IT MIGHT surprise you to know that Victoria is the best-performing state in three key health measures; surgery wait times, adverse events and readmissions.
It is also the highest overall performer, as ranked across 15 measures of system performance of availability, affordability, access, equity and outcomes, according to Professor Euan Wallace AM, Secretary Department of Health, who addressed the State Government’s Public Accounts and Estimates Committee in mid-November this year on just these issues.
And that in the context of Australia being a global leader in health, outperforming the likes of the Netherlands, UK, NZ, France, Sweden and Canada.
So, a lot of the things we do here are best practice but not everything about the health system is rosy.
Earlier this year, the government commissioned an expert advisory committee to prepare a Health Services Plan and they found that “while our health services system has served us well in the past, it is no longer fit for purpose to meet current and future challenges”.
Duplication of services and competition for staff between multiple health services in the same geographic region, inconsistent access to high-quality care especially for patients from rural and regional areas and the steeply rising cost of service delivery have led to cost blowouts at all of our major hospitals, and some locally.
Last financial year, Bass Coast Health reported an operating deficit of $3.233 million on a budget of almost $170 million and Gippsland Southern Health Service, at Leongatha and Korumburra, an operating deficit of $1.933 million.
An ageing population, the increasing level of chronic disease and enduring impacts of the COVID-19 pandemic have applied further pressure.
Key to the response recommended by the expert advisory committee is the establishment of Local Health Service Networks, in Gippsland’s case, putting all of the hospitals from Cowes and Wonthaggi through to Bairnsdale in the one group effectively controlled and supported by Latrobe Regional Hospital (LRH) as the region’s Group A Hospital.
The advisory committee found that for these integrated health networks to operate optimally, from a cost and service point of view, they need a catchment population of greater than 200,000 people.
Gippsland would have 250,000 people with South Gippsland and Bass Coast included.
The obvious problem for these two urban fringe Local Government Areas (LGAs) is that local patients, local doctors and visiting specialists are still going to want to use established links to providers at hospitals such as Dandenong, Frankston and Monash.
That’s all right, except that it’s going to create the false economy of locating and paying for service delivery at and out of LRH that a quarter or more of the catchment is not going to use.
The other obvious issue with dividing regional Victoria into five networks is that while it might work with back-office functions such as payroll, accounts and records, while facilitating more structured cooperation around service planning and delivery, it’s too simplistic to be trying to deliver most health care within artificial boundaries.
You’ll also have the problem we’ve all become familiar with since local government amalgamations where bureaucrats can’t see anything outside their own main town limits.
What will happen to local hospitals if an overarching, skills-based network board and a network CEO are based in Traralgon, or worse, Lonsdale Street? You be the judge.