President’s Message: The case for change

As we move closer to the NSW election in March, healthcare must become more than another campaign talking point.

We need a government prepared to confront the challenges doctors see every day and build a properly planned, sustainably funded health system focused on keeping people healthy before they require hospital care.

Over recent months, AMA (NSW) has consistently challenged governments to look beyond announcements and focus on the patient experience. The latest Bureau of Health Information report, the NSW Budget and a recent series of hospital announcements all reinforce the same message – demand continues to grow faster than capacity, doctors continue to work under enormous pressure and patients continue to wait too long for the care they need.

The NSW Government described this year’s Budget as a record investment in health, but headline figures do not tell the whole story. The reality is that health funding failed to keep pace with health inflation and much of the additional funding reflected the well-deserved pay rise awarded to nurses and midwives through the Industrial Relations Commission. 

The NSW Government has promised 9,000 additional health workers, yet there has been no detail as to how many will be doctors, where they will work or how they will support the new hospitals, wards and services that continue to be announced. Doctors are not optional. Every emergency department, operating theatre, outpatient clinic and hospital ward depends on doctors to diagnose, treat and lead patient care. Infrastructure is important, but hospitals cannot function safely without the workforce to support them.

Additional beds at Westmead Hospital, and more recently at Blacktown and Mount Druitt hospitals, are welcome investments for rapidly growing communities. However, many of these announcements have been made previously, while the workforce required to deliver those services remains largely absent from the discussion.

As a surgeon in western Sydney for more than two decades, I know that population growth has consistently outpaced investment in frontline medical services. 

At the same time, we continue to overlook one of the most effective ways of reducing pressure on hospitals: preventative health.

The latest Australian Institute of Health and Welfare report confirmed that overweight and obesity are now the leading preventable contributors to Australia’s disease burden. Almost two-thirds of Australian adults and more than one-quarter of children and adolescents are living with overweight or obesity. Those statistics translate directly into rising rates of diabetes, cardiovascular disease, cancer and other conditions that place increasing pressure on hospitals every year.

The NSW Government’s own report, the Special Commission of Inquiry into Healthcare Funding, has already provided a clear roadmap for reform. Its recommendations, which were meant to be implemented by April this year, include making preventative health a permanent whole-of-government priority, assessing the health impacts of new government initiatives, addressing unmet primary care needs and providing ongoing, quarantined funding to implement reform.

While the NSW Government has supported many of the inquiry’s recommendations, AMA (NSW) calls on politicians to commit to fully implementing every recommendation, backed by a clear public implementation timetable, ongoing funding and transparent progress reporting.

The most effective health system prevents illness before it requires hospital care. That means investing in strong general practice, early intervention, doctor-led public outpatient clinics and evidence-based preventative health initiatives. 

Prevention should not compete with acute care funding every budget cycle. It should be recognised as core health system investment. 

We will continue advocating for a national levy on sugar-sweetened beverages, with the revenue reinvested into preventative health. Directing that funding into childhood obesity prevention and preventative health infrastructure is a practical way to reduce the long-term burden of chronic disease while easing pressure on hospitals.

Another key election priority will be expanding doctor-led public outpatient and rapid access clinics across NSW.

These clinics are an investment in prevention, but they must be backed by a comprehensive medical workforce plan that ensures enough doctors are available to staff them safely and sustainably.

Alongside these priorities, AMA (NSW) will continue calling for a comprehensive medical workforce strategy, stronger support from the Federal Government for general practice and more aged care and disability beds to unblock NSW hospitals, sustainable public hospital funding and practical reforms that improve access to care across metropolitan, regional and rural NSW. 

We will continue to ensure doctors are heard throughout the election campaign. Our advocacy will remain independent, evidence-based and firmly focused on patients. We will support policies that strengthen the health system and challenge those that fail to address the realities facing doctors and the communities we serve.

The months ahead provide an opportunity to have an honest conversation about how healthcare in NSW should look like over the next decade – not just the next election cycle. 

The road to March has begun. And we are ready.