As the South Australian government considers housing aged care patients in hotels amid an ongoing ramping crisis, a Flinders University researcher says little can be fixed without a “proactive and collaborative Commonwealth government”.
Combined, patients waited a record 5,539 hours in ambulances outside state emergency departments (EDs) last month, despite the SA Labor government’s 2018 election promise to fix an issue that had blighted the previous Liberal government.
“The reality is that the state and territory budgets, particularly WA, SA, and ACT, simply don’t have the fiscal space to enact changes within health and community services on their own,” honorary fellow Andrew Partington said.
“Combative Commonwealth-state relations had been the norm during [former Coalition prime ministers Tony] Abbott, [Malcolm] Turnbull, [Scott] Morrison, but now timidity reigns at a national level.”
SA Health Minister Chris Picton has said there were 273 older South Australians in hospital beds medically ready to be discharged but did not have an aged care service to go to, and it was blocking hospital flows.
Mr Partington said the federal government had been “incredibly slow to respond to the burning platform that was the Royal Commission into Aged Care Quality and Safety”.
He said the Aged Care Taskforce’s final report had made recommendations for the new Aged Care Act, “but by continuing to push the timelines out it seems the Commonwealth are unable, or unwilling, to address one of the key root causes — of unwarranted use of hospital services”.
Mr Partington said it also needed to do more to fix the Community Health and Hospitals Program (CHHP) after a national audit found its spending decisions “did not meet ethical requirements and deliberately breached the law in some cases”.
It was found to have resulted from a poor internal culture.
“Simply splashing the cash, through the CHHP and other one-off payments, is not the answer,” Mr Partington said.
“The Commonwealth should explicitly plan to integrate care across the various state and federal systems.”
Seeking bipartisan support
Federal Health Minister Mark Butler said the government had received “strong feedback” in response to a draft of the new Aged Care Act and it was working through them to introduce it to Parliament “as soon as possible”.
“We want this to be bipartisan,” he said.
“Older people need to feel confident that dignified aged care will be there when they need it, and the sector wants certainty to ensure sustainability into the future.
“No older South Australian wants to spend longer in hospital when they can be back at home in aged care.”
Mr Butler added that in response to the damning CHHP audit, the federal government had implemented “significant improvements to grant processes, guidance, and training for staff”.
‘Band-Aid’ solutions?
Yesterday SA Health announced it wanted a new 25-bed facility, which could even be a hotel, to host mostly aged care patients to free up critical hospital beds in Adelaide.
Health Minister Chris Picton has also announced plans to fast-track work at the Hampstead Rehabilitation Centre to build 50 beds for older patients and 20 for memory support unit patients.
“There is a patchwork of different Band-Aid solutions … to make up for the lack of system-wide direction,” Mr Partington said.
“My sense is that there is currently a lot of political brinkmanship at a state level to force some collective action.”
Transforming health legacy
Liberal MP David Speirs, who yesterday stepped down from his role as opposition leader, said the public had not forgotten Labor’s election promises to “fix the ramping crisis”.
He called for a change of management at SA Health because it was “clearly not working”.
Former head of obstetrics at Flinders Medical Centre, Emeritus Professor Warren Jones, was one Labor’s loudest critics in its previous term when it implemented its highly controversial Transforming Health hospital reform package in 2014.
He labelled it an off-the-shelf rationalisation “disaster” bought from an international firm that took about 200 beds out of the system and would never work in a sprawling region like the Greater Adelaide area.
It followed significant health spending cuts in former Coalition treasurer Joe Hockey’s 2014 federal budget, which put the “states on the line”.
Dr Jones today backed Labor to overcome ramping, pointing out it was a “nationwide issue with a history and context that extended beyond political gamesmanship at a state level”.
“They have put more money and resources into the health system than has ever been put in before, and the beds will get up to 500 extra by the time they get kicked out, or go to the next government,” Dr Jones said.
Is the cure around the corner?
Mr Picton said the SA government was adding the beds in a staggered rollout this year; next to the Lyell McEwin, Noarlunga, Modbury, and Queen Elizabeth hospitals, and Flinders Medical Centre.
“We are fast-tracking as many hospital ward extensions as we can to bring additional beds online,” he said.
Mr Butler added that the federal government had invested $53.3 million to help the situation and “deliver better care for older South Australians”.
This included:
- $42.9m for hospital outreach to residential aged care and a grants scheme for transitioning elderly patients.
- Up to $4.6m to extend the Acute to Residential Care Transition program for people with dementia.
- $2.1m to help older people recover from hospital with short-term care.
- Up to $1.8m to extend the Comprehensive Palliative Care in Aged Care program.
Get local news, stories, community events, recipes and more each fortnight.