Increasing bed numbers alone would not solve the growing problems in hospitals and aged care, say groups.
Nursing and other health groups have questioned the Coalition’s health policy, saying while parts have merit, it lacked a “whole system view”.
Among the health announcements made by Opposition leader Tony Abbott was a $3.6 billion “beds and boards” policy on public hospitals that include the establishment and operation of community controlled public hospitals and 2800 new public hospital beds over four years.
Funding for the beds - which include the previously announced 800 sub-acute and acute mental health beds – would be contingent upon the states and territories providing evidence that these beds have opened.
Kathleen McLaughlin, RCNA acting CEO, said the policy did not go far enough.
“Extra beds for hospitals are important, but addressing bed block alone will not solve the many and complex issues facing our health system. Australia needs a clear workforce strategy to ensure these new beds will be staffed,” she said.
While it was true that public hospitals were under pressure and struggling to cope with rising demand, an increase in bed numbers would not – on its own – solve the growing problem of preventable hospital admissions, said Prue Power, Australian Healthcare and Hospitals Association (AHHA) executive director.
“Australia’s hospital admission rate is already higher than most other countries and will continue to grow due to our ageing population and rise in chronic disease,” Power said.
“Unless the cause of this demand is addressed, through putting increased resources into community-based care and programs to prevent and manage chronic disease, hospitals will continue to treat people who should not be there in the first place.
“Furthermore, by increasing bed numbers without a commensurate increase in hospital infrastructure and workforce, hospitals will not have the resources required to utilise the additional beds for patients most in need of care.”
The Coalition has also got it wrong on hospital boards, said Power. “While it is vital that the community have input into the health system, the creation of hundreds of separate boards will simply increase micro-level bureaucracy and entrench the existing fragmentation of our health system.”
Other announcements in the policy, particular to nurses, was: the funding over four years to establish the Nursing Professional Development Fund, to provide support for nurses to improve their skills, participate in short courses and attend professional conferences; an annual $10,000 bonus for up to 300 nurse practitioners working in remote communities that have no resident medical practitioner, and; an additional 100 scholarships for rural and regional nurse practitioners.
McLaughlin said the proposed Nursing Professional Development Fund could potentially lead to the realisation of some key priority areas for the profession, but she had some concerns about timing.
"It is essential that the development of new health workforce initiatives is not at the expense of work on other important national health workforce reform programs.
"It should not put at risk the solid work of health stakeholders and professionals who have been consulted and who have contributed extensively to inform and guide fundamental change to Australia's health system.”
The Coalitions announcement of more aged care beds has also been a target of criticism.
Abbott has promised a $935 million package that would free up 3000 beds for high-care aged-care patients.
The program would begin immediately if elected, with funding of $90 million for incentive payments to nursing home operators.
Nursing home operators would receive $30,000 for each bed in an attempt to push them to make allocated places available.
Much like the response to the new hospital beds, the ANF said a policy which pledges to make more beds available for the aged care sector must also include measures aimed at boosting nurse numbers.
The $30,000 per bed incentive payment also ignored the often complex health needs of aged care residents, said Yvonne Chaperon ANF federal assistant secretary.
"Beds without more nurses or a strategy to get more nurses into aged care will create a crisis in the aged-care sector," Chaperon said.
"There is no detail about how that money is to be spent by the providers. The $30,000 per bed must to be tied to the nursing care of that resident, not left to the discretion of providers to spend where they want."
Funding new beds without having the nurses to support them is pointless, said Mc McLaughlin. It also does not help the thousands of older persons remaining in their own homes, needing increasing nursing and other care, she said.
"New models of care are necessary. Nurses can work at advanced levels of practice in aged care, they can work across communities, visit aged care facilities, manage people in their homes and in hospital and liaise with other health care professionals,” McLaughlin said.
"Nurses provide aged care services where currently none exist, or are difficult to access, as well as ease the pressure experienced by hospitals and general practices, that are attempting to meet the service needs of ageing communities.
"Increasing nursing home beds is commendable but this is the tip of the iceberg of aged care. Incentives should expand choices for ageing and older people."
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