Hello Everyone!
I thought I would provide you of a little
snapshot of the Legislative Assembly for the ACT, Select Committee
on Estimates 2015-2016 ’s report on the Appropriation Bill 2015-2016.
It sounds a bit dry but is as
noted by the chair of the committee an inquiry process that ‘is one of the key scrutiny mechanisms
enabling the Assembly to assess each year how the Government intends to spend
taxpayers’ money and whether it is achieving stated outcomes.’
The committee looked at all kinds
of ACT Government spending and the two volume detailed report can be found at http://www.parliament.act.gov.au/in-committees/select_committees/template4
In the first volume there was
132 references to health, including mental health, justice health, health
infrastructure, preventative health in child and breast and cervical cancer
screening. I have selected some key points and recommendations from volume one
around health and health services in the ACT that may be of interest. They are
all reworded or directly quoted from Report 1 Volume 1.
Cross
Boarder Health Care Provision
·
An acknowledgment that ‘a quarter or more’ of
patients come from across the NSW border for health care. The NSW Government is
likely to compensate the ACT Government on a population basis. It was also
stated that people travelling from NSW to ACT for care often require acute care
as these services are not available to them in NSW.
·
The Committee recommended that the ACT Government continue to
work with all First Ministers and the Commonwealth Government to ensure
sustainable health funding for State and Territory governments so they can
continue to deliver high quality health services to the community.
Community
Consultation
·
The Committee recommended that any decision-making by the ACT
Government around community access to health services be undertaken with proper
community consultation
·
A Committee recommendation that ACT Government consider an
improved way of communicating how health services and health outcomes are
delivered to the community.
Postcode
Health Care
·
The Committee discussed the number of people presenting at
Calvary and Canberra Hospital Emergency Departments. The Deputy
Director-General of Canberra Hospital and Health Services stated, “We are
working with Medicare Local to try and get a better sense of that and work out
what the patterns are and what, if anything, can be done with them. But, of
course, it is individual choice there and if people have confidence in Canberra
Hospital and prefer to present there rather than Calvary hospital, then that is
their choice.”
·
Additionally, the Committee followed up concerns about the
possible use of postcodes to determine where patients would be allowed to
access maternity and other health services. The Minister advised that: “These issues warrant consideration but no
decision has been made in relation to them and nor would it be without
engagement, discussion and consultation with the broader community.”
·
The Committee noted that, whilst the ACT Government has not
decided to implement a postcode-based approach to hospital choice, it has not
ruled it out. The Committee also agreed that the ACT Government should ensure
all its health services are being utilised effectively.
Training
and Hospital Culture
·
The Committee sought information on training culture in ACT
hospitals and was advised by the Minister that: “It is the case, as we know, that there have been a number of issues
raised nationally when it comes to the training of junior medical specialists.
Junior medical specialists undertake training in our hospitals to become
consultant specialists in their own right. We have seen, for example, the
recent reporting from Four Corners about poor behaviour on the part of certain
specialists in hospitals interstate when it comes to the training environment
they provide for junior medical officers. We have seen similar concerns raised
here in the ACT. The maternity services concerns are a good example of that
where there was significant discord and what I would characterise as not
healthy relationships at that time between trainees and the senior medical
staff involved in the training.”
·
The minster then announced “So today, Ms Fitzharris, that I have instructed my director-general to
commence an immediate review of the training culture inside the Canberra
Hospital to make sure that respectful and professional relationships are being
sustained and maintained, and that our existing policies and programs are being
effectively implemented—and, if they are not, to look at what we can do to make
sure that they are.”
·
The Committee further heard from the Director-General that
the review of training culture would be started immediately and would be an
independent external review. The review is to be conducted over three or four
weeks and will be ‘fast, deep and responsive’, with recommendations to be made
‘to ensure that the training culture remains a positive one, productive and
develops the clinical and professional skills that we need to see in our future
clinical leaders.
Elective
Surgery
·
The Committee discussed concerns raised by community members
around the cancellation of non-elective surgeries, particularly where people
had turned up and been prepped for surgery and then sent home, in some cases
multiple times. The Committee noted that there is no information available
publicly that indicates targets and achievements for the timeliness of
non-elective surgery and the number of people waiting.
Adolescent
Mental Health
·
The Committee recommended that a whole-of-government inquiry
be carried out, and the findings presented to the Legislative Assembly by March
2016, on the inpatient and outpatient services, support programs and care
models for adolescents facing mental health issues.
These recommendations and
review of health service provision in the ACT is useful to remember as health
consumer advocates and are worth keeping a watching brief on as they directly affect
our care.
Eleanor
Kerdo, Policy Officer
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