partner with consumers at three levels, as patient, consumers and as citizens.

Darlene Cox
Executive Director

The Health Care Consumers’ Association is the longest running health consumer group in Australia. We receive funding from ACT Health to train and support consumer representatives and to provide consumer perspectives on policy and operational matters.

We do not have Consumer Advisory Committees like other health services. Consumer and carer representatives and consumer organisations are heavily embedded in ACT Health and health services. The consumer voice is heard across all levels of the health service - as patients and carers, as consumer representatives, through consultation with consumer groups and the broader community.
HCCA supports more than 50 consumer representatives who are participating in over 100 committees across ACT Health. There are also more than Mental Health Consumer Reps and Carer Reps.

We run training sessions 3 times a year to recruit new members of the community who are interested in becoming involved. I want to touch on a few of our achievements.

Consumer representation has been a constant through quality and safety processes and clinical governance.

We have had a consumer representative on the Canberra Hospital Clinical Review Committee for almost ten years which is significant.

We also have consumer reps on the Interagency Clinical Review Committee, Quality and Safety Committees, Clinical Ethics Committee, Awards Panels, and the Medical and Dental Appointments Committee.

The consumer perspective is also valued in the corporate governance with consumer representatives on the Executive Directors Council, and Executive Council as well as the Local Hospital Network Council.

We also have consumers as members of selection panels for senior staff, including Clinical Directors, the Deputy Director General and Director General positions, a well-established indicator that an organisation has a culture of consumer centred care.
Consultation with consumers and carers is embedded in the policy development and review processes.

We also have significant involvement of consumers in the Health Infrastructure Program with active involvement of consumers in User Groups and project management committees. There is also consumer and community consultation to inform the designs and models of care. There are consumer representatives in the governance committees for HIP, so consumer voices are part of the strategic discussions and decisions.

Since the introduction of the national standards we have had Consumer Leads. This is a group of experienced and well connected consumer representative who take on a leadership role. We are very proud of this model and it reflects the commitment of ACT Health to partnering with consumers.

This year the Consumer Leads are participating in the ACT Leadership Network, a welcome development and builds on the involvement of consumers in training of ACT health staff.

We have built strong relationships and have a good working model of participation that works for us.
We have enthusiasm and commitment to continue to improve the way in which the consumer voice shapes the services for our community so that we have health services that are safety and consistently of a high quality.