The delivery of public hospital health services in Western Australia is in an unprecedented crisis by any measure.
This is not due to “unprecedented demand” or the pandemic. Hospital activity over recent years has increased in line with expectations and COVID-19 lockdowns have, in fact, resulted in fewer emergency department presentations.
The hospital system is paying the price of a persistent shift in focus to fiscal savings and cost-cutting over service delivery. This has culminated in inadequate health system capacity, poor patient outcomes, reduced safety and quality, and unacceptable wait times.
This lack of economic and political investment in WA’s health system has manifested in a number of problems, which are the hallmarks of this current crisis:
- A staggering 43 per cent increase in the number of patients on WA’s Elective Surgery Wait List.1
- More patients exceeding the safe, recommended wait times for elective surgery.
- The lowest number of public hospital beds per capita, compared to anywhere in Australia. 2
- Dangerous ambulance ramping levels, where monthly rates are comparable to previous yearly rates.
- A workforce whose morale has collapsed to dangerously low levels, threatening the lives of staff and patients in our public hospitals.
- Systemic workforce shortages in critical areas of care such as psychiatry, rural medicine and many others.
- Hospitals regularly operating beyond safe occupancy rates and regularly calling internal emergencies (code yellow). Potentially preventable deaths occurring in our hospitals – not because healthcare workers aren’t doing their best, but because our healthcare system is struggling.
- A system that struggles to cope with a comparatively infinitesimal number of COVID cases and which will be overrun in a matter of days, in the event of a large COVID outbreak in WA.
- Incidents of fraud, with WA Health executives pleading guilty in the Corruption and Crime Commission.
WA’s public hospital system is moving towards a point where patients will not be able to rely on access to safe and timely care, deaths will be directly attributed to overcrowding or excessive waiting times, and entirely avoidable human tragedies will occur on a regular basis in our hospitals.
The AMA (WA) has closely examined the issues confronting our health system and in response proposes an Action Agenda with a range of viable and practical solutions that can be implemented immediately and over the medium and long term to prevent further catastrophe and system collapse.
A fundamental pillar of our Action Agenda is a call for a corporate governance review of WA Health. WA Health cannot be expected to provide solutions or resolve problems unless its corporate and organisational governance is fixed first.
The reestablishment of engagement with clinical staff and the development of a collaborative culture based on safety and quality is of paramount importance, which will allow the system to move away from cost-cutting and embrace a patient-centred approach.
The AMA (WA) plans to hold an Emergency Care Summit in September to generate immediate solutions that address the current ramping crisis and the anticipated 6,000 hours that ambulances with sick patients have spent waiting outside EDs in August.
The State Government’s Sustainable Health Review addressed several of these issues as well, but its observations and recommendations lacked detail and direction. Notable was the claim that there were enough hospital beds in the WA health system to serve demand through the next decade.
WA’s ongoing health system crisis was avoidable and is reversible. All WA’s health system needs is the political and bureaucratic resolve to invest in and address the crisis as a matter of urgent priority.
I commend the AMA (WA) Action Agenda to the WA Government, as a means of avoiding further future tragedies, and delivering the healthcare WA expects and deserves. This will secure the health and wellbeing of Western Australians and WA’s healthcare workforce and move to a system that is integrated, efficient and predictably funded.
DR MARK DUNCAN-SMITH MBBS FRACS GCGOVM MAICD
AMA (WA) PRESIDENT
Saturday 28 August 2021
Click here to read the AMA (WA) Action Agenda