WA’s healthcare system is world class according to the state’s health minister, yet critics claim it is heading towards crisis point as ambulance ramping hits all-time highs.
- Health represents about one third of WA’s budget
- ED admissions have grown 12 per cent in five years
- This has contributed to record ambulance ramping
When Roger Cook became Health Minister just over four years ago, one of his immediate priorities was getting a handle on the sector.
“When we came into government, you were seeing double digit growth in the health services year after year, anywhere between eight and 12 per cent,” he said.
Soon after entering office, Mr Cook ordered the Sustainable Health Review and labelled its 2019 report, which outlined eight enduring strategies and 30 recommendations, a “blueprint for change”.
Health remains the largest consumer of WA’s annual expenditure, with the $9.6 billion committed towards the sector making up almost a third of the 2020-21 state budget.
But under the McGowan Government, growth in spending has reduced significantly, to around one to two per cent year on year.
“The Sustainable Health Review is a long-term program,” Mr Cook said.
“It’s about rebalancing our system, putting more emphasis on prevention, making sure that we have an outward, integrated and innovative health system.
“This is not going to be a change which will happen overnight.
“It’s about changing culture — it’s about changing the way we deliver our healthcare and it’s really about the future of healthcare in Western Australia.”
Mental health system at crisis point, says AMA
The report from the Sustainable Health Review has been almost universally welcomed.
The Australian Medical Association’s WA president Andrew Miller said progress, however, was lacking.
“Now, they may have slowed down the rate at which it’s deteriorating in some areas, but overall, those people on the front line tell me that we’re reaching crisis mode in mental health, in emergency care provision, and it’s not getting better.”
In fact, Dr Miller went as far as stating the WA Government was failing to provide a safe public health system.
“I think that they have good intention, I think they’re good people, I think they work very hard,” he said of the State Government.
“I think they’ve delivered on border control, which is the thing that the doctors called for initially, and so they have kept the virus out of the community— and for that they should be rewarded.
“But they had other things to do, including [the provision of] a safe state health system, and as far as the metro is concerned, as far as the regional is concerned, they’ve failed to deliver.”
Hospitals busier than ever
Despite WA remaining relatively COVID-free, hospitals have never been busier.
More than 900,000 people attended an Emergency Department in WA last financial year — 12 per cent more than five years ago.
In December alone, EDs saw 250 more people every day than the previous month.
The pressure of all those patients is perhaps most visible outside hospitals — in the queues of ramped ambulances often waiting to transfer their patients.
“The unfortunate fact of the matter is that the current Health Minister, when he was in opposition, was very animated about the issue of access block to emergency care, and described it as a disgrace at the time,” Dr Miller said of Mr Cook.
“Unfortunately, it’s at more than double those levels now.
Mr Cook admitted the waiting time for ambulances was a problem but said the McGowan government had a plan.
“Emergency departments are challenged in relation to being overwhelmed by an increase in the number of patients but also in terms of the complexity and acuity of those patients, particularly in the mental health area,” he said.
“We need to look at how we respond to doing that and one of the ways that we are seeking to respond is by developing more mental health beds … we’re developing an extra 300 beds across our healthcare system, 100 of those are in mental health.”
Advocates say prevention is key
Health Consumers Council of WA executive director Pip Brennan said adding more beds was not going to solve the problem in the long run.
“It’s a simplistic statement in a way to say there’s too much demand on our hospital, we need more hospital beds, we need more doctors,” she said.
“What we need is more prevention.
“What we need is more things that work for people, other than emergency departments.”
The Sustainable Health Review called for five per cent of the state’s health spend to go towards prevention — currently it sits at less than two per cent.
Christina Pollard, director of the Public Health Advocacy Institute of Western Australia, said it had been reassuring to hear Mr Cook commit to reaching that target by 2029, and she now wants to see it become reality.
“I think that we need quite a lot more attention applied to prevention, and to creating strategies within the community and assisting society to prevent mental health issues ahead of time,” Ms Pollard said.
The associate professor of public health priorities at Curtin University said in order to achieve that, it was important to ensure people aren’t struggling with financial distress and issues related to alcohol and unemployment.
McGowan has failed on health, Kirkup says
Opposition Leader Zak Kirkup said apart from its response to COVID, the Government had failed to deliver on health.
“Nurses tell us, doctors tell us, patients tell us that they’re getting more and more pressure in the hospitals, that patients are waiting longer,” he said.
“It’s simply not good enough that the Government continues to ignore the area of health.”
Mr Kirkup, who has all but conceded defeat ahead of the March 13 poll, said it was more important than ever that there be a strong opposition to ensure a re-elected McGowan Government is held to account.