It’s hard to overstate the impact the pandemic has had on our healthcare systems. During the past few years, doctors, nurses and other healthcare professionals have been working under unprecedented pressure. Now, healthcare providers across the country are grappling with pent-up demand with thousands of elective surgeries having been delayed during the peak of the pandemic. As all of this is happening, uncertainty brought on by budget cuts and resourcing challenges are putting an even greater strain on the whole sector. Add to this the spiralling inflation and you have the perfect storm.
Axing of the 50:50 funding is putting a strain on public hospitals
For the public sector, a major point of contention is the axing of the 50:50 funding. The policy of splitting COVID-19 related hospital costs evenly between federal and state governments will expire at the end of 2022. This decision has been highly contested by healthcare providers. The Australian Medical Association has previously called for the funding scheme to be made permanent, warning of a deepening crisis if the funding is discontinued.
A wide range of solutions have been brought forward in order to tackle the crisis. In Victoria, these include everything from providing wait-listed patients with vouchers to access private clinics to billions of dollars in increased funding for overhauling the whole system. The wide-ranging solutions further add to the uncertainty which the public healthcare sector is forced to grapple with.
That healthcare funding also remains a highly divisive political issue is another contributing factor. With resourcing tied to election cycles, it is even harder for healthcare providers to plan ahead. Instead of managing work and resources in a sustainable way, more and more providers are forced to work reactively. This has an adverse effect on employee satisfaction and patient experience alike.
GPs grappling with an outdated system
While general practitioners are still the most accessible doctors in Australia, many GPs are now seeing unprecedented wait times. Some practices are even having to close their doors all together. The situation has gotten so bad that it’s been labelled a full-blown crisis. To make matters worse, the Australian Medical Association is predicting a shortage of 10,600 GPs by 2031 – 2032. Restricted access to GP care will have a huge adverse impact on our entire healthcare system.
Constrained by an outdated system, general practitioners are struggling to provide the kind of care that would benefit their patients the most. The Medicare Benefits Schedule has remained largely unchanged since it was first created in the 1980s. Meanwhile, patients’ needs have changed drastically. Our population is a rapidly ageing and the occurrence of chronic diseases has increased dramatically. In a recent report, one third of GPs stated that 75% of their patients have several chronic conditions.
During the General Practice Crisis Summit in October 2022, participants widely agreed that the current system doesn’t prioritise the kind of healthcare needed by Australians today. In an attempt to tackle the escalating crisis, the federal government has pledged 250 million dollars a year in order to keep healthcare accessible and affordable. A taskforce has been created to try and decide what this will mean in practice. This adds yet another layer of uncertainty for GPs already stuck in financial purgatory.
Private hospitals and the SLACIP Act
Besides public hospitals and general practices, private hospitals are also under increased financial strain. In addition to inflation which doesn’t discriminate between public and private providers, the private sector is also facing its own unique set of challenges. These include the implementation of the Security Legislation Amendment (Critical Infrastructure Protection) Act 2022, or the SLACIP Act. The act requires certain organisations to set up a risk management program to identify and protect them from attacks. The bill is designed to “strengthen the security and resilience of critical infrastructure.” This includes hospitals with intensive care units.
During a public hearing, representatives from large private hospital groups voiced their concerns regarding the huge financial cost of implementing the required changes. These costs would be added on top of the huge amounts already spent on tackling the COVID-19 pandemic. Moreover, the representatives noted how taken off guard they were by the proposed changes. While agreeing that the bill was needed, private providers urged the government to provide financial aid to help cover the costs. This all goes to show just how rapidly and drastically the financial landscape can change.
The impacts felt at the frontlines
As ever, the impacts of the crisis will be most acutely felt by those at the coal face. During the peak of the pandemic, it was the doctors and nurses who bore the brunt of it. These same healthcare professionals are still continuing to manage the ongoing impacts of the pandemic while much of society seems to have moved on. Now, the resourcing crisis will be felt by them too.
Uncertainty in funding shows up in many ways in day-to-day work. Despite limited funding and understaffing, providers are having to treat patients needing more complex care. There are many contributing factors: an ageing demographic, delayed care, the impacts of long COVID and a deepening mental health crisis. Limited resources are also contributing to ambulance ramping and long wait times, both of which can result in adverse care outcomes, aggressive behaviour from patients and negative media coverage. All of this increases the risk of staff burnout which is on the rise across the board.
Building a more sustainable future for healthcare
The pandemic has had a lasting impact on healthcare as a whole. Some experts predict that our healthcare systems might never return to what they were pre-pandemic. Now the ups and downs of funding decisions are putting healthcare organisations, both public and private, in increasingly challenging positions. Now is the time to adapt and evolve.
With the uncertainty that comes with elections and unknown funding outcomes, healthcare providers must try to increase productivity in a sustainable way by focusing on process and systemic improvements. This will free up important funds to increase their workforce, thus improving the patient experience and enhancing employee satisfaction in a way that’s not tied to election cycles.