What will the next few months tell us about the true capabilities of the Australian health system? While many politicians continue to offer reassurances there are leading clinicians who have been saying for decades that our system is outdated, overly complex, and no longer fit for purpose. Did we need a global pandemic to provide the necessary impetus for a long overdue overhaul of our health system? Unfortunately, it would appear so.
With borders now open and the threat of Omicron manifest, our health system is being stress-tested. The lack of integration between health sectors is laid bare, and while we cross our fingers that this will not see a public health emergency descend into a disaster, the signs are ominous. Hospitals across the country are groaning under the strain. Too many people risk falling between the cracks with the public belatedly told that Do-It-Yourself (DIY) COVID-care should probably be OK with the mild Omicron variant. Having been told for two years that COVID is a deadly illness we are now instructed to avoid hospitals and emergency services like the proverbial plague (joke intended). We are scrambling to stop our hospitals descending into chaos over the coming months.
Health system siloing has been the natural consequence of the way in which our Constitution allocates responsibilities between the Commonwealth and the States/ Territories. But this has degraded the nation’s capacity to respond to the global pandemic. All of this was predicted. It has a resulted in a confusing maze difficult for the public to navigate at the best of times, let alone during a public health crisis. The current gridlock we are experiencing sees patients bouncing between logjammed phone hotlines, General Practices and Hospital Emergency Departments, seeking advice as to how to safely do DIY COVID-care.
Some readers will recall the controversy surrounding the statement by the then Treasurer Paul Keating who said in 1990, in response to a worldwide economic crisis, that this was the “recession that Australia had to have”. In effect what he was saying was that the recession was the crisis needed to generate the impetus for ‘root and branch’ change to our economy. ‘Australia Reconstructed’ was the policy mantra of the time, and it resulted in a raft of economic changes including floating of the currency and compulsory superannuation. These changes are felt today, and Australians are benefitting from the bold thinking of political leaders of the time.
So, is now the time for a radical redesign of a healthcare system that has served Australia for the last 50 years, but is increasingly out-of-step with the needs of an ageing population living longer under the burden of complex chronic illness? We can expect that the inevitable Inquiries and Royal Commissions dissecting the health system’s performance during the pandemic will provide ample evidence of systemic failures, but political leadership and great vision are necessary to enact the necessary reforms over the balance of the COVID decade.
Let us invoke the national spirit of the 1990s when our political leaders took bold steps in the national interest.