2018 AMA TASMANIA ELECTION PLATFORM

Reforming 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 a strategic plan for our public hospitals
and community health services.
The AMA identifies five key areas of broad health policy that deserve cross party political
support:
• Sustainable and effective health governance and policy development.
• 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.

Sustainable and effective health governance and policy development
The Tasmanian Health Service requires urgent reform. A single state-wide health service
which is self-governed has failed to deliver stable and effective management. The selfgoverned
model has failed to recognise the need for engaged regional healthcare leadership
and has proven ineffective in managing the service complexity that arises as a result of
Tasmania’s decentralised population.
RECOMMENDATIONS
• Urgent action to abolish the THS Governing Council, state wide THS Executive and state
wide THS CEO roles.
• Ensure oversight management of Tasmania’s public health services are directly from the
DHHS.
• Urgently establish two Area Health Networks (one Southern and one Northern) to
manage hospitals and community health services.
• Urgently establish an Executive team for each Area Health Network that reports directly
to the DHHS and is responsible, accountable and authorised to deliver integrated acute
hospital and community health services in their area.
• Improving interaction / communication between the state health system and GPs.

Sustainable healthcare facilities and infrastructure
We need a strategic approach to managing and maintaining the physical infrastructure
and equipment that supports patient care. Hospitals require ongoing maintenance,
refurbishment and redevelopment. The RHH “K Block” Redevelopment will provide long
overdue replacement and capacity expansion to support a proportion of services offered by
the State’s major hospital. Aging and inadequate facilities supporting key RHH services such
as ICU, ED, Pathology and Medical Imaging also require replacement.
RECOMMENDATIONS
• Progress planning for a collocated Private hospital at the LGH.
• Progress facilities redevelopment at the RHH by committing to next steps planning for
the “L Block” redevelopment. This stage needs to incorporate contemporary Psychiatry,
Emergency, Intensive Care and Pathology facilities.
• Progress development of the Repatriation Hospital campus of the RHH as a dedicated
subacute and community transition facility to efficiently complement the acute health
services role of the RHH campus.

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 requires strong and stable partnerships
to be forged with professional bodies and the University of Tasmania.
RECOMMENDATIONS
• Progress 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 in strategically
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 in
conjunction with a state-wide approach to service distribution, guided by the DHHS, would be
capable of delivering effective public health services.
RECOMMENDATIONS
• Progress ABF funding for Tasmania’s hospitals, ensuring the “dollars follow the patient
care journey”.
• Ensure overall healthcare system efficiency is strategically maintained by upholding the
Tasmanian 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
• Ensure health service quality and safety is a paramount consideration in decision
making, including factors such as service scale and staffing sustainability.
• Progress an effective patient transport and retrieval service.
• Ensure patients and relatives from regional and remote areas are supported when
accessing services not available in their home region.

Mental Health Sector
As a result of shortcomings in leadership, planning, funding and resource allocation, the
Public Mental Health sector in Tasmania has recently had difficulty in the provision of even
the most basic services. These 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 increasing 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
• A wide-ranging external review of the entire State-wide Public Mental Health Service be
undertaken, with a focus on resource distribution, and workforce planning.
• Decision-making ability to be devolved to local levels, so that each regional hospital
employs an on-site clinical director.
• Urgently locate a suitable space for 10 new acute psychiatric beds for Southern
Tasmania, either at the Royal Hobart Hospital, or within a very short distance,
appropriate the necessary funds, and design, build and commission the beds within 12
months.
• Recognising that none of the current or planned units at the Royal Hobart Hospital
are large or suitable enough, begin the design process for a state of the art acute
psychiatric facility at that hospital, so that a contemporary, therapeutic unit can be
available to the people of Southern Tasmania within five years.

Primary Short Stay Units
The costs of hospital care in Tasmania keep rising and are clearly 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 are
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 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
• Look at the number of international examples of alternates to hospital care - most notable of which are general practitioner led short stay facilities.
• Establish Primary Care Short Stay and Treatment Units in Hobart, Launceston and the North-West Coast.
• Staff 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.