How do you fix a broken health system?

With the election only two weeks away, the Perrottet Government is promising, if re-elected, to fix its broken health system, injecting $1.2 billion to build and upgrade critical health infrastructure and, according to the Premier, improve the quality of healthcare across the state. So, why has the health system, under the Liberal-National Party, fallen by the wayside over the past twelve years and is Perrottet’s promise nothing more than just shallow and meaningless pre-election promise? And on the Central Coast our hospital system is in crisis – the second worst in NSW.

10 March 2023

ALAN HAYES

 

DEPUTY Premier and Minister for Regional NSW Paul Toole said the NSW Liberal and Nationals Government had driven the biggest investment in regional hospitals and health services in the State’s history to deliver better care closer to home. So, why is the Health Services Union (HSU) calling for a royal commission into New South Wales’ funding for health and hospitals, claiming in a new report that the system is “at breaking point” because it incentivises unnecessary or expensive procedures, rather than primary or preventive healthcare.

 

The report, prepared for the HSU by Impact Economics and Policy, says the “fragmented” nature of the health system intrenched inequality and did not produce the best outcomes for the money spent.

 

It was particularly scathing of the state’s failure to invest in community and preventive healthcare, which the report says ultimately costs the state via avoidable hospitalisations.

 

Other findings include:

 

• 10% of people in NSW waited more than two hours after calling for an ambulance from July to September;

 

• Patient complaints about healthcare services have increased 40% since the start of the pandemic, and 144% since 2011-12; and

 

• Half of almost 4,500 Health Services Union workers surveyed said they were considering leaving the profession within the next five years.

 

“Emergency department wait times have blown out not because there is an underinvestment in emergency departments, but because the funding of primary health care does not prioritise keeping people healthy in the community,” the report says.

 

Yet Liberal Regional Health Minister Bronnie Taylor said only a re-elected Liberal and Nationals Government can guarantee that regional health projects are delivered. So, what has gone wrong for the past twelve years?

 

Currently our health and hospital staff in NSW are leaving because there are better offers, better wages and better conditions elsewhere.

 

This means less workers in our hospitals and more pressure on our hospital system and the people who work in it.

 

The cost of study is also a financial burden for prospective healthcare workers. Opposition Leader Chris Minns says, if elected on March 25, his government will follow through on an already developed plan that will actually help health services maximise recruitment in key areas of need in NSW.

 

“This policy will complement a plan to remove the wages cap, which unfairly keeps wages low for key frontline workers such as paramedics, nurses and hospital staff,” Chris Minns said.

 

“That means more nurses, paramedics, and healthcare workers in the NSW public health system – guaranteed.

 

“After 12 years under the Liberals and Nationals, our hospitals and health system has been left understaffed and over-stretched.

 

“As a result, hospital and treatment wait times have continued to escalate.”

 

Under Dominic Perrottet and the Liberals and Nationals, people in NSW have to wait longer to get an ambulance, longer to be treated in an emergency department and longer for important non-urgent surgeries.

 

“The people who look after us need more support. There is widespread burnout, fatigue and under-resourcing in our hospitals,” said Chris Minns.

 

“I’ve heard stories of dozens of experienced ED nurses who had quit, taking with them irreplaceable practical knowledge and experience.

 

“I’ve spoken to paramedics and nurses about what it is really like in our emergency wards - every day, every night and on every shift - they’re not just tired, they’re exhausted and they’re leaving in droves because this government isn’t listening.

 

“I want to boost recruitment of the next generation of paramedics, nurses and doctors for our public health system, that will take pressure off and ensure patients get the care they need.”

 

Closer to home, how does the Central Coast stack up?

 

The Central Coast Health system continues to suffer under the severe strain of nurse shortages, staff burnout and cuts according to new data from NSW Health.

 

Data released by the Bureau of Health Information (BHI) has revealed that the Central Coast has slipped to the second worse Local Health District (LHD) in NSW for emergency treatment and elective surgeries wait-times. The data also exposes a large increase in ambulance arrival times.

 

The October – December data released by the BHI on Wednesday shows that the growing crisis within our local healthcare systems on the Central Coast continues to impact our hospitals.

 

Emergency Departments

 

Central Coast Hospitals fell to the second lowest result in NSW for emergency department treatment times falling behind every other Local Health District except Western Sydney.

 

At Gosford and Wyong Hospital Emergency Departments about 50 per cent of patients didn’t receive treatment on time (48.1% at Gosford & 49.8% at Wyong).

 

Some patients waited for nearly 50 per cent longer in Central Coast Hospitals to be transferred from an ambulance to staff within EDs compared with other LHDs (CCLHD 90th percentile of 1 hour and 20 minutes compared with the NSW average of 56 minutes).

 

Elective Surgery

 

Elective surgery wait times have blown out to second worst in NSW for urgent and non-urgent surgeries. Central Coast was second only to Far West Local Health District.

 

Waits for elective surgery now stand at 17 days and 401 days for urgent and non-urgent elective surgeries respectively.

 

Ambulance Wait-times

 

Emergency cases are classified as priority 1 (P1) by NSW Ambulance and require an immediate response.

 

In the Gosford area (SA3) nearly 60 per cent of P1 patients not have an ambulance arrive within the arrival benchmark time of 15 minutes. In the Wyong area (SA3) 53 per cent of P1 patients waited beyond the arrival benchmark time. Both areas were down compared with October – December 2021 during the tail end of the height of Covid-19.

 

Member for Wyong and Shadow Minister for the Central Coast David Harris said "The figures for our local hospitals have declined from the same period last year when Covid was still a big factor. The government has dropped the ball and our hospital staff and community are suffering the consequences with long waits."

 

David Mehan, Member for The Entrance, said “These statistics are further proof that we need to be upgrading Long Jetty Hospital to provide primary care for the community.”

 

NSW Health said in a statement its priorities were “to keep the people of NSW healthy and well, and to deliver excellent experiences and outcomes of care”.

 

Waiting eight hours to see an ED doctor at Wyong Hospital is not conducive to a healthy outcome. And in spite of Regional Health Minister Bronnie Taylor saying that “We will continue to ensure our rural and regional communities have the health facilities they need and deserve” it is blatantly clear that she is out of touch with a health system that’s falling apart around her. Maybe, she should walk in the shoes of EA patients seeking medical help at Wyong and Gosford Hospitals? Then, and only then would she, and the Perrottert Government, understand that there are staff shortages, nurses and doctors are overworked and underpaid and that ambulance wait times are going from worse to worse because of the government’s failure to address a growing crisis.

 

Member for Swansea Yasmin Catley said “The latest BHI data proves that we are experiencing a health crisis. We know that at Gosford and Wyong about 50 per cent of patients didn’t receive treatment on time. The Coast also had the second worst wait times for elective surgery.”

 

“This simply isn’t good enough. Local patients and health staff have been crying out for help, but the Government has failed to act. Labor is committed to fixing this crisis,” Ms Catley said.

 

Liesl Tesch, Member for Gosford, said “Our hospitals are in crisis and our healthcare workers are overstretched and overworked.

 

“Labor’s policy will employ more nurses at Gosford and Wyong’s hospital wards, ease the huge workload on our burnout health staff and pay them a fair and decent wage.

 

“After 12 years of neglect, pay cuts and staff shortages, Dominic Perrott needs to go to save our hospitals and ensure we keep our nurses and health workers to deliver better care for our community."

 

Labor Candidate for Terrigal, Sam Boughton expressed concern that our local health workers kept going through years of COVID-19 and a lot of them are feeling exhausted and overworked.

 

"Many nurses have left the profession because the conditions have become so hard," he said.

 

“We need a government which cares for our nurses so that they can deliver quality care for our community.”

 

Member for Terrigal and Parliamentary Secretary for the Central Coast Adam Crouch was asked by the Grapevine’s editor, via email, what will he do if re-elected to help alleviated the public healthcare crisis on the Central Coast. Mr Crouch did not give the courtesy of a reply, yet he is supposed to represent the people of the Central Coast.

 

And while patients wait hours to see a doctor and are being monitored in waiting rooms and hallways NSW's embattled healthcare sector is being pushed to the brink, what do we hear from Regional Health Minister Bronnie Taylor? “We are also investing in our workforce, with regional communities reaping the rewards…”

 

The HSU NSW secretary, Gerard Hayes, said the case for a royal commission was “overwhelming”.

 

Mr Gerard Hayes’ words are an understatement of a health system that’s badly broken.