More than a third of Tasmania's budget goes to health - an amount that continues to rise in the face of increasing demand.
But as Northern Tasmania's largest employer, the health and social assistance sector also offers significant opportunities for economic growth.
According to the Regional Australia Institute, over the next five years the health sector is expected to add more jobs than all other industries put together.
This is a national trend, but Tasmania is facing its own unique circumstances - and opportunities.
This includes Calvary's $100 million unsolicited bid for a private co-located hospital.
Those in support of the development believe it could provide a much needed economic boost and renewed economic confidence in the area.
It could also help meeting growing demand by taking pressure off the public system.
Because, while health as an industry could be one of our greatest assets, Tasmania's poor health outcomes are continuing to hamper our economy.
In the context of a global pandemic and the findings of the Aged Care Royal Commission, many are now calling for a complete reset on how we think about health as an industry - and a service.
Health industry growth
RAI estimates health as an industry in regional Australia accounts for more than 15 per cent of jobs in a regional place.
There are also national forecasts for another 85,000 jobs in the healthcare and socials assistance industry by 2023.
As demand continues to increase, it is also expected that the quality and diversity of health services will also need to grow.
As it stands, there are more than 10,800 full-time equivalent paid employees in Tasmania's public health system.
It remains our largest employer of skilled and unskilled people, particularly in the state's North, accounting for more than 16 per cent of employment.
Kim Houghton, chief economist for the Regional Australia Institute, said a private co-located hospital in Launceston could be a huge boost for the region and would demonstrate great confidence in the future of the health industry.
"I have no doubt that this confidence will bring further private investment in associated health services such as pathology, diagnostic imaging and a wide range of much needed allied health services," he said.
"We find there is a close relationship between the scale of public and private investment in core primary health facilities in region, and the flow on impacts to the independent providers of allied health services - spurred by the confidence in the future that these capital investments bring."
When the Northern Tasmania Development Corporation was established in 2017, it was tasked with actioning targets set out in the Northern Regional Futures Framework.
Funded by local government members, at its core NTDC aims aims to improve the prosperity and living standards of Northern Tasmanians, by finding ways to boost economic output, increase investment and create more jobs.
Now more than four years on, chief executive Mark Baker said health remained the number one priority when it comes to economic development.
Why? Because it directly relates to improvements in the social and political welfare of people.
"Health outcomes are directly related to economic outcomes and vice versa," Mr Baker said.
"There is a lot of evidence about the social determinants of health; the non-medical factors that influence health outcomes such as where people are born, grow, work, live, and age. At all levels of income, health and illness follow a social gradient: the lower the socioeconomic position, the worse the health.
"Improving factors like health and education outcomes is key to growing an economy."
A reset on health, with a focus on prevention
Health Consumers Tasmania is the peak body representing patients, carers and communities in the state.
While supportive of Calvary's co-located hospital proposal and the potential for it to take pressure of the public system, HCT chief executive Bruce Levett said a new hospital alone would not fix the health system.
Rather, he said communities were crying out for alternatives to hospital care, including a strengthened approach to community care. This includes a greater focus on prevention and keeping people out of hospital altogether.
"People often say 'if someone told me this 10 years ago, I would have done something different'. So the message there is we need to do a lot more preventative work, before people get sick," he said.
"The health system was designed at a time - it is very reactive. People get sick, it responds and people go to hospital for care. But that system is now out of date - it needs to be more proactive.
"We know that if people don't have a job, a home, or an income, then they can't access healthcare. So when you get symptoms, if you can get treatment early that's a form of preventative care.
"If you can't do that and you wait, you wait for the health condition to get to a point that you have no choice and it's much more expensive to fix."
Based on consumer engagement, Mr Levett said there were growing concerns within in the community that it was getting harder to navigate the health system - particularly for those with disability, chronic conditions or those trying to work out differences between the public and private systems.
For many, he said it remained almost impossible to gain access to services, while primary care is no longer working the way it should in a community setting.
These were among key findings from the state government's Our Healthcare Future document, which found that up to 44 per cent of admitted patients in the Tasmanian Health Service were not receiving care in the right setting for their condition.
It also estimated that up to $100 million each year is allocated to areas of care in acute settings that "could otherwise be provided in less expensive, more appropriate sub-acute, non-acute or community based settings".
Mr Levett said the COVID-19 pandemic had presented the Tasmanian health system with the perfect opportunity for a complete reset on the way people think about healthcare.
"We are already spending a third of our budget on health at the moment at a state level ... it could go over 40 per cent. At some point we need to stop doing the same thing over again and think differently about our approach to health," he said.
"For us COVID is a great example of a preventative health strategy that has worked. For the first time in my lifetime, we have used a preventative measure as a priority over and above everything else.
"It has come at some cost, but our focus has gone to health and we've prevented something. We could have been like Italy or the UK or US, but we have been very strong. So preventative approach has worked, but it means we need to reset our thinking."
- This article is part of a six-week series Critical Condition exploring the what the future of health service delivery in Northern Tasmania looks like.
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