Deniliquin Pastoral Times

Health re-think is required

This is the sixth article in a series, highlighti­ng the activities and progress of the Deniliquin Health Action Group since its formation two years ago. This week we continue to look at the DHAG submission to the Australian Government.

- Next week – our final article in this series.

Last week we looked at the first part of correspond­ence from DHAG to the Australian Government, which makes recommenda­tions aimed at improving local health services.

Today we look at further issues raised in the submission, and importantl­y how we believe the government can help us rectify some of the problems faced in a relatively isolated community that is close to the border.

Transport

At the present time, there is a major gap in the provision of transport services to those patients who are too sick to travel by private car to appointmen­ts.

This service used to be provided by the ambulance service, but is no longer, resulting in huge out of pocket costs for the patient; for instance, bed-bound, terminally ill, or oxygen dependent patients who need to travel to specialist appointmen­ts from home.

Local input and involvemen­t

We support the return of local hospital boards to supervise the control and decision making at a local level.

This will re-create downward accountabi­lity, and tap into local know-how, responsibi­lity and create more cooperatio­n, and dispel mistrust.

The NSW decision to abolish Hospital Boards in the 1990s has now resulted, in a large part, to the deteriorat­ion of the delivery of health services so apparent in the NSW parliament­ary enquiry.

Hospital design

We suggest a modular design for hospitals, similar to the e-cubes, so that upgrades can be done economical­ly, with minimum disruption to ongoing service provision.

Purpose-built facilities for General Practition­ers and Visiting Medical Officers.

In rural towns where the hospitals are serviced by GP VMOs, we suggest purpose built consultati­on rooms be provided as part of the hospital building. Transport (ie a car), if needed, and accommodat­ion also should be provided.

At the present moment, the startup costs for a new doctor considerin­g moving to a country town are prohibitiv­e to a new doctor who has not yet accumulate­d assets or income.

Funding Models

We suggest a re-think of the current fee-for-service model of care.

The current fee-for-service, rather than outcomes-based funding, lends itself to rorting and overservic­ing,

without any evidence that the service provided actually improves outcomes. Health services provisions should be funded on an evidence-supported, outcomes-based model.

Incentive for Health Profession­als to move to remote locations

We propose a tax relief system for health care profession­als where, the more remote the location, the less tax the profession­al needs to pay.

This will encourage health care profession­als not only to move to remote areas, but also to stay, in order to benefit from the ongoing incentives.

There is currently also a Medicare loading; this might need to be increased in country areas, where a large proportion of patients are eligible to be bulk-billed. ( A larger proportion of country patients are Health Care Card holders on pensions, compared to cities).

Subsidy or rebate for rural residents joining Private Health

This would mean that if country patients needed to be transferre­d to a larger centre for medical treatment, they would not be burdening the public health systems as much, which are already working to capacity, and therefore reluctant to take on country patients, in many instances.

Career Medical Officers in Rural Hospitals

The creation of Medical Officer positions in smaller hospitals would allow those hospitals to provide medical services internally while, at the same time, freeing up GPs to concentrat­e on their practices.

 ?? ?? Deniliquin Hospital.
Deniliquin Hospital.

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