One eye on the horizon

TODAY’S CASE NUMBERS are scary. The lag between writing this column and when its published means the situation could be different by the time you read this, but the upward trend indicates it’s going to get a lot worse before it gets better.

NSW Health and the Commonwealth Government have shutdown non-urgent surgery in public and private hospitals. Unlike the elective surgery in the first wave, which was in response to PPE concerns and an unvaccinated workforce, this suspension is in direct response to workforce concerns.

It signals an all hands on deck response to the urgent COVID crisis. We support this. We recognise that we need to put the fire out first. We need to get as many people vaccinated as possible and we need to stop transmission in our healthcare facilities. But we can’t ignore the long-term impact this will have on our patients. Patients who have already been waitlisted for too long, face even longer delays to treatment.

This impacts throughout the whole system. We cannot have a situation where patients are unable to access care for months at a time. We need to put a plan in place for the medium and long-term.

We don’t have all the answers yet, but we are asking the questions and we are working towards solutions.

The other aspect of this shutdown that needs consideration is the impact on training. It’s an issue that many will be tackling at a facility level, but we hope we can find solutions by working with Colleges and NSW Health to put plans in place across the system.

While we’re planning for the future, we also need to look at what pressure our hospitals will face in a post-lockdown world. At some point, NSW will open up again. The Doherty Institute suggests if NSW were to open up at 70% adult vaccination with daily case numbers still in the hundreds, as they are at the time of writing, then we face 385,000 coronavirus cases and almost 1500 deaths in six months. There are a lot of variables to consider, but modelling suggests that even with higher vaccination rates and low or no cases, there would still be some infections and deaths.

Our public hospitals were under pressure before COVID, and it looks like there will be sustained pressure if and when the crisis abates.

In this issue, we present the results from our Senior Doctor Pulse Check. The loudest message from doctors is that while they feel valued by patients and motivated to provide high quality care, there isn’t a corresponding perception of value from management or NSW Health. Lack of resourcing was cited as a major concern and a contributing factor to high levels of stress.

Any plan for our healthcare system needs to address these issues, which will undoubtedly become more acute as we move from the current crisis, to “living with COVID” and dealing with the flow-on effects of this elective surgery shutdown. We need a map for the future, or we risk running aground.