Blog
State Budget 2021: a fighting chance for health?
Wednesday August 25, 2021
Last year the AMA (WA) took a major swipe at the 2020/21 State Budget, calling it a “lost opportunity” due to its lack of workforce foresight, a concrete workforce plan and miserly commitment to health infrastructure funding. This year, however, desperately-needed opportunity seems to be knocking on health’s door.
In a welcome shift, the State Government announced a major handout to health four weeks before the budget is scheduled to be handed down on 9 September. Health Minister Roger Cook explained the $1.9 billion in new funding that had been committed would be channelled towards “health and mental health services, including more staff, more beds and more services to address unprecedented demand in WA’s health system”.
Following years of underfunding, the possibilities stemming from the capital commitment look appealing and form an important first step in the process of reviving WA’s public health system. What the AMA (WA) is keen to see and examine, however, are the nuts and bolts of the health budget.
Here are the key takeaways from the State Government’s announcement, followed by the AMA (WA)’s analysis.
$960 million for WA Health to help address unprecedented demand in the health system.
AMA (WA): There has not been “unprecedented demand”, rather a steady and forecast increase of 3-4 per cent over the last four years. There was also no massive increase in activity in ED presentations. We welcome the increased investment; we don’t need any more excuses.
The overall funding boost includes opening 332 new beds across WA
AMA (WA): The detail is critical here, with immediate relief for widespread bed block nowhere in sight. At 2.28 available beds per 1,000 persons, WA has the lowest ‘available acute public hospital beds per capita’ rate in Australia (which is 2.44 available beds per 1,000 persons). With a potential 60 per cent increase in WA’s population forecast by 2042, the WA Government needs to remediate for today, and plan for tomorrow. A long-term policy to keep beds at least at the national average is required.
These new beds will be supported by around 100 new doctors and 500 new nurses working on hospital wards. Details of the recruitment plan include $8,000 for those international doctors and nurses who agree to relocate to WA.
AMA (WA): All very good in our bid to attract overseas trained doctors but let’s dive deeper.
WA Health doctors are primarily employed on fixed-term contracts, some less than five years. St John of God Health Care public hospital doctors are permanent employees and are paid higher salaries. Public hospital doctors in other states have permanent employment and many are paid higher salaries. Why would any doctor look to relocate their life and family to WA, for a short-term opportunity and all the harmful impacts associated with insecure employment currently experienced by the WA Health medical workforce?
Permanency for senior doctors is a cost-saving, safety and quality-improving change the WA Government could make today. Making WA Health an attractive place to work costs nothing.
Record $495 million increase in spending for Mental Health Commission, including $129.9 million towards youth mental health services and initiatives.
AMA (WA): Investment in mental health services is always welcome. However, funding doesn’t remove barriers to effective governance, nor address critical Psychiatry workforce shortages. Effective clinical governance structures linking community services to our public health system and sub-speciality services, and workforce development are goals that, if met, will improve consumer outcomes and service efficiency.
An additional $487 million for COVID-19 preparedness and response measures.
AMA (WA): Investment in mental health services is always welcome. However, funding doesn’t remove barriers to effective governance, nor address critical Psychiatry workforce shortages. Effective clinical governance structures linking community services to our public health system and sub-speciality services, and workforce development are goals that, if met, will improve consumer outcomes and service efficiency.
Includes an additional $88 million for extra staff and beds at Perth Children’s Hospital.
AMA (WA): Perth Children’s Hospital has faced an uphill battle since its inception. Short-sighted decision-making in the planning phase left it two storeys too short. Chronic underfunding of health services in WA has left healthcare workers at the Child and Adolescent Health Service (CAHS) scrambling to do more with less.
Additional nursing staff and extra emergency department patient monitoring areas will only address some of the problems faced by the beleaguered hospital. The $88 million won’t reduce the number of children waiting on the elective surgery waiting list, the blown-out waiting times, or the unsafe delays in access to care, including at the Child and Adolescent Mental Health Service.
The AMA (WA) would like to see more detail on the specific issues the $88 million will address, and how the other major areas of concern faced by the CAHS workforce and patients will be remedied.
More than $1.3 billion investment in health infrastructure over the next four years, including an additional investment of $225 million in this Budget. This will include major hospital redevelopments and expansions across the State, including works at Joondalup Health Campus, Fremantle Hospital, Bunbury Regional Hospital, Peel Health Campus, Geraldton Health Campus, Laverton Hospital, Tom Price Hospital, Newman Health Service and more.
AMA (WA): Investment into WA’s hospital network is essential to ensure the effective delivery of patient services. Some of our tertiary hospitals are in dire need of major redevelopment. Medium and long-term plans for Sir Charles Gairdner Hospital, Royal Perth Hospital and the services currently operated out of dilapidated Graylands Hospital continue to be the subject of discussion and political conjecture, yet not enough action.
We would like to see the prioritisation of the WA Health Clinical Services Framework 2014-2024, and the corollary infrastructure development across our system to ensure the delivery of effective and efficient clinical services.
Hopefully, the flagged hospital redevelopments won’t take as long as the State Government’s much-hyped medihotels.
$1.8 billion allocated for the construction of a new Women and Babies Hospital.
AMA (WA): The long-overdue commitment to relocate the WA’s Women’s and Newborn Hospital to the QEII Medical Centre was announced in December 2020, in the run-up to the 2021 WA State Election. What WA women and newborns need now is action, in the form of a new hospital that houses all the required services, equipment and independent governance structures. Clinical engagement is key to an optimal outcome and ensuring the legacy of King Edward Memorial Hospital is maintained.
