Issues in Australian Health Services - Literature review Example

Running Head: ISSUES IN AUSTRALIAN HEALTH SERVICES Issues in Australian Health Services Course Tutor Date Issues in Australian Health Services Public Hospitals Introduction Hospitals, more so public hospitals in Australia are always in the media spotlight as well as of the community. The key issues that have been generating the attention include; matters dealing with public hospitals’ funding, bed closures, Commonwealth-State relations, private health insurance as well as the rationing of services all highlight the rising problems faced by public hospitals in offering services to the patients. The chief causes of the rising costs within public hospitals include technology, the ageing population in addition to augmented demand for and use of the health services. Another factor contributing to the problems in public hospitals is the impact of wage and salaries increases and the capacity of the public hospitals to adapt their systems, care procedures and methods to the potentials and demands of modern medicine (Penington, 2009). Apart from the persistent and grave predicament of long waiting lists for elective surgery, key public hospitals are not capable of providing well-timed emergency treatment and spontaneous admission to a hospital bed for considerable numbers of acutely sick patients. The practical cause of the public hospital predicament and the countrywide scarcity of acute in-patient beds is 25 years of reductions to public hospital beds, whereas the general cause is the misdistribution of resources from forefront, bed-based hospital care and the matching growth in the size, cost and difficulty of the government administrations that manage badly the public hospital system (Australian Medical Association, 2010). There are serious problems in the Australian public hospitals, like for instance, 2566 patients taking more than a day on trolleys within emergency departments while waiting to get a space in the hospital beds, into intensive care or while waiting for procedural treatment within one of the public hospitals. The beds are always full and there is basically no capacity in the public hospitals. Australian public hospitals regularly run at over 95%, and the auditors as well as others who are familiar in this area claim that if hospitals operate over 85%, they are more likely to have serious problems with moving the patients through the hospital arrangement. The Australian population is increasing and the number of the ageing is increasing as well and still there are fewer beds which is likely to aggravate the problems within public hospitals (Penington, 2009). Public hospitals lack adequate beds to offer a safe and sound care for acutely sick patients who need unexpected emergency admission. Public hospitals are overcrowded and cannot admit and take care of patients in a timely manner given that the entire number of acute public beds within Australia has been reduced by one third to a point so much below the OECD average requirement since Medicare was set up in 1984. Considering the population growth, the real decrease in the bed numbers is even bigger; a 60% drop from 4.8 beds per 1,000 population within 1983 to about 2.5 per 1,000 population today (Australian Medical Association, 2010). According to the Australian Institute of Health and Welfare (AIHW), public hospitals accounted for some $15.35 billion of spending within 1999-00 and presented about 3.9 million incidents of admitted patient care making use of the equivalent of nearly 220 000 full time employees. In 1999-00 there were about 52 947 public hospital beds, a decrease from the 53 885 beds reported in the preceding year. In this regard, the health workers within public hospitals are not sufficient to take of the growing number of the patients which could also be a cause to the increasing mishaps within public hospitals (Penington, 2009). A sovereign analysis by the Australian Medical Association has come up with findings that public hospitals in Australia are not functional, are being operated at full or above full capacity and urgently require capital funding. A key finding was that chief metropolitan teaching hospitals are operated on a bed occupancy rate of 95% or even above. The report also indicated that overcrowding within public hospitals was the most serious cause of decreased patient safety. It is apparent that the Australian public health system is struggling to deal with with the increasing demand (Penington, 2009). Changes are necessary to address the current problems in public hospitals which could be resulting from the greatly increased, yet still ageing population as well as the attendant numerous comorbidities, countless attributable to enlarged urbanization. Useful measures in addressing these problems include disinvestment which means the health resources being relocated from the current health practices, methods, technologies in addition to pharmaceuticals that do not deliver as required in the benefit of the health system for their cost. This means that the areas that are not functional within the public hospitals will be scrapped off and replaced with functional systems that are in a position to cater for the merging health issues. Other realistic measures include investing in prevention of diseases. This will prevent unplanned hospital admissions within the public hospitals which will as a result reduce overcrowding in these hospitals. Moreover, the reduced unplanned hospital admissions will increase the bed capacity within public hospitals since disease cases that are preventable will not be presented in the hospitals (Penington, 2009). Increasing health workforce as well as focusing on community health issues can improve the current state within public hospitals. In several instances, there have been incidences of the public hospitals having insufficient personnel to take care of the growing number of the patients. As a result, nurses’ and doctors’ shortage has aggravated problems in public hospitals since the patients are not catered for as they should. Increasing health workforce in public hospitals will therefore provide adequate health personnel to serve the patients. There will no longer be cases of unattended patients in public hospitals which are commonly caused by staff shortage in public hospitals. Focusing on community health will also improve the current situation in public hospitals since the people will be educated on various ways of adopting health practices in order to avoid preventable diseases. Furthermore, this will educate people on how to tackle different kind of disease conditions which do not necessitate hospital attendance. Again, this will not only reduce overcrowding within public hospitals but will also reduce the bed shortage that is often observed within public hospitals. Other measures include increasing the position and involvement of the practice nurses as well as expansion of the pharmacist’s role. This will offer the health system with increasing number of health workers and hence sufficient health personnel to address the increasing number of the patients. Moreover, this will ensure that the health workers within the public hospitals are not overworked and thus they will sufficiently and effectively offer their services to their patients. Again, this will also tackle the problem of staff shortages common in public hospitals (Milton, 2007). According to proposals by professionals who have been keen for extra clinical efforts to be perfect in management of public hospitals specifically at home level, more input should be put in place to achieve the desired goal. Clinicians who make a diagnosis, care for and treat patients have express input to the administration, management, not forgetting being among the fiscal decision makers at the hospital level. Having in mind the fact that the state of majority of health centers, hospitals and even dispensaries are in deplorable conditions we must look for ways and means of curbing this time bomb before it’s too late. It is the responsibility of each and every Government to support clinicians to be fully involved in decision making at local levels in their respective public hospitals, this will tremendously accelerate the growth of efficiency and management in public hospitals (Eileen, 2005). Public hospitals deliver medical care to the ill people. Several other countries now acknowledge importance of medical contribution within management. Enormous improvement within hospital care has lately come within Britain with this structure following leads from Belgium, Sweden, Singapore and Finland. University hospitals are at the hub of these approaches within country after country, examining using their clinical research the quality and safety of the present and latest treatment as they are becoming available with developments in medical science, new medications as well as technologies. Apparently, the Australian public hospitals deserve such developments (Australian Medical Association, 2010). The increasing population will put more stress on public hospitals. This is because there will more funds which will be required for health care as well as aged care. The population of individuals aged 65 years and over has increased from 8.4 in 1981 to 13.9% in 2005 and is estimated to reach 18% by 2020. The sum of GDP spent on health care has changed only a little between 7.5% and 8.5% of GDP for mostly. Statistics show that there will be a rise in the percentage of GDP spent on health from present levels of 7% to around 11% within 20 years. The number of individuals who are aged between 65 and 84 years will be than twice of the current number. Increasing population slows the GDP growth and this means a slow development rate. This means that there will be more pressures on health budget and hence inadequate funds to cater efficiently for public hospitals’ needs (Mooney, 2008). University hospitals offer education to the future medical practitioners who require to be developed within a professional environment devoted to testing quality in addition to safety. There is need to make sure that the future doctors, nurses and other medical practitioners are real professionals dedicated to superiority within health care, which will continue to progress in fulfilling the requirements of our community. Each and every health care is supposed to be clustered together within 17 groupings around Australia with medicine and health sciences faculties, joining professional skills into delivery of medical, nursing and other services that the patients require. Northern Territory ought to make use of the excellent Menzies School of Medical Research while Northern WA should form a cluster to meet its special needs. General practice is equally important just like the hospitals, but these require to be connected, and not operate as separate silos. Preventive care should be integrated instead of being separate. Aged care still requires to become part of the integration, supporting patients to remain at home as long as possible with good community nurses, instead of being overly dependant on bureaucratic guidelines and more inadequately staffed nursing homes managing failures of care (Garling, 2008). The tradition of malfunction by bureaucrats to fulfill inevitably growing requirement for beds must be tackled. To relieve pressure on hospitals, the private sector could rapidly bring on stream new “sub-acute” hospitals, which would be quicker and cheaper to build and operate than traditional hospital structures (Elder, 2008). The growing pressure on the health because of the raised immigration may offer additional motivation for a move to a sole level of funding the public hospitals, with the federal government taking over the role for the public hospitals from the states. This can diminish the blame game as well as the cost shifting that has contributed to the current mishaps within the public hospitals (Sax, 2004). The plan to radically raise the population of Australia has to be debated and decisively assessed, and a population policy should be developed. Above all, health care professionals must connect with the federal government to make sure that it obligates to and delivers on wide-ranging national health and hospital reform, harmonizing its desire for unfettered, economically practical migration to this country. If this is not done, Australian hospitals will experience the destructive health results of super sizing (Penington, 2009). There should be systematic reforms for an ageing Australia. To furnish the hospital structure to handle and manage the ageing population and offer quality care to each and every age groups, the methods that have been tried and have failed in operating and ruining the public hospitals should be discarded. Policy makers are supposed to decentralize the management and administration of public hospitals and develop and launch flexible and responsive voucher based procedures of funding the bed based public hospital care that will be required to take care of the increasing numbers of older and sicker patients in future decades (Lapsley, 2009) The public hospitals can also make use of IT in processing some of their services, for instance hospital admissions as well as data entry. This will reduce the requirement for labor intensive, manual data entry and considerably reduce hospital’s costs and also increase efficiency in public hospitals. As a result, this will partly solve the overcrowding within public hospitals in addition to reducing the number of patients in the waiting lists for admission (Australian Medical Association, 2010). References Australian Medical Association. (2010). AMA public hospital report card 2009: an AMA analysis of Australia’s public hospital system. Austria: Australian Medical Association. Garling, P. (2008). Final report of the Special Commission of Inquiry: acute care services in NSW public hospitals. Sydney: New South Wales Government. Elder, R. (2008). Australian public affairs information service. Sydney: National Library of Australia. Eileen, W. (2005). Understanding the Australian Health Care System. Sydney: University of New South Wales. Lapsley, M. (2009). The Australian health care system. California: School of Health Services Milton, R. (2007). National Health Structures: The issues. London: Oxford University. Mooney, G. (2008). Economics and Australian health policy. New Jersey: Allen & Unwin. Penington, DG. (2009). Does the National Health and Hospitals Reform Commission have a valid solution in for public hospitals? Med J Aust, Vol.191: 446-447. Sax, S. (2004). A Conflict of Interests: politics and policies in Australian health services. Sydney: George Allen & Unwin.   Read More