COMMENT || If we want a better health system we have to champion reform, not oppose it | The Examiner

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More and more it seems to be an accepted truth in Tasmania that our health system is, well, buggered. Our politicians even agree; though they moderate their language depending on what level of responsibility they have at the time. When in government they’ll say our hospitals are under pressure from growing demand due to our ageing population and rising health costs, while in opposition it’s a crisis and it’s all the other side’s fault. The big problem with this never-ending blame game is we rarely point the finger where we should – in the mirror. This is not about preventative health, although, let’s be honest, much of the workload we inflict on our hospitals is due to our “lifestyle choices” – eating too much of the wrong foods, failing to exercise regularly and so on. What is really at the heart of our troubled health system is the failure of Tasmanians to accept the need for reform. We refuse to listen to the advice of the experts on service delivery and oppose any move that might mean, for example, that we have to travel a little further. All we have to offer to those who work in the health system – who we profess to support – is the demand for our government to spend more. Yet we scoff at the thought of putting our hands in our own pockets. Too often we lose all perspective and make absurd claims, such as comparing our hospitals to those in the Third World. Or we advance fanciful “solutions”, including building a new hospital at Ulverstone at the cost of untold millions. The state of our health system is not what we would want it to be, but that’s been the case for a very long time. In 2007 then health minister Lara Giddings had this to say: “We cannot ignore the fact that our system is stretched and there is growing demand on all of our services. “Our work force is ageing and people have different lifestyle expectations, making it harder to attract and retain staff. “The spiralling cost of modern health services is making our current approach unsustainable. Added to this we have changes in technology, meaning the delivery of our services and treatment has changed and, therefore, we need to update the way we deliver our services.” Ms Giddings’ answer was her Clinical Services Plan, which featured the transition of the Mersey Community Hospital into a “centre of excellence” for elective surgery. Critics called it a downgrade and it was, but we could not then and cannot now expect to maintain two major hospitals with duplicate services in the North-West. We can see this in the persistent difficulties in staffing the Mersey’s emergency department due to an over reliance on locums that becomes only too evident when they cannot be found – particularly recently thanks to the pandemic. Ms Giddings’ plan provided for the Mersey to help northern Tasmanians to get the surgeries they need sooner. Unfortunately, in an act that should be remembered with disdain because it was driven by nothing more than an attempt to sway votes, then prime minister John Howard decided to “save” the hospital. It failed to save the seat in an election that ended Mr Howard’s career, and it failed the test of time with the Mersey eventually handed back to the state government. We have largely come full circle with the Liberals’ One Health System reforms meaning the hospital is again playing more the role of a dedicated day surgery centre. In the same year that Ms Giddings released her health plan the then Labor government also tried to introduce a user pays model for the ambulance service. Most states expect their residents to contribute to the cost of ambulances through insurance or a levy, but not Tasmania. Labor dropped the idea and never revisited it; terrified, just as the incumbent government is, of the public backlash. For the same reason the idea of a small charge – for those who can afford it – on emergency department walk-ins would be a non-starter, even though it would arguably reduce the demand from those who are only there because they don’t want to pay a GP. Since the decision-making falls on our politicians it is reasonable that they be held to account for their failures of leadership. But the old saying goes that in a democracy we get the government that we deserve, and in that same vein Tasmania surely has the health system that we deserve. If we want better, and we should, not least of all for the sake of those who work in our hospitals, then we need to do better. We cannot sit in silent support of necessary change, allowing a vocal minority to scare a government into backing down. We must not let parochialism or self-interest scupper reforms that will deliver safe and sustainable services. And, yes, we should be prepared to pay more to have the health system we want for our loved ones and for ourselves. What do you think? Send us a letter to the editor:

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