News

Being President of the AMA (WA) has been a rare privilege. Like all leadership roles, it is not just about providing leadership by drawing on personal characteristics, judgment and prior experience, but is in itself an intense learning experience. There are few similar opportunities to be simultaneously connected with decision-makers from across our entire health system – private and public hospitals, private specialist practice including general practice, doctors in training, public health, the bureaucracy, industry, academia, and more – and to engage in advocacy at all levels. Using all of these inputs to synthesise the views of our profession on every possible issue into seven-second soundbites for the evening news provides a degree of focus and clarity that can’t be obtained from sitting in another summit or workshop.

So what have I learnt? Well, this won’t sound surprising or revelatory to anyone engaged enough to be reading this, but I’ll say it anyway. Our health system is in serious trouble. Yes, there is nothing new in us bleating on about the pressures the system is facing and its need for more funding. But the slide only continues and shows no signs of abating. Two of our tertiary hospitals are dilapidated to the point of needing replacement or top-to-bottom refurbishment. Addressing this, whilst necessary, will not solve the other problem – we don’t have enough hospital beds, probably by a margin of a couple of thousand. National averages are a reasonable comparator that bear this out, but blind Freddie can see it by glancing at how over-full our hospitals are and as ramping – the media’s favourite bellwether for an under-cooked health system – continues to worsen.

This is all without going into the challenges the private hospitals are facing and the continual threat to good quality general practice posed by entrepreneurial and non-medical models of care, many of which are perversely supported by governments.

More distressing than the problem itself is that our State Government won’t articulate it. The closest we get to an acknowledgement of reality is that the system is “under pressure from increasing demand.” This is not an admission of a deficient system, but a victimhood statement placing the blame on the demand rather than the failure to invest. We are told that the system has added 800 beds in recent years, though we are yet to see an audited account of this claim.

So our role at the AMA (WA), an apolitical organisation, remains holding the state government of the day to account on its operation and planning of the health system, which includes those parts under its direct ownership and control, and those parts to which its policies and advocacy to the Commonwealth can make a real difference. I believe a big part of our role, therefore, is educating the community about the current state of affairs, and prompting it to ask the question: what kind of health system does our community want over the next 50 years? One in which people who can afford timely and high-quality medical care can receive it, while those who can’t wait, suffer and ultimately experience worse outcomes? Or one in which universal access to care – something I’ve always been taught that our society considers to be a basic human right – is actually supported by government?