As part of an international collective of consultants supporting health system reform globally it is clear that the Covid-19 pandemic will test the capabilities of countries to cope with surging demand.
While there has been longstanding evidence that health systems are in trouble across the developed world the pandemic will effectively be a ‘stress-test’ and the existing weaknesses and vulnerabilities will be laid bare for all to see.
Some countries and jurisdictions have acknowledged the need for ‘root and branch’ change and have commenced their change journeys while others continue to deny their sustainability challenges in efforts to reassure their citizens. However, pandemics like Covid19, and others to come, will bring the days of reckoning when the true resilience of a nation’s health system will be made known.
Yes, while it can be argued that pandemics are exceptional and represent short-term challenges, they do test the fundamentals of an effective health system including:
- The strength of its primary health sector
- The capacity to sustain basic public health standards including water and food safety, sanitation, waste management, communicable disease prevention, etc.
- The ability and willingness of healthcare providers across different sectors to work together in the interest of patients
- The ability and willingness of health system managers to set aside their institutional and parochial interests
- The ability and willingness of institutions to work together rather than compete
- The willingness of governments across national jurisdictions to work together i.e. federal, state and local
- The willingness of healthcare professions to prioritise the needs of the public over professional interests and agendas
- The capacity for timely information sharing across care settings
- The willingness of everyday citizens to shoulder our own responsibilities to maintain our health and well-being
Covid19, as a novel virus, does represent a serious pandemic threat, but it is a passing threat, unlike the other pandemics to which we currently give scant attention, such as the rising tide of diabetes and dementia across the world. If there is anything positive that can be drawn from a terrible event like a pandemic it will be a reminder that we need to get our fundamentals right. The fundamentals include public health and disease prevention, aged care, mental health and a strong universally accessible primary health sector well integrated with locally accessible generalist hospitals. Building more, bigger and better specialist hospitals suits the interests of the few not the many. Our friends in Scandinavia are showing the way ahead for us.
Health systems globally are not fit for the challenge of ageing populations living longer under the burden of complex chronic illness. Let’s work together to get the everyday fundamentals right so that when something exceptional happens we can cope.
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