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What is the Liberal policy prescription?

medicSA article | May 2018

SA now has a Liberal Government. What will it mean for health? We provide an overview of Liberal health pledges in the election lead-up and beyond …

Governance and engagement

As the election approached, the Liberal Party pledged to improve engagement with clinicians, through measures such as a Commission on Excellence and Innovation in Health, governed by a board including doctors. A key element of the party’s health policy platform is also to decentralise the public health system through the establishment of boards of management for each Local Health Network. Clinicians are to be included on each board, which will also be required to develop formal clinical engagement strategies.

Doctors’ working conditions and wellbeing are also on the agenda, with a pledge from Minister Wade pre-election to work with professional bodies “to drive cultural change” in SA Health and the workforce.

Clinical data analytics

On the AMA(SA)’s call for an independent clinical data analytics unit to better inform health policy with sound data, Minister Wade indicated pre-election that the party is open to engaging university research units to help manage and utilise data, but that government health management would need to maintain capacity for data analysis.

Outpatient waits

The AMA(SA) has long called for the ‘hidden’ outpatient waiting lists to be made easily and publicly available online. Pre-election, the Liberal Party undertook to publish information on outpatient clinic waiting times online from 1 July 2018, on a quarterly basis by speciality and hospital. While not at the level the AMA(SA) would like to see, this certainly represents progress.

EPAS review

The new government has already acted on the AMA(SA)’s long-running EPAS concerns, issuing draft terms of reference for the independent review the Association has called for, and in fact halting the rollout. The pre-election commitment was to an independent review of EPAS’s functionality, performance and future, to determine if it should progress, costs to fix it, or a pathway to a better system, with a pledge to involve the AMA(SA) and others to address the issues. The AMA(SA) has already discussed EPAS with new health minister Stephen Wade, and responded to the draft terms of reference.

Co-located WCH

The AMA(SA) has long called for a co-located Women’s and Children’s Hospital with the new RAH, in what Minister Wade has described as “strong and consistent advocacy”. Pre-election he committed to “deliver best practice health services for women and children by building a new WCH co-located with the RAH”. The new government has promised better consultation, and appointed former WCH and SA Health CE Jim Birch to chair “a high-level task force to drive the project and develop a fully-costed project plan” for co-location by 2024.

Children’s health and wellbeing

A new WCH is not the only Liberal policy prescription for children. Also on the list is a paediatric eating disorder service ($4 million in funding) and a focus on young people within a $10 million Borderline Personality Disorder program. Also, a welcome commitment to appoint an Aboriginal Children’s Commissioner.

Other policies include aquatic safety; school literacy and dyslexia; breakfast programs; anti-bullying measures; health and drug education in schools; and magistrate drug treatment orders for under-18s for up to 12 months. While the AMA(SA) is supportive of the principle of health and drug education in schools, the Association does not support mandatory treatment measures or the focus on sniffer dogs in schools.

Also on the agenda are a range of child protection measures, including reforming recruitment of child protection workers; making foster care and kinship care payments available to the age of 21; compensating child sexual abuse victims; and protecting children from forced marriages.

Members may also be interested in the proposal to register social workers.

Drugs and DV

The drugs focus extends beyond children to include tougher penalties, and limiting the number of drug diversions; measures against drugs in prisons; real-time prescription monitoring; and drug addiction rehabilitation services for the Riverland.

Also proposed are measures against domestic and family violence, including to address the shortage in emergency accommodation, especially in regional areas, and a Personal Protection App.

TQEH, Modbury, Noarlunga

Under pre-election Liberal plans, the TQEH is to be a key cardiac centre as part of a $270 million upgrade. There is to be a $110 million to upgrade Modbury facilities and services, including a 16-bed purpose-built palliative care unit; extended emergency care unit; acute medical unit and four-bed HDU. While the AMA(SA) has advocated a different suite of measures to the HDU model, we have had welcome discussions with Minister Wade on Modbury plans and look forward to engaging with the Minister and Department on what is needed. At Noarlunga, there is to be a 12-bed acute medical ward (with capacity to expand to 15); admission to three days; and a new Women’s and Children’s Health Hub.

Repat, veterans, mental health and aged care

Many welcomed the Liberal promise to retain the Repat site as a health precinct, which includes looking at Ward 18 for people with BPSD, plus two other sites for this patient group. Also, re-opening operating theatres to reduce the elective surgery wait list and re-opening the hydrotherapy pool. Also on the policy list are some veteran-support and aged care measures. The new Government has also pledged a statewide mental health service plan within 12 months.

The RAH

Pre-election the Liberal Party stated that it recognised the need for operational and design problems at the RAH to be urgently addressed, including securing sites for respiratory and eye services, with the involvement of frontline clinicians and organisations. The old RAH site is flagged to include a range of innovation, tourism, hospitality and cultural features.

Rural health

Health Minister Stephen Wade told us: “We agree with the AMA(SA) that country practitioners are working under significant stress” pledging a $20 million rural health workforce strategy. It includes doubled country interns; recruiting and retaining resident specialists; and increased support for rural generalists.

The Party has pledged to urgently address a backlog in country hospital capital works, promising upgrades for Murray Bridge, McLaren Vale and Yorketown, and a 24-hour GP emergency service at Mt Barker. Also on the list is permanent renal dialysis on the APY Lands, and upgrading and expanding the Mount Gambier unit. Also, a country cancer initiative with doubled regional chemotherapy, and piloting GP training in oncology. There is also a proposal to reverse speed limit reductions on eight roads in favour of “systematic review”, and maintenance.

Integrated care

Minister Wade has pledged to invest in preventative health, with targeted interventions for chronic conditions, end of life, and complex conditions. The Liberal Healthy Communities Program is to focus on physical activity, smoking, alcohol, access to affordable healthy food, and improving health literacy. Also flagged is a bowel cancer prevention initiative to catch up overdue colonoscopies in 12 months.

AMA(SA) members, what do you think of the Liberal Government’s policy prescriptions? Share your views at policy@amasa.org.au. Our advocacy will continue … You can also find out more by viewing teh Liberal party's pre-election policy documents, available at the links here.