Recent media reports around health system reform have raised the spectre of further amalgamation of services in regional and rural communities.

An independent expert advisory committee is leading a Health Services Plan that will provide a draft report with recommendations to the Department of Health in April.

Amalgamations of services are one option being proposed as part of changes to the structure and design of the state’s healthcare system. While it has been indicated there are no pre-determined outcomes at this stage, we know that substantial reform is needed, and likely coming. For this reason, we need to take a step back and consider what would be needed to realise a different and better experience for patients.

Any attempts to reform the Victorian public healthcare system must be driven by the evidence with patient needs at the centre of the conversation. Substantial changes will require greater investment, not efficiencies.

A key goal of reform will be to achieve a more collaborative and interconnected healthcare system. There must be clearer care and referral pathways that capture where a patient needs to go and who is responsible for referring them.

But you cannot create a more interconnected health system without investment in the critical enablers.

Victoria’s public healthcare system needs a skilled and mobile workforce that is able to move quickly across the regions in response to workforce shortages. Workforce planning needs to be adapted to suit regional and rural areas where services face additional challenges in attracting and retaining workers due to tyranny of distance.

There will also need to be investment in modern digital infrastructure that supports the system to work as one. Widespread use of paper-based medical records and the absence of a unique patient identifier means it is difficult to track the way patients move across the system.

The Victorian Government introduced the Health Legislation Amendment (Information Sharing) Act 2023 last year to enable health services to quickly access patient information in one centralised location. But to date we’ve seen no commitment to invest in a statewide roll-out of an electronic medical record, despite a push towards a more interconnected public healthcare system.

Importantly, health system reform will not be achieved without adequate buy-in from Victorian public healthcare leaders.

If amalgamations are considered as one possible option towards greater collaboration, then this reform must be pursued in the best interests of the entire health system. Communities require time to be consulted and need to be brought into the conversation before the outcome is finalised. All proposals must be scrutinised to ensure the benefits outweigh the risks, and recognise that local hospital boards, CEOs and their staff know their communities best.

The pathway to reform is not without its challenges. Victoria’s public health services are working in an incredibly difficult budget environment. The fact that the statewide deficit sat at a collective $1.46 billion in the six months to December 2023 should speak volumes.

If the Victorian Government is serious about reforming the public healthcare system, then it must invest in it.

 

This article originally appeared in Australian Community Media on Thursday, 21 March.