President’s Blog: A week’s a long time in (COVID) politics | AMA (WA)

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President’s Blog: A week’s a long time in (COVID) politics

Saturday February 12, 2022

Dr Mark Duncan-Smith, AMA (WA) President

With the COVID-19 Omicron variant’s rapid community progress, it’s a challenge to keep up with the endless changes to government policy. 

Consider that since the last edition of Med e-link, with the start of the scholastic year, the AMA (WA) was campaigning for a reduction in the quarantine period for close contacts in school settings, from two weeks to one. 

Our reasoning was that: “We can find no justifiable evidence-based reason, from an infection control and public health point of view, for the second week of quarantine for children. It is doing harm to schooling and socialising, and taking parents out of the workforce.” 

A week later, this past Monday, the Government announced a move to high caseload settings, which resulted in the desired change to school quarantine settings. Indeed, there was a similar reduction to quarantine for approved international and interstate travellers. 

The Premier channelled some of my lines when he said: “Unfortunately, these new protocols are not a sign of the pandemic ending – they signify the real impact of Omicron beginning in Western Australia.” 

If projections are borne out, the next couple of months will be very bumpy for WA, though there are vastly different scenarios potentially that could play out. 

Unfortunately, the WA Government Omicron modelling is ‘top secret’, and we can only be guided by South Australian modelling. South Australia peaked at 5,680 new cases per day with its social restrictions. Without the modest social restrictions introduced, South Australia was predicted to peak at 30,000 to 40,000 cases per day. 

Based on these figures, WA is predicted to peak at 9,020 cases, if we introduce similar restrictions at the appropriate time. If we do not introduce restrictions and ‘let it rip’, based on South Australian modelling, WA will face an estimated 48,00064,000 new cases at the peak of this Omicron outbreak.  

Though it’s difficult to extrapolate the expected peak date, it’s projected to be in April, slightly later than that seen in South Australia, due to lower initial infections. 

As part of its response to the bumpy ride ahead, the Government announced that no new bookings will be taken for non-urgent category two and three elective procedures in public hospitals after February 28, for 6–8 weeks.  

The AMA (WA) gave its approval of the cautious approach to changes to public elective surgery, acknowledging that this was better than having to cancel such procedures at the last minute.  

Subsequently, the Government informed private hospital providers that no further multiday and same-day category two and category three elective procedure cases should be booked from 7 March, for up to seven weeks.  

Cancellation of private elective surgery is a different matter entirely, something I sought to clarify early in my term as president.  

Our stated policy is that while the cancellation of some public elective surgery can be warranted as a COVID response, the cancellation of private sector elective surgery will not have the same effect.  

 In fact, a premature cancellation of private elective surgery will simply cause unnecessary delayed access to care and lead to unpleasant and unsafe medical and social outcomes.  

 WA Health should be nimble and responsive enough to allow subtle nuances of elective surgery policy to allow optimisation and safe use of available resources, for both public and private settings.  

 AMA (WA) has continued to demand the release of the Omicron modelling and its impact on hospitalisations.  The WA Government needs to monitor and review the case numbers and trends on a weekly basis and respond to ensure it maximises the use of private elective surgery capacity. 

As if all this isn’t enough, there’s a Federal Election coming up (noticed the atmosphere is getting rather heated in Canberra, not just because of runaway climate change?)  

Yesterday I had the pleasure of appearing with AMA President Dr Omar Khorshid at the launch of the campaign to end the public hospital logjam.  

In light of the kind of logjams we’re discussing, it’s a timely intervention to get governments and voters focused on what really matters here. 

As Dr Khorshid puts it: “The long-standing public hospital funding failure is so serious we can no longer allow this issue to be punted between state and federal governments; it’s a national issue. Australians are in danger of losing their access to universal healthcare and that’s a tragedy we can’t allow.” 

For its part, the State Government has only latterly seen the need for a true commitment to appropriate spending levels. 

As I said when the Government laid down its last Budget in September last year: “WA Health must change its financial fixation with cost-cutting to a patient-centred approach towards quality and safety of healthcare delivery.” 

Since then, the Government has been in catch-up mode, with lots of funding and workforce capacity commitments. But it’s a shame that the lag between commitment and delivery is taking place during this extraordinary pressure point in the history of the State’s health system. 

Regardless of whether the new Federal Government that emerges after the election sees sense and puts lots of extra cents into the public system, it will still depend greatly on the calibre of the politicians and bureaucracies that need to administer those funds at the state level. And of course, the ongoing commitment of our phenomenal medical workforce. 

You have hopefully read or bookmarked the compelling Q&A with Health and Mental Health Minister Amber-Jade Sanderson that appears in the latest excellent edition of Medicus. With issues about the status and treatment of women so prominent in the national conversation right now, it’s sobering that it’s been seven whole decades since the last time this State has had a woman as health minister. 

Considering women make up more than half the population, and represent about 60 per cent of doctors these days, it’s unfortunate that they have had such sparse representation in the health portfolio.  

I have met with the new health minister on several occasions now. Gender aside, I have found Ms Sanderson approachable, intelligent, energetic and keen to move forward productively for better outcomes. I look forward to working with the minister and her team towards those better outcomes for our patients, the system and all stakeholders.