Health, unsurprisingly, has been one of the big ticket items this election campaign.
Fresh off calling the state election, the Liberals were quick to outline a plan – promising to provide the “biggest ever” boost to healthcare.
What followed was a string of commitments, mostly building on existing strategies and plans, with additional funding aimed at addressing elective surgery wait lists and outdated infrastructure.
Labor, on the backfoot, were quick to follow suit, pinning most of their hopes of fixing Tasmania’s “health crisis” on Bastian Seidel – a GP and past president of the Royal Australian College of General Practitioners.
But despite a rollercoaster few weeks of pledges and plans, how do the policies compare – and what’s missing?
What stakeholders have asked for:
Australian Medical Association:
The peak professional body representing doctors called for a commitment from all parties for a $400 million investment in information-technology to allow for health services to be delivered within homes.
The organisation said the investment would allow specialist services to be delivered to patients without the need for travel.
It said the investment could allow for general practitioners to observe what was happening to their patients in real-time through an electronic medical record.
However, no party has adopted the bid.
“Without this major commitment, many of the issues that are breaking the health system today will continue,” AMA Tasmania president Helen McArdle said.
“Small buckets of funding for a software program here or there will not suffice.”
Australasian College for Emergency Medicine
The body of emergency medicine called on both major parties to solve the “insidious” systemic issues leading to access block in Tasmania’s hospitals.
This includes addressing healthcare workforce supply issues, alongside system-wide solutions.
However, the college says health plans put forward by both major parties “don’t go far enough”.
ACEM also called for a commitment to opening another 100 general medical beds statewide within the next year, and a total of 300 by 2024.
It says they must be staffed and resourced to remain open.
Alcohol Tobacco and other Drugs Council
Representing and supporting community organisations, ATDC says community-managed services are already stretched, at a time when demand is increasing.
In outlining its election priorities, the council warned the next government was headed into a funding shortfall of more than $9 million.
ATDC chief executive Alison Lai said the focus for all major parties should be on ensuring the sustainability of existing programs and services, while injecting additional funds into the sector to ensure that it can respond to increasing costs and demand.
ATDC chief executive Connie Digolis.
Mental Health Council of Tasmania
MHCT’s election campaign, A Tasmanian State of Mind, called for an increased focus on prevention and early intervention by ensuring all Tasmanians have access to the resources, education and support they need to be mentally fit and healthy.
Chief executive Connie Digolis said while there would always be a need for accessible acute mental health services, for too long Tasmania has focused on only providing support to people once they become acutely unwell.
“Instead, we must now look towards a preventative approach, that helps people to maintain and boost their mental wellbeing, and supports them to stay mentally healthy, rather than reacting when their mental health declines,” she said.
ANMF state secretary Emily Shepherd.
Australian Nursing and Midwifery Federation
The peak nurses union for Tasmania says issues with staffing levels and ED access block can’t be ignored any longer.
It called for political candidates to commit to an alternate health policy to address a vacancy rate of almost 400 positions across the state.
This included the appointment of a statewide executive director of nursing and midwifery, to lead operational strategy implementation and collaboration on key issues with the nursing workforce.
The union has also recommended the establishment of recruitment units to help streamline the existing six to 12 month recruitment process and reduce “lengthy and unnecessary approval chains”.
Both Labor and the Greens publicly supported union’s alternative policy.
Michael Murrell, 79, is among more than 51,000 Tasmanians waiting for an outpatient appointment.
What the parties have promised –
As of December 2020, more than 12,000 Tasmanians were awaiting elective surgery. This includes 1051 category 1 patients, 4494 category 2 and 6541 category 3 patients. There is also more than 51,000 Tasmanians waiting for an outpatient appointment.
The Liberals have promised to deliver an additional 22,300 elective surgeries through $156.4 million over four years, across the state.
In 2021-22, this includes providing 8300 surgeries statewide. For the north, it’s promised an additional 7400 surgeries and endoscopies, with a funding boost of $52.1 million over the next four years.
It’s something Health Minister Sarah Courtney said would bring the total number of surgeries for the year to 22,800 – “almost twice the size of the waiting list, and the largest year of surgery ever in Tasmania”.
More than 180 staff statewide are expected to support this increase in volume, including more than 112 nurses, 14 doctors, 16 allied health staff as well as more than 40 hospital support staff.
They’ve also promised to provide 20,000 more dental appointments across the state.
Labor’s $137 million plan to address the elective surgery backlog centres on “more doctors, more appointments and less waiting”, committing to 215 new jobs to bust the elective surgery and outpatient waits lists it says have ballooned under the Liberal government.
This includes an additional 65 permanent doctors – including 35 medical specialists and 30 surgical specialists and an additional 150 nurses and midwives across the state to improve the standard of patient care.
Dr Seidel said Labor’s plan would also prioritise screening for patients with suspected cancer, guaranteeing that they will be seen within two weeks, along with a major IT upgrade to enhance telehealth and online health services.
The Liberals will invest an additional $56 million into Tasmania’s mental health, alcohol and drug treatment system, with an additional $26 million for Child and Adolescent Mental Health Services.
This includes $8.5 million over two years for a Mental Health Hospital in the Home pilot in the state’s North-West, $500,000 to commence the roll-out of Rethink 2020, targeting suicide prevention initiatives, and $5.1 million over two years to pilot an Emergency Mental Health Co-Response Team model.
It would also invest $10 million of new funding into alcohol and drug treatment services, and prioritise prevention through a $20 million investment.
Labor has promised to recruit mental health workers to all 195 Tasmanian state primary and high schools as part of a focus on prevention and early intervention.
The party says its $40 million Mental Health Workers in Schools program will ensure students have access to specialist mental health support, when they need it.
It’s also committed $250,000 each year for three years to Speak UP! Stay ChatTY’s Schools Program and an additional $200,000 each year for three years for its Sports Program.
The party would also establish a suicide prevention commissioner, with $1 million a year, and employ 30 new mental health social workers in community health centres.
It’s also promised to fund a new $67.5 million mental health facility at the North West Regional Hospital.
The party has promised to deliver a co-located private hospital adjacent to the Launceston General Hospital, with an expected investment of around $120 million.
This includes finalising a memorandum of understanding with Calvary Health Care within the first 30 days of being sworn in.
It will also commence the next stages of the LGH masterplan, with a $580 million major investment over 10 years, along with $60 million towards the first stage of a redevelopment of the North West Regional Hospital.
The party says its focus will always be on investing in people, but that the state’s hospitals are in need of improvement.
They have promised $67.5 million at the North West Regional Hospital for a new mental health facility, more beds, and the upgrades required to bring back maternity services.
There’s also $580 million over 10 years for the Launceston General Hospital, in partnership with the federal government.
The state’s 17 district hospitals and community health facilities would receive $59.5 million, while $38 million would go to upgrading ambulance stations to ensure every community has 24/7 paramedic coverage.
The party has also promised to deliver a 10-bed dedicated hospice for Northern Tasmania, with a financial commitment of $5 million for capital works and $2.8 million for workforce development and transition of services.
The party has promised to strengthen palliative and community healthcare with an additional $52 million for in-home and local community delivered health services.
They will also deliver 48 paramedics over the next two years and upgrade the Ambulance Tasmania vehicle fleet with an investment of $9 million.
The party says new paramedics would be recruited to both urban and regional locations across the state.
Labor revealed its “game-changing” plan to make 1000 bulk-billed visits a day available at 10 GP extended care clinics throughout throughout the state, in an effort to take pressure of EDs and help ambulance ramping and bed block.
It’s also promised that all 17 rural hospitals will offer 24/7 emergency care through 85 new on-site nurse practitioners and remote area nurses.
Also included is a commitment to re-write the Rural Medical Practitioners Agreement and a training package for 50 rural generalists.
There’s also $5.1 million to recruit 510 ambulance volunteers, as well as appointing two full-time recruitment and volunteers support officers.
The Greens health policy
The Greens’ health plan puts a “strong emphasis” on making sure the health system has the staff, beds and resources we need now and into the future.
- Develop a statewide strategy for emergency departments, introducing mandatory reporting of incidents of 12- and 24-hour waiting times in EDs.
- $120 million over four years in developing the infrastructure identified as priority in the LGH Masterplan.
- Prioritising an additional 21.43 FTE nurses for the LGH ED.
- Fast-track the design of the new Royal Hobart Hospital campus on the repatriation hospital site and commence construction in 2022.
- Fund the establishment and operation of two urgent care centres in the public health system – one in the north of the state, and one in the south.
- Hire 600 new graduate nurses in the next four years.
- Recruit 40 permanent pool staff nurses and midwives for the Launceston General Hospital, 40 for the Royal Hobart Hospital, and 40 for the North West Regional and Mersey Hospitals.
- Recruit 10 Psychiatric Emergency Nurses (PENs) to enable proper triage, assessment and treatment of ED mental health presentations.
- Re-establish the role of Statewide Executive Director of Nursing and Midwifery, and ensure it sits on the Department of Health’s Executive.
- Establish a dedicated, specialised recruitment process to tackle the shortfall of nurses and midwives in Tasmania.
- Invest in 25 Clinical Educators and 50 Clinical Coaches to assist with policy and professional support, and to onboard new nurses into individual areas.
- Invest in 224 FTE more into Ambulance Tasmania staffing, the first tranche will be 119, followed by 105 more after two years.
- Invest in 27 new ambulances, 7 new light fleet vehicles, and new stations in Rokeby, Channel, Ouse, and Legana.
- Establish an independent inquiry into issues in the Statewide Mental Health System, and provide an additional $5 million per year into staffing, recruitment and retention initiatives.
- Allocate $3 million each year towards a grants program for community-based preventative health initiatives around the state.
- Fund an additional 50 allied health professionals in areas of critical need in community health centres
- Increase beds for withdrawal management to 23, and establish three new rehabilitation facilities in the public system. These facilities will be places in the south, the north, and the north west, and will have a total of 70 new beds.