As the father of medicine once said, “the physician must be able to tell the antecedents, know the present, and foretell the future”. You don’t have to be Hippocrates to know that for over two years COVID-19 has caused immense upheaval to our health system, capacity to deal with this upheaval is the biggest issue for health authorities at present, and if the right decisions aren’t made quickly Australian patients are going to pay the price for years to come.
Measures taken by governments and health organisations to mitigate the spread of the virus massively reduced patient traffic in health settings. Experts also observed changes in the healthcare-seeking behaviour of many patients, many of whom actively avoided accessing health services. With some of the longest and strictest lockdowns anywhere in the world, for better or worse Australia’s response to COVID was nothing if not decisive.
However, it has become clear that in attempting to protect Australians, health settings and vulnerable patients, treating one health issue has potentially triggered another: capacity deficit.
Postponed elective surgeries, the suspension of routine medical appointments, and the deliberate reduction of patient traffic has resulted in enormous backlogs that cascade through every stage of the treatment pathway. Between staff COVID infections and a shortage of qualified personnel in essential services, the strain is being felt across the country. A trend of patient deferment has also developed, further compounding the problem.
Take cancer screening and diagnostic services, for example, where COVID took a particularly heavy toll. One analysis observed that by October 2020 there were some 2530 fewer cancer diagnoses in Victoria alone. That doesn’t mean there was less cancer, but more cancers that hadn’t been detected. Studies confirm, delayed diagnoses result in more advanced disease.
Bowel cancer is another example, we’ve seen an increase in mortality rates over the past few years, particularly in the younger cohort and these cancers not detected until they had reached an advanced stage largely as a result of colonoscopy screening capacity issues. More advanced disease requires more intensive treatment. Quite simply, the data shows that backlogs result in poorer health outcomes.
This is a situation replicated across numerous areas of health. As normal services resume, coupled with higher volumes of patients now able and willing to access health services, experts are warning that extra resources and remedial measures must be deployed to ensure our health system has the capacity and to reduce these surgical wait times. What’s more, this has to be done in a way that causes minimal disruption to existing services.
Just a few days ago, four regional Victorian hospitals declared “code yellow” internal emergencies in response to staff shortages. In January and February Victoria’s Health Department announced a “code brown”; an emergency alert designed to ease the burden on stretched health services.
With a Federal election imminent, and State elections in Victoria and NSW within twelve months, healthcare is certain to be a dominant policy issue – and extremely competitive. As a former Minister, I know that any incoming health administration is going to be inundated with requests for funding and attention. Governments always face difficult decisions allocating scarce resources for the best effect.
There is no shortage of problems to address in our overburdened health system. The good news is, as the reader of Healthcare Spaces will shortly learn, there is also no shortage of innovative solutions and players in the Australian health sector. The challenge will be ensuring the key decision makers understand the choices that they will need to make, and are committed to addressing patient needs in the years ahead.
Author: Alan Griffin
Alan Griffin is Managing Partner at the Civic Partnership, a Melbourne-based public affairs agency with a specialist health government relations practice.
A former Australian Member of Parliament, Alan was Shadow Parliamentary Secretary for Health and Shadow Assistant Health Minister through most of the period from 1998 to 2004, and was responsible for policy oversight in the pharmaceutical, food regulatory and gene technology areas. Later, Alan served as Minister for Veterans’ Affairs, Minister for Defence Personnel and Parliamentary Secretary to the Prime Minister and Cabinet Secretary in the Rudd Government.