Industry & Reform

Major review of NSW healthcare funding damning of aged care bed shortage

The special inquiry has concluded that “it is time for action, and reform that is funded”

A special inquiry into NSW public healthcare system funding has delivered a stark warning to politicians; “serious problems will continue to bedevil our public hospitals if something is not done urgently to address the lack of aged care beds available.”

Led by Commissioner Richard Beasley, the Special Commission of Inquiry into Healthcare Funding delivered its report on Friday after almost 70 hearing days and extensive consultation with health policy experts, patients, consumers, and NSW Health employees.

The report makes 41 recommendations across 12 key areas including workforce, education and training, funding and procurement processes.

In his conclusions, the Honourable Justice Beasley said that he was astonished by the current state of the national healthcare system. The government’s failure to reform Medicare and primary care funding models, prioritise preventative care, and deliver adequate aged and disability support is “beyond comprehension,” Justice Beasley said.

“If I, generously, take as a starting point the recommendations made by the National Health and Hospitals Reform Commission in 2009, it is 16 years past the date from which the Commonwealth and the states, including NSW, should have been working together and collaborating to ensure gaps in primary and aged care did not emerge, and to embed and fund preventive health services,” he said.

“Based on all I have seen in the last 18 months, the long term health reforms outlined in the Addendum to the NHRA, and its aspirations for ‘shared intentions’ and to ‘work in partnership’ towards a ‘nationally unified and locally controlled health system’, are just words on paper.

“It is time for action, and reform that is funded.”

Aged care

A key focus area of the Commission’s report was the state’s delivery of aged and disability care.

Justice Beasley details the significant toll of the high number of older patients occupying beds in public hospitals that could, if an aged care bed were available, be discharged.

Key finding 2.43: Thin or failing aged care markets are also having a significant and detrimental impact on care delivered through public hospitals in NSW.

Local health districts (LHDs) are bearing the financial cost of these patients, who also contribute to ongoing issues such as bed block, ambulance ramping and ED wait times.

The Commission also recognises that the hospital environment is not an optimal place for older patients to be, with the risk of hospital acquired complications, falls and social isolation all increasing the longer a person stays.

Key Finding 2.49: Serious problems will continue to bedevil our public hospitals if something is not done urgently to address the lack of aged care beds available for the particularly challenging patients which the private market based providers will not accept. It is unrealistic to think that this problem can be solved without the State stepping in to play a greater role than it presently does in the aged care market – albeit it is entitled to be funded by the Commonwealth Government where it does so, at least to the same extent as would any other market based provider of aged care services.

In response to the suggestion that it should step in to address this problem, NSW Health said that it would be “assuming responsibility for delivering services that are not only squarely within the Commonwealth realm of responsibility but also ancillary to health services.”

The Commission warned NSW Health against waiting for federal funds and increasing the risk of being overwhelmed by “a huge increase in healthcare demands by an ageing population with high expectations.”

Overall health system fine

Despite delivering a lengthy and damning report, Justice Beasley reassured NSW residents that the state’s healthcare system is both well managed and efficient.

“[T]he NSW public health system is a very good one. It comprises doctors, nurses, other clinicians, and workers who are well trained, highly skilled, and dedicated. It is well managed,” he said.

“It is not, and is unlikely to be in the near future, entirely mistake or incident free, but any person experiencing an illness or injury who attends a NSW public hospital, facility or service, is very likely to receive treatment and care comparable to the best that is provided in any other developed country.

“The money allocated to the NSW public health system by a combination of the NSW and Commonwealth Governments is generally not wasted. Likewise, the local health districts and specialty health networks do not waste their budgetary allocation.”

NSW Health Secretary Susan Pearce thanked the people working in the NSW healthcare system for their dedication, skill, and commitment.
Picture: NCA NewsWire/Nikki Short

NSW Health secretary Susan Pearce said it is important to remember that the report is not an inquiry into the failure of government and its agencies but rather an exploration into how health services may be improved.

“We work in a huge and complex public health system and there always has been and always will be room for improvement and innovation, as we strive continuously to enhance patient experiences and outcomes,” Ms Pearce said.

“We have longstanding recruitment issues, particularly in regional, rural and remote areas, which are challenging for staff and communities in these areas, as well as in some clinical areas and practice disciplines. This continues to be an area of focus.”

“So, while I am the first to acknowledge that we have significant challenges to address, it is also true that we are addressing all these challenges from a position of strength, with one of the best healthcare systems in the world, staffed by the best workforce in the world."

The NSW Government said it will “carefully consider and develop a response to these findings” over the coming months.

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