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President’s Blog: Congratulations, and some unsolicited advice to the new Director General
Friday April 19, 2024
I’d like to extend my warmest congratulations to AMA (WA) member and infectious diseases physician, Dr Shirley Bowen, on her appointment as Western Australia’s Director General of Health. Shirley is well-known to many, having most recently served as Chief Executive of the North Metropolitan Health Service, and prior to that as Dean of the University of Notre Dame Medical School, and CEO of St John of God Hospital Subiaco.
The job is, at its core, to lead WA Health, the provider of State-funded health services (mostly public hospitals) and public health initiatives. As we all know, this is not the end of the story for healthcare delivery: we have a large, complex, dynamic private sector that includes nearly all primary care delivered by general practitioners, and other specialists providing a huge amount of outpatient and inpatient care, pathology, radiology, and much more. Whilst any patient can choose between public and private care, we live in a society that regards access to healthcare as a universal right; therefore, the public system has an obligation to provide care at no charge, in just about any geographic location. It is therefore, in essence, the “default” provider, at least of hospital-based care.
Meanwhile, private health insurers are inadequately rebating many medical services, placing the private hospital sector under enormous pressure and causing it to narrow its range of services. Additionally, the Commonwealth has failed to adequately index Medicare rebates for decades now; when compounded by the current cost-of-living pressures, this is a major barrier to access to general practice. General practice is absolutely key for keeping patients out of hospital, both by managing acute illness and injury, thereby preventing admissions, and managing chronic disease to reduce the burden on most facets of hospital care over the longer term.
So, to prevent the ballooning of the cost of, and wait times for, State-funded healthcare, collaboration with private healthcare needs to be firmly in the picture for WA Health’s overall strategy. I would encourage the new Director General to take a holistic view of healthcare delivery in Western Australia. All Western Australians are, by default, patients of WA Health; but most care can be delivered privately, and the more that is, the more protected State infrastructure will be from being overwhelmed as demand increases. Partnership is key, and the State has the resources and influence to play a major coordinating role.
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