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Moving care from hospital to the community


Amanda Lyons 23/03/2018 3:34:42 PM

RACGP President Dr Bastian Seidel addressed delegates at the 4th International Health Care Reform Conference in Sydney, speaking on the topic, ‘moving care from hospital to community’.

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Dr Seidel called on all healthcare professionals to remember to place patients at the heart of their practice and their advocacy.

The 4th International Health Care Reform Conference, held this week in Sydney, brought together healthcare organisations, policy makers, consumers, researchers and clinicians from around the globe to discuss healthcare reform and build international networks.
 
RACGP President Dr Bastian Seidel spoke during the closing plenary, outlining what he believes are the three main barriers to moving healthcare from the hospital to the community.
 
Problem one: White elephants
Or, in other words, hospitals.
 
‘The ones that cost billions to build and represent the promise that “fixing health issues” rather than “preventing health issues” is the answer,’ Dr Seidel said.
 
Dr Seidel argued that the hospital ‘promise’ often proves to be false, but they and their ‘high tech’ treatments remain popular with politicians, the public and the press.
 
Solution one: Clinical subsidiarity
‘Clinical subsidiarity means that the lowest organisational unit that can do the job, does the job,’ Dr Seidel said. ‘And in healthcare, that means hospitals should only provide the clinical services that cannot be provided in the community, in primary care.’
 
Dr Seidel observed that this solution would allow hospitals to focus more on the services they are better designed to provide, such as complex surgery and intensive care. He believes it would also go a long way to cutting down on waiting times in accident and emergency, as many of these services could be delivered in general practice.
 
Problem two: Non-cohesive systems
Dr Seidel made a case for simplifying funding streams within the health system.
 
‘At some stage we need to have a hard look at how we can streamline the distribution of funds in order for patients to access quality healthcare,’ he said.
 
Solution two: Funding that follows the evidence
Dr Seidel suggested that funding for medical procedures should be continuously reviewed, in order to ensure it is being used on effective treatments. He also observed the need for equivalent services to attract equivalent funding, and that the current funding model short-changes general practice.
 
‘The funding for a patient who presents to a public accident and emergency with pneumonia is at least $250, if she presents to a GP the funding is $37.05; funding for treatment of a heart attack in the emergency department is thousands of dollars, funding for preventing the same heart attack by a GP is pro bono,’ he said.
 
Problem three: Us
In his final category, Dr Seidel targeted himself and all the other attendees of the conference who represented institutions.
 
‘We all think we are relevant in the scheme of things, and we all believe we can solve the problems at other institutions’ cost,’ he said. ‘When the same people on the same panels talk about the same problems year after year, we have a serious issue.’
 
Solution three: Patients
Dr Seidel issued a reminder to all healthcare professionals to remember to place patients at the heart of their practice and their advocacy.
 
‘Why are we really here today? Not to make ourselves feel better or more relevant,’ he said.
 
‘We are here to improve the health of our patients and all Australians.’


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