Ideas@TheCentre
More spending on prevention is no solution for hospital crisis
Public health experts have long claimed the problems in Australia’s public hospital system are due to government policy focusing too much on hospitals rather than on preventive and health promotion strategies. The report on health reform released this week by the National Health and Hospital Reform Commission endorses this idea.
The reality is that average life spans have increased dramatically in the last 40 years. Healthier lifestyles and more effective medications have resulted in significant falls in rates of heart attacks and strokes.
People who once would have entered hospitals and died while in their 50s and 60s now live longer. Improved medical treatments are also enabling people to live to older and older ages. These people inevitably get acutely ill and eventually become users of emergency departments and require admission to hospitals when they are older and sicker.
Overcrowded public hospitals are already bearing the brunt of the inexorable ageing of the population.
Between 2004 and 2007, the number of patients presenting at emergency departments with medical problems requiring unplanned admission increased faster than population growth by 15%.
This was driven mainly by rising admissions by frail and ‘very old’ patients aged 75 years and over. Patients in this age groups accounted for 14% of public hospital admissions in 1996–97. They accounted for 20% of public hospital patients in 2007–08.
The problem is that total public acute beds in Australia now number roughly the same as in 1996 – about 2.5 beds per 1000 population. Public hospitals simply do not have enough beds to care for Australia’s ageing population.
More spending on prevention will not address the tsunami of ageing-related demand that will hit public hospitals across the country in coming decades.
For the last twenty-five years, State governments have cut bed numbers while opening offices filled with ‘area health’ bureaucrats. The challenge for policy makers is to reverse this process.
A national hospital voucher system, in combination with the reestablishment of local hospital boards, will close down offices, open beds, and rebuild and equip the hospital system to cope with the unprecedented impact of demographic change.
Dr Jeremy Sammut is a Research Fellow at the CIS. His report Why Public Hospitals Are Overcrowded: Ten Points for Policymakers was released by CIS on Tuesday. To read the report click here [http://www.cis.org.au/policy_monographs/pm99.pdf]
