States should Call for More Money in the Australian Health Care Agreements - radio interview ABC Melbourne

DR CAPOLINGUA: Good morning.

TIM COX: Well, as I said before, if this is where the rubber meets the road for health reform, and we believe it's going to be, what should be the very first thing the State and Territory leaders are discussing with Kevin Rudd and his team?

DR CAPOLINGUA: They should be calling again and continuously, as they have done in the past, no different with a different government, calling for more money in the Australian Health Care Agreement so that we can open beds across Australia.

TIM COX: How much more?

DR CAPOLINGUA: Actually the shortfall across Australia is three billion, would you believe? In Victoria the Commonwealth component of the funding has dropped to 40.5 per cent and the Victorians want dollar for dollar matched funding, State and Federal.

So we need the money. It's about time to show us the money so we can open the beds and then tackle those issues that are on the agenda, the elective surgery waiting lists, and the emergency departments.

TIM COX: Is there though a sufficient supply of medical professionals to staff those beds?

DR CAPOLINGUA: You know, you've currently got strikes happening right here in Victoria in the public sector across the allied health workers, the physios and speech pathologists, et cetera, you've had the nurses' strike here. They strike because the conditions in the hospital sector are difficult to work in and, of course, there's a pay issue behind that.

If we actually funded the public hospitals properly, if we actually took the pressure off, if we gave them beds to put patients in so that the doctors and the nurses and the other staff don't feel compromised in the way they're looking after patients, you wouldn't have them leaving the sector as they have done so readily.

You know, there's a huge nurse workforce out there that don't go to work as nurses at all because they can't cope with that environment. So let's bring them back by firstly correcting the problem at the grass roots.

There are issues around staffing but there is capacity in the public sector to open theatres that have been closed, theatre days, sessions, to extend theatre operating times, if you pay the nurses overtime to work the extra hour to do that other case on the end of that list. You have to invest to get the return. I'd love to see that happen.

TIM COX: Is there a danger though that going down that path would soak up so much of the all too scarce funding that is available, even if it is expanded, that it won't be spent on other areas? There are plenty of health experts, academics, former health ministers, that say we're spending too much on health care and not enough on awareness, on prevention, et cetera. Where does that balance need to be struck?

DR CAPOLINGUA: We can do both. If you're sick and you need surgery now, no amount of talking about preventative health is going to make a difference to you, as an individual and we've got a lot of Australians who are sick and need care now, a lot of Australians who will be sick tomorrow and need surgery tomorrow and for many years to come.

We've had a huge increase in population, increase in longevity, okay, you live longer, you actually need more acute access to health care services but we haven't been investing in the health care services to grow, to address those needs.

Yes, let's have the public health campaigns, let's talk about obesity, alcohol intake, smoking, drug abuse - all the issues that we know are core to lifestyle and wellbeing over time.

Let's invest in preventative health but we cannot do that and ignore the current needs, the gaping needs that are there.

TIM COX: There is a concept on the table that if there's no satisfactory result achieved within the first term of this government that perhaps there'll be a referendum, or there will be a referendum on returning hospitals or taking hospitals to the Commonwealth. Do you support that? Do you think that real, long-lasting reform can be achieved in this three-year period?

DR CAPOLINGUA: Everyone's using that word reform.

TIM COX: But what you're talking about sounds like reform.

DR CAPOLINGUA: You know - what I'm talking - I guess if you're talking about reform making things better, investing so that we actually treat patients, then I'm all for supporting that. I'm worried about reform agendas where there's a big bang change theory in Australia about health care delivery and I don't think we need that.

I'm sure that the states want to succeed and I'm sure that the new Prime Minister wants the states to succeed in improving the health outcomes in the public hospitals. In order to do that, of course, they have to get the money so if the money is not exchanged to the States then the States will be set up to fail, then that would lead to this potential takeover of the public hospital system across Australia.

I think we need to go always back down to the bottom line. What we're after is making sure that our patients in those public hospitals are well looked after, that they get timely care. You know, the wait lists are long, the emergency departments are overloaded and the patients there themselves feel compromised at times.

The doctors and nurses are doing the very best they can but we're beginning to feel as though we're not treating Australians with respect when they enter the public hospital system.

Let's go back to making sure that what we do is about them, about looking after them. The rest will fall naturally into place.

TIM COX: Now, by what measure would you say, three years from now, that the sort of improvements that you're saying are necessary, and I'm sure that the bulk of Australians feel are necessary, have been reached? What should we, as individuals, be looking for by way of improvement in the health system.

DR CAPOLINGUA: There are some quite clear measures. The hospital occupancy rates - safe hospital occupancy is 85 per cent. That allows for maximum efficiency and safety for patient care. Most of our public hospitals run at over 95 per cent and at peak times up to 110. So there's a measure that you can look at in three years' time, quite readily.

Emergency department pressures - you know, the ambulance ramping issues, the hospital bypass issues - they're figures that you can actually count and know that you're coping well when those things don't occur.

So they're two very key measures that really relate back to funding and beds again, you relieve access block - the other two things.

Elective surgery waiting lists. Being able to have your surgery in the public sector at an appropriate clinical time for your need, so that ongoing disability doesn't occur. You know, people with knees and hips and eyes and all sorts of things, who are actually disabled and not well because of their delay in surgery. There are measures that we can look at.

TIM COX: It sounds like a great idea. Building new hospitals takes more than three years, a lot of this will take more than three years, training staff will take more than three years. Do you think we'll be looking at that referendum three years from now?

DR CAPOLINGUA: I would hope that we aren't setting up the hospitals to fail because the goal here is success for the people. If the hospitals are doing well, that means the patients are being treated well and the doctors and the nurses are happier in their environment.

So let's go for the gold and let's go for that high standard of Australian health care.

TIM COX: All right. Thanks for coming in this morning. It's good talking to you.

DR CAPOLINGUA: Thank you.

TIM COX: That's Dr Rosanna Capolingua there, the national President of the Australian Medical Association.

Ends