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Call to curb surgery ‘blitzes’ and seek better funding model

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The Australian Medication Association (AMA) has called on policymakers to reconsider funding models to carry the health system through the COVID-19 crisis, stating that one-off initiatives like elective surgery ‘blitzes’ do little to address the underlying issues.

AMA president Dr Omar Khorshid made the comments before the Senate Select Committee on COVID-19 on 21 September, stating that governments must urgently invest in the sector and implement structural funding reform if the nation is to get its health system working for all Australians and through the pandemic.

Dr Omar Khorshid.

Khorshid said a blame game had dominated previous discussions of health funding and reform, and COVID-19 had only exacerbated the crisis facing the sector.

He said one-off funding boosts would not address the problems, and neither would one-off initiatives like elective surgery blitzes used to address waiting lists that have blown out due to elective surgery shut downs.

He said the country could not continue to look at the health system, and its resourcing, through the current lens which “focused on surge planning”, and that governments must look at the resourcing and planning around healthcare to ensure the system was sustainable.

Additionally, he said the medical profession wanted to see society reopen and return to some semblance of normal. However, the health system had not been ready for the pandemic and it wasn’t prepared for the consequences of opening up – particularly if this is done too quickly.

“We are worried that as we open up, the cracks in the healthcare system will widen and we will face very significant impacts, particularly if we open too fast or go too far ahead of our vaccination rates, which of course are the best way to protect the hospital system,” he told the hearing.

“So, the AMA believes you must be aiming for the highest possible vaccination rate as a society. We should be easing out of the restrictions in those states that are living with COVID-19 already, cautiously, slowly, and looking at the results before moving to the next phase of opening up, not waiting for the health care system to be overwhelmed before actually stopping.”

He said governments must prepare the health system to clear backlogs, deliver usual care, as well as meet the demands that COVID-19 will place on the system. These include the extra costs of more robust infection control and prevention measures and the impact these have on productivity.

Khorshid said a sustained increase in funding across primary care and the public hospital system was needed, as well as long term reform of funding arrangements.

Public hospitals will need new infrastructure, more beds, more operating theatres, expanded emergency department and ICU capacity, as well as extra staff needed to support these.

“We do see an urgent need to address the funding issues, the structural issues, the capacity of the healthcare system,” he said.

“What better time to start that conversation than when the AMA’s calls for attention to the sector are now very starkly visible, I think, to everyone in the community as the system fails – even in those states where we don’t actually have COVID-19 just yet.

“I think some of the solutions are going to revolve around innovation – use GPs to prevent hospital admissions, and in particular when it comes to COVID working out how we can use our primary care network to monitor COVID-19 patients in the community and to help look after them without them having to go to hospital.

“So, this will require vision, cooperation, and an end to the blame game that has dominated our health system for so long,” Dr Khorshid told the hearing.

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