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Building health services in Tasmania
Tasmanians deserve high quality, accessible public health services, and political parties must support long term strategies that focus on this outcome. Our health care staff must be supported in delivering frontline care and we need to implement a strategic plan for our public hospitals and community health services across Tasmania.


The AMA identifies five key areas of broad health policy that deserve cross party political support:


• Sustainable healthcare facilities and infrastructure
• Sustainable healthcare workforce
• Sustainable health funding based on activity and community need
• Accessible, high quality health services for all Tasmanians
• Strengthening the health of families and communities

Sustainable healthcare facilities and infrastructure

All hospitals require ongoing maintenance, refurbishment and redevelopment. The Royal Hobart Hospital is southern Tasmania’s only public hospital and the states tertiary referral hospital for all Tasmanians. The new RHH “K Block” will provide long overdue replacement and capacity expansion to support a proportion of services. However, there is an urgent need for a Federal Government commitment to ongoing infrastructure funding to implement the Tasmanian Government’s recently announced strategic approach to master planning and redevelopment of RHH facilities to address ageing and inadequate facilities supporting key RHH services such as ICU, ED, Pathology and Medical Imaging also require replacement.

 

RECOMMENDATIONS

Fund much-needed hospital redevelopment in Tasmania by:

• Support for the state government to undertake the facility improvements in Hobart, Launceston and Burnie that are identified as being necessary through the Clinical Planning Taskforce

• Committing to funding the proposed and much needed Mental Health Facility development at the Repatriation Hospital campus

• Committing to funding the “L Block” development at the Royal Hobart Hospital

 

Sustainable healthcare workforce

Our greatest asset is our staff. To deliver high-quality healthcare services, we must be adequately staffed with skilled clinical professionals. This requires improved methods of workforce recruitment, retention and training. It also needs strong and stable partnerships to be forged with professional bodies and the University of Tasmania.

RECOMMENDATIONS

• Sustained and strategic support for funding staffing of Tasmania’s healthcare facilitiesis required; not episodic and inconsistent package for time-limited periods

• Ensure development of a workforce plan that is a partnership with staff, and training entities such as UTAS, Colleges and the AMA

• Ensure the University of Tasmania Medical School remains a viable force instrategically providing doctors for the Tasmanian community


Sustainable health funding based on activity and need

Tasmania’s public health system must be adequately funded. An ABF funding model that recognises the need, scale and necessary distribution of public health services in Tasmania.

RECOMMENDATIONS

• Progress ABF funding for Tasmania’s hospitals, ensuring the “dollars follow the patientcare journey”

• Ensure overall healthcare system efficiency by strategically funding and upholding theTasmanian Role Delineation Framework that determines the scope of services that are delivered and developed at each of Tasmania’s public hospitals


Accessible, high quality health services for all Tasmanians

Tasmanians must have access to transport to appropriate healthcare facilities. This may not be the closest hospital, but it must be the one best matched for their need.

RECOMMENDATIONS

• Support effective patient transport and trauma retrieval services so that all Tasmanians have access to timely care

• Ensure patients and relatives from regional and remote areas are supported when accessing services not available in their home region


Mental Health Sector

The Public Mental Health sector in Tasmania has recently had difficulty in the provision of even the most basic services. The difficulties have occurred across the state and across all subspecialty groups, Child, Adult, Older Persons, Alcohol and Drug, and Forensic Services, but have particularly involved the protracted bed crisis at the Royal Hobart Hospital, brought about by the redevelopment at that site. The number of people presenting to the sector also continues to increase, with many suffering with rising levels of acuity and complexity. Substance abuse, particularly involving the drug crystal methamphetamine, or “ice”, further complicates the needs of many in the sector.

RECOMMENDATIONS

• Urgently fund Mental Health facility building works in Tasmania by committing to funding the proposed and much needed Mental Health Facility development at the Repatriation Hospital campus

• Support patient access to appropriate mental health services across Tasmania

 

Primary Care Short Stay Units

The costs of hospital care in Tasmania keep rising and are outpacing Tasmania’s capacity to pay. The current solution of repeated “one-off emergency” investment in elective surgeries to provide only a temporary appearance of system stability. Meanwhile, our capacity to invest in a balanced and longer-term manner across the health system is increasingly challenged because of additional pressure on oversubscribed acute facilities needs to be dealt with now. There is a more cost-effective and sustainable solution that can achieve timely and responsive service outcomes for Tasmanians. Importantly it is also one that will, over time, lead to ongoing reductions in hospital demand through more effective integration of services. We need to think differently about how we most effectively mobilise our workforce and utilise available resources in Tasmania to ensure Tasmanian’s remain well and out of the hospital. There are some conditions, e.g. minor fractures, infusions, wounds, asthma and diabetes etc. that do not always require admission or treatment by a medical specialist in a Tasmanian Public Hospital; however, currently, these patients end up in the public hospital system because there is no alternative.

RECOMMENDATIONS

• Fund establishment of Primary Care Short Stay and Treatment Units in Hobart, Launceston and the North-West Coast.Fund staffing of these with Specialist General Practitioners drawing upon their skills and capabilities, supported by hospital medical specialists and funded by the State Government aiming to manage a host of conditions and discharge back into community care within 24 hours. Build upon and extend the learnings from the recent Community Rapid Response Service and integrate this skilled community nursing/acute nurse workforce into this new model of care


Homelessness and Intergenerational disadvantage
AMA Tasmania notes that there has been an increase in the housing shortage and homelessness. This increase is predominately due to Tasmania’s growing tourism industry and population. The AMA also identifies that the step-down process from the health system, and mental health specifically, is not catering for patient’s needs. Too many people fall out of the system and are left homeless. The AMA calls on Government at all levels to develop an effective strategy involving health and housing to ensure all Tasmanians have access to emergency and long-term housing as required. This strategy should particularly strengthen the communications and oversight of the transfer of patients from the care of one department to another to minimise the risk of homelessness.


ADDRESSING INTERGENERATIONAL HEALTH:

The AMA will judge all policy, implementation strategies and actions against five target domains for building health reserves and enhancing disease prevention by supporting and raising awareness in relation to:

• Healthy families: housing, food, economic, employment, physical and emotional security. Parental general literacy and health literacy
• Preconception planning: nutrition, iodine, tobacco, alcohol, obesity, exercise
• Healthy pregnancy: exercise, general nutrition, iodine, tobacco, alcohol, obesity
• Healthy early childhood: exercise, play, general nutrition, iodine, immunisations, healthy family environment, emotional and physical security, parental literacy and education
• Education for a healthy life: language development, foundations of literacy and later learning

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