The Legislative Council’s subcommittee inquiry into Tasmania’s acute health system held hearings in Launceston on Tuesday. Five presentations covering a diverse range of topics across the health system’s successes, failures and progres were heard by MLCs Rob Valentine, Ruth Forrest and Kerry Finch.
The detailed live blog from the hearing is available online at examiner.com.au.
Safer Care Victoria was created by the Victorian state government in response to a review and report into a cluster of stillbirths in the state’s health system.
Safer Care Victoria works to increase safety outcomes for patients and clinicians, and said they had seen a significant improvement in clinical and patient communication since establishing in January 2017.
Their presentation offered insight into an organisational support system Tasmania could adopt for greater improvements. The word “customer” was frequently used rather than “patient”.
Janette Tonks, nursing director for women and children services at the Launceston General Hospital, presented information on the planned upgrade to paediatrics ward 4K and its cost, number of beds to be available, and delays around the construction.
Key areas that Ms Tonks said needed to be addressed for the mental health, paediatric and obstetric wards were postgraduate mental health training for nurses, practical construction of new beds in the ward and cost of staffing for the future ward.
Ms Tonks said LGH had also seen three admissions for young people in crisis with nowhere else to go, an increase from the past year.
Dr Stuart Day from the Australian Medical Association issued a scathing critique of the “top-heavy”, “toxic” executive culture in the Tasmanian Health System.
He reiterated the AMA’s “lack of confidence” in the THS chief executive officer, and said there had been a “high level governance failure” in the leadership and structure of the THS executive sector.
“The AMA believes that Tasmanians deserve access to a well-performing public health system that supports our hospitals in delivering high-quality health services with a minimal level of bureaucracy,” Dr Day said.
A toxic and controlling executive culture and controlling administrative requirements that took away basic level decisions around hiring staff from hospitals, were all part of the AMA’s concerns around the state’s health system.
Dr Day said the AMA still supported the one health system policy, but wanted to see a smaller administrative sector supporting rather than making decisions in hospitals.
The Royal Australian College of General Practitioners brought the need for a greater focus on preventative health to the inquiry, saying general practitioners could generally provide many of the healthcare services often provided at hospitals “at a fraction of the cost” for outpatients.
RACGP president Dr Bastian Seidel said there needed to be a commitment to more mental health beds and facilities, and greater support for GPs who lead the treatment of mental health in the community.
Dr Seidel said he also wanted to see a combination of federal and state funding for $50,000 innovation funding for all GPs to support preventative health practices to keep patients from being readmitted to hospital.
The RACGP also highlighted discharge paperwork from hospitals not being sent to GPs quickly, often taking up to two weeks – Dr Jenny Presser from headspace said this delay “could risk lives”.
Tasmania’s Health Minister spent more than two hours answering the subcommittee’s questions, from across the projected cost of staffing for the future upgrades of ward 4K, to the AMA’s criticisms of the system and the issues of preventative health and mental health in the community.
Noting the state government’s “record spend” of $7 billion in health, Mr Ferguson said a major focus had been driving down waiting times for elective surgeries, with success.
However, he said “there is no doubt for many Tasmanians their experience at Tasmanian hospitals is not as good as it gets.”
Mr Ferguson noted while criticism from the AMA over the THS chief executive was an issue, the positive changes should also be recognised.
He said he recognised the “increasing appetite” for healthcare decisions to be made at the local level in hospitals rather than by a top-level executive branch.
Mr Ferguson had not heard of the RACGP’s proposal for a $50,000 spend for GPs, and questioned the appropriateness of state funding for a federal health system.
Describing the state’s health system before the Hodgman government was elected, Mr Ferguson said he “inherited a complete basketcase” and the health white paper was a driving, long-term vision for the state’s health future.
Touching on the Deloitte report repeatedly discussed in parliament, Mr Ferguson reiterated that there was no such report, but that Deloitte had conducted research for the state government on the health system. He had received a briefing from Deloitte on the findings.
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