During the election campaign in 2016 Health featured strongly. The ACT
Labor released a range of election commitments as part of their Ten Year Health Plan. This included
significant infrastructure investment with the design and construction of the
SPIRE centre, a new, expanded emergency department, an extension of the women
and children’s hospital, more walk in centres and funding for a new building
for Winnunga
Nimmityjah Aboriginal Health Service. This budget starts to bring
this vision into reality.
People will notice that there are delays in the state of many of the
commitments, such as SPIRE, and these will not see services
delivered before 2020. This is for a number of reasons.
ACT Health has started a process of planning for health services for the
next ten years. This process is called theTerritory Wide Health Services Plan. This will
include the development of models of care (the way care is delivered) as well
as looking at planning for the workforce we will need to deliver the care.
Technology – through the Digital Health Strategy – will also be considered. And
all of these feed into the design of the new buildings. To bring the
infrastructure projects forward without doing this planning is putting the cart
before the horse. That is not to say the system is working well currently.
We know that there are significant pressure on our public hospital
system. Canberra Hospital is one of the busiest Emergency Departments in the
country. Calvary continues to experience increase in the number of people
presenting there. And the Outpatients Departments are busier than ever.
There is a vast amount of work underway to address thedata issues that ACT Health has been
experiencing with the territory wide data Review announced by the Minister in
March 2017. This is not due to conclude until early 2018. It is extremely
difficult to effectively plan for the future if you do not have confidence in
the data you have. And the other major activity is the completion of theUniversity of Canberra Public Hospital, the
rehabilitation centre that will provide sub-acute inpatient care for older
people, people who have had neurological events like strokes, and longer term
mental health rehabilitation. These people will stay at the centre for their
treatment and care. It will also provide a range of day programs – where
consumers will attend each day but stay at home. This has to be a major focus
for the Government. The opening of this centre will free up much needed clinical
spaces at Canberra Hospital and Calvary that can then be used for other
services.
As mentioned above, there are a number of elements that need further
explanation including consideration of workforce issues and the eHealth agenda.
Workforce is a critical element of a safe and efficient health system.
There are a range of initiatives that demonstrate investment in the ACT
workforce, such as the University of Canberra Clinical School and the
additional nursing positions. The existing ACT
Workforce Plan is for 2013-2018 and there is a need to have in
place strategies to address the attraction, education, recruitment and
retention beyond that date, to reflect the timing of the budget initiatives. We
need staff for the new services.
The eHealthy Futures that was announced in the 2010-11 budget has
experienced delays. This was first announced in 2009 when the ACT Government
allocated $90.2 million over four years for eHealth initiatives. It was it
described as an "unprecedented level of investment" by the then
Minister for Health, Katy Gallagher MLA. The intention of this commitment was
to ensure our health system was better positioned to meet the needs of the ACT
community at the time and into the next decade. The Budget this year says it
will be complete by June 2018. There needs to be some fresh thinking on how
technology can improve the quality, safety and efficiency of services .We know
it is difficult but it is worth the investment to help people have better
experiences and outcomes of care and improve the connection between our very
fragmented health system.
A couple of highlight include:
Mobile dental clinics: The community's most vulnerable people suffer the
poorest dental health. So two new mobile dental clinics should help. The larger
of the two will visit schools in more disadvantaged areas. A smaller one will
visit disadvantaged adults in shelters and halfway houses. Turning room and
power supplies are among the challenges still to be sorted. The government will
spend $2,173,000 over the next four years.
Nurse navigator positions: We are very interested in the announcement of
twelve nurse navigator positions. Queensland Health introduced the role in
2015. The nurse navigator roles are clinical roles held by experienced nurses
with expert clinical knowledge and in-depth understanding of the health system.
Their focus is to support patients with complex health care needs to identity
their needs and facilitate access to services. They support and coordinate
patients across their entire journey rather than focusing on just a specific
disease or condition.
HCCA has been funded in 2017-8 ($100,000) to undertake work to develop a
model of patient care navigators. It will be important for us to with ACT
Health in this. We are particularly interested to develop the navigator role to
help educate patients about self-management of their health needs which
supports people to feel empowered to make decisions on their own health care.
While the government has invested in health care services, accounting
for a third of the budget, ACTCOSShas called for greater ambition to deliver on
the community’s expectation for a practical plan to drive back gathering
inequality. Susan Helyar said “we are disappointed that, while the Budget
checks off a number of election promises, we are still not meeting the
community’s expectations about action for those who face sustained long term
cost of living pressures especially those who can’t find affordable and
accessible housing.” Their Media Release is available online.
ACTCOSS commissioned research into cost of living pressures over the past three
years which revealed a persistent and widening gap between income and living
costs for individuals and households living on low incomes in the ACT.
The Budget was well
received by the ACT P&C Council. Their media release is
available online. The Youth Coalition welcomes elements of the
budget but remains concerned that the Government does not have a plan to
address education inequity and recognition of the skills, knowledge and
expertise of community services in supporting students who are at risk of
disengaging from school.
An update on SHOUT. Our members will be interested to learn
of the ACT Government commitment to SHOUT. SHOUT supports many community groups
and the government wants that to continue. The government also wants to see
SHOUT with a sustainable operating model. The government's solution is
• to await the review's findings and
• to give $70,000 to ensure SHOUT keeps ticking over.
Pending the review's findings, SHOUT may receive recurrent funding in
the 2018-19 budget.
The Budget Papers are online:http://apps.treasury.act.gov.au/budget/budget-2017-2018/budget-papers.
The Government’s glossy overview of the health budget is available here:http://apps.treasury.act.gov.au/budget/budget-2017-2018/better-care-when-you-need-it
The Budget Papers for Heath Directorate are available herehttp://apps.treasury.act.gov.au/__data/assets/pdf_file/0007/1069369/C-Budget-Statements.pdf.
The Government is to be commended for their commitment to funding the
health service to meet the needs of the community. Thirty one percent of the
budget has been allocated for health services. This is $1.6 billion. The
challenge for the Government is ensuring that the election commitments
complement the health services planning that is currently underway within ACT
Health.
We will continue to analyse the budget and share our thoughts with
members via our newsletter.
Darlene Cox
Executive Director
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