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.
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.
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.
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.
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.