Public hospital improvements will be short-lived without proper long-term funding
AMA President, A/Prof Brian Owler, said today that hard-won improvements in public hospital emergency departments will be short-lived without guaranteed long-term funding at required levels.
A/Prof Owler said that the National Health Performance Authority (NHPA) report – Time patients spent in emergency departments in 2012 and 2013 – shows that our major metropolitan public hospitals have significantly improved the number of patients who are leaving their emergency departments within four hours.
“These improvements are a direct result of the specific funding that was provided by the Commonwealth to State and Territory governments to increase the capacity of public hospitals,” A/Prof Owler said.
“The improvements reflect the efforts of the dedicated and hardworking doctors and nurses working around the clock in our emergency departments and in the other areas of the hospitals that need to work efficiently to allow patients to be admitted from emergency.
“We need to build on these improvements, and that will require planning and proper funding.
“But the Improving Public Hospital Services agreement has now ceased, and there is no replacement in sight.
“There has also been a significant reduction in funding guaranteed for public hospital services in the National Health Reform Agreement.
“This means that there is no certainty that hospitals will be able to maintain capacity to reach the four hour target of 90 per cent by 2015.
“Public hospitals are a vital part of our health system. They provide quality accessible care for millions of Australians, and they are the engine room of medical training in this country. They must be properly supported, and that means more funding, not less,” A/Prof Owler said.
Background
· under the National Emergency Access Target (NEAT) agreed by all governments in 2011, patients presenting to an emergency department are to be treated within four hours (admitted, referred to another hospital, discharged);
· the 2015 target is 90 per cent of patients to be treated within 4 hours. Each State and Territory has interim targets set for each calendar year leading up to the 2015 target;
· the NHPA report covers performance against the 4 hour target in calendar years 2012 and 2013 for 112 major and large public hospitals. These hospitals cover 75 per cent of the 7 million ED presentations across Australia. NHPA allocates them in four peer groups: major metropolitan, major regional, large metropolitan, and large regional.
· the data itself is not new; NEAT data was originally published by AIHW and the COAG Reform Council. The AMA Public Hospitals Report Card 2014 published NEAT data for the financial years 2011-12 and 2012-13;
· For context, the following table shows emergency department performance by jurisdictions in 2012 and 2013 against the NEAT, including the baseline levels and targets. This data is taken from AIHW and COAG Reform Council reports (the targets are included in the NHPA report state and territory pages);
NEAT baseline, target and performance by state and territory
| NSW | VIC | QLD | WA | SA | TAS | ACT | NT | AUS |
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Baseline | 61.8% | 65.9% | 63.8% | 71.3% | 59.4% | 66.0% | 55.8% | 66.2% |
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2012 Target* | 69.0% | 70.0% | 70.0% | 76.0% | 67.0% | 72.0% | 64.0% | 69.0% |
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2012 Performance* | 61.1% | 65.0% | 66.9% | 78.5% | 66.0% | 67.0% | 56.7% | 64.3% | 65.5% |
2013 Target* | 71% | 75% | 77% | 81% | 75% | 78% | 65% | 75% |
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2013 Performance* | 70.8% | 67.3% | 75.6% | 77.8% | 65.1% | 67.1% | 59.4% | 62.5% | 70.9% |
*Calendar year. 2013 targets taken from MyHospitals website and include revised targets for NSW and ACT from targets previously published by COAG Reform Council.
· the National Partnership Agreement (NPA) ‘investment in the NEAT target’, included capital and facilitation payments to 2012-13, and $200 million allocated by the Commonwealth to reward payments from 2012-13;
· the NPA has not been renewed or refunded by the Commonwealth and provision for possible reward funding of $100 million (total) for 2014 and 2015 has been cut in the Commonwealth Budget 2014-15. No State or Territory qualified for reward funding in 2013;
· the 2014-15 Budget also cut the Commonwealth’s funding guarantee for public hospital services by $1.8 billion over the next four years, and $16.4 billion in growth funding between 2014-5 and 2019-20.
29 May 2014
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