Public hospitals ‘completely overrun’ due to COVID delays

Matt Woodley

17/05/2021 4:31:31 PM

State health ministers across the country reportedly did not expect the record demand placed on tertiary care following a 10% drop in GP presentations, despite warnings.

Hospital emergency sign.
The issues being faced by public hospitals were ‘entirely predictable’, according to RACGP President Dr Karen Price.

A joint report published by Nine Newspapers and Sun-Herald has quoted health ministers from Australia’s five mainland states as saying their systems are being overrun due to ‘unforeseen’ ill health arising from the pandemic.
The ministers have reportedly asked the Federal Government to increase funding to public hospitals as well as fix the National Disability Insurance Scheme (NDIS) and aged care systems, where assessment delays are apparently locking up hundreds of beds as people who no longer require hospital care are left with nowhere to go.
Victorian Health Minister Martin Foley said the group had a ‘lightbulb moment’ during a meeting with Federal Health Minister Greg Hunt in Melbourne last month, when they realised the crises were occurring across the country.
‘They all said they were being completely overrun,’ West Australian Health Minister Roger Cook said. ‘We’re quite frankly being smashed.’
The ministers have also reportedly said they are not sure why Australians are getting more seriously ill and in greater volumes than in the past, and admit they did not expect the record demand that has occurred this year, despite general practice visits dropping by 10% in 2020.
However, RACGP President Dr Karen Price told newsGP the issues currently being faced by public hospitals were ‘entirely predictable’, and that pouring more money into the sector will not solve the problem.
‘What these reports demonstrate more than anything is the unsung value general practice provides to the Australian healthcare system, and how properly investing in primary care and preventive health should be the model going forwards,’ she said.
‘If a 10% drop in GP presentations can result in this amount of chaos, imagine the difference we could make if increasing presentations by 10% was an absolute priority?
‘Time and again it has been shown that greater investment in general practice would not only ease pressure on our expensive public hospital system, but also result in healthier, happier patients.
‘Surely it is time to act on this advice, rather than double down on a strategy that is clearly not working.’
RACGP-commissioned research published last year has shown fully implementing the college’s Vision for general practice and a sustainable healthcare system would save the healthcare system at least $1 billion in 2021, and upwards of $5.6 billion over the next five years.
Yet a Productivity Commission report released earlier in the year shows that public hospitals receive six times more in terms of total funding than general practice.
A Department of Health spokesperson also recently told Nine Newspapers that the Commonwealth is set to continue with its ‘record investment’ in the public hospital sector; $25.6 billion in 2021–22 alone and $135.4 billion over the next five years.
‘This money, roughly double what general practice receives each year [$12.3 billion in 2018–19], is used to help fund 45% – less than half – of the cost of running Australia’s public hospitals,’ Dr Price said.
‘Meanwhile, state and territory governments will chip in the remaining $165 billion, while almost completely ignoring general practice and primary care.
It is beyond time to end this ridiculous jurisdictional blindspot, and the dysfunction that exists between state/territory and federal governments when it comes to healthcare.
One in every four dollars in government tax revenue is spent on healthcare in Australia, which is fantastic. But if the states really want to ease the pressure on their hospitals and receive a better return on their investment, they should start by allocating some of their health budgets to general practice.’
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Dr Michael Lucas Bailey   18/05/2021 6:45:03 AM

One simple way for state governments to get more value from general practice and save money would be to stop treating GPs as if they don’t know anything. For example public hospital referrals now require more and more irrelevant tests before they can be triaged. For example, a patient with a raised PSA and a prostate mass won’t get triaged until they have done 3 urine cytology tests for bladder cancer. The same goes for a renal mass that isn’t near a renal pelvis. This is a waste of GP time and MBS funding being spent on irrelevant tests. Patients with progressive cataracts that meet surgical requirements won’t get triaged without and accompanying optometrist letter.

Public hospitals are not run efficiently and push their inefficiencies back onto general practice as well. Pre-op patients need a referrals from their GP to the anaesthetic department because the hospitals won’t pass the patient chart to the anaesthetists for preadmission clinic.

Dr Ian   18/05/2021 9:07:04 AM

With GPs getting vaccinated and their being more PPE General Practice will be able to do more .
What is needed is the analysis of the presentations and calculations of what General Practice can prevent and treat .
With winter Respiratory presentations will increase and General Practice now vaccinated and with PPE can relatively safely attend to more .
Reliable accredited tests for virus will be needed with rapid turnaround eg Covid Antigen rapid turn around .
New medical centres that are being built will need to incorporate better ventilation with part open windows even with air conditioning on as now occurs in trams in Melbourne .

A.Prof Christopher David Hogan   18/05/2021 9:18:34 AM

There is little comfort in being right sometimes.
We warned them. Either they did not listen or they hoped we were wrong.
Hope is as poor a health strategy as it is a contraceptive.

Rabid Dog   18/05/2021 9:21:41 AM

Not just tertiary ED either - come and do some ED work in the country - the local GPs have full books, and no 'emergency' space so they tell the punters to head to ED. For things like asymptomatic BP readings done at home, or a week-long rash, or a child with a cold ('...we can't see them here, they may have Covid....') - um, yeah, OK...

Dr Gisselle Hull   18/05/2021 9:29:46 AM

“ However, RACGP President Dr Karen Price told newsGP the issues currently being faced by public hospitals were ‘entirely predictable”

Well I hope Karen price is telling this to the department heads and not just news GP because we all know this. The politicians are the ones needing educating.

Dr Paul Po-Wah Hui   18/05/2021 10:18:57 AM

Why should GP do pre-op assessment? You should have the patient’s background, past and present to have some initial discussion on choice of anaesthesia, GA or Spinal. Should the patient who has developed angina, has the coronary angiography prior to knee replacement? I’d it time to repeat a lung function test for COPD ? A good GP specialist should be able to do most of the assessment and investigations. Leaving everything to another doctor in the pre-op clinic is not ideal.

Dr Paul David Fitzgerald   18/05/2021 10:39:25 AM

I understand the value of piggybacking this issue, but talking to my public hospital colleagues the news story and this response miss the point.
The real problem is not presentations, it’s hospital discharges. It is increasingly difficult to return seriously ill patients back to their community ( and it’s not about nursing homes) because of lags in NDIS, Community care packages, and identifying a GP prepared to deal with complex continuing care.
If the RACGP really wants to help, it needs to enhance the competence and availability of real GP’s as opposed to medical center part timers.