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Vision for health must transcend politics

Vision for health must transcend politics

It is no surprise that the issue of health care has again been prominent in the first half of the federal election campaign.

What is surprising, and disappointing, is the lack of policy commitments the major parties have shown thus far to enable genuine reform in the private health sector – reforms that would lay a platform for strengthening the entire health system, increasing access to care and services and ultimately boosting health outcomes for all Tasmanians.

The private health system plays a critical role in reducing demand and pressure in the public system.
The more people who can access care and treatment in the private system, the less pressure there is on Tasmania’s public hospitals. This means the public system is there for people who need it the most.

There are more Tasmanians with private health insurance than without. More than 275,000 Tasmanians, or 52 per cent of the population, have some level of private cover.

Unfortunately, the continuing COVID-19 pandemic has placed even more pressure on the public system. Elective surgery waiting lists are ballooning against a backdrop of surgery slowdowns, staff shortages and ward closures. In just the last week we have seen an entire medical ward at the Royal Hobart Hospital closed to admissions due to COVID-19. Combine those immediate and significant impacts with longer-term trends of an aging population and an increasing prevalence of chronic disease, and the pressure only looks set to increase into the future.

Governments need to implement reforms that support a modern and dynamic health delivery approach that sees people provided with timely and appropriate care while keeping them out of hospital, not enshrining hospitals and hospital admission as the only way to deliver specialised medical care.

Under current regulations, private health insurers are only able to fund procedures when they are performed in an admitted hospital setting.

Private health insurance should be able to fund procedures outside of a traditional hospital, where clinically appropriate, by non-hospital health providers.  Services like wound care, intravenous infusions, rehabilitation and other post-operative procedures could be undertaken in a community setting and appropriately funded by Private Health Insurance. This would enable privately insured members to access modern care delivery, in their preferred setting.
This would have the immediate effect of reducing inpatient demand in our hospitals and help decrease instances of bed block in hospitals.
Importantly, such a reform would allow fit-for-purpose patient care to be offered at a lower cost to consumers, with increased access, and a focus on early intervention that addresses health issues before they require hospital inpatient treatment.
St.LukesHealth members have already recognised the need for these type of policies. One of the strongest messages from a recent member survey was that improving health care in northern Tasmania goes well beyond providing acute hospital care. Instead, we need a major increase in health care system capacity, both in terms of an increased number of services as well as a significant improvement in those services already available, to meet the future needs of our north and north-west communities. 
A collaborative, well-functioning network of health care services that people can access close to their homes, families and communities, especially in regional settings, that afford high quality health care without the need for unnecessary hospital admissions is critical to achieving this.
The regulations applying to private health funds need to be reformed. The limitations that restrict private insurers from funding services outside of a hospital admission are in turn limiting the ability of the private system to relieve pressure from the public system.
It is in everyone’s interest to have a health system that is able to respond and provide the very best in health care when it is needed. No-one should have to endure hours or even days stuck in emergency departments, nor should anyone have to wait years on public hospital elective surgery waiting lists.
As we get older and sicker, and the system gets more and more stretched, governments need to act to allow the private system to help provide better health outcomes for all Tasmanians.
Health reforms aren’t easy. They take a government with resolve and preparedness to be bold, with the vision to implement changes for long-term benefits, not short-term political wins. Decisions around health care cannot be limited in scope to election cycles or simply increasing taxpayer funding without addressing ways to make the entire system work more effectively.
There is an opportunity right now for the next government to make fundamental changes that can underpin an improved health future for Tasmania. It is an unfortunate fact that our public system permanently struggles to cope with demand, and the state’s overall health will not improve unless changes are made to better support the public system.
Paul Lupo, Chief Executive Officer, St.LukesHealth