Time to invest in healthcare

Time to invest in healthcare

With the Federal election upon us, and the State election around the corner, the AMA (NSW) is highlighting key election health priorities that matter in NSW.

The health platforms announced by both political parties to date have been underwhelming. When The NSW Doctor went to press in late April, neither the Coalition nor the ALP had come to the table with a health offering even close to the AMA election platform which was launched in April. 

The AMA’s election platform outlines areas for health reform, including measures to improve primary care, public hospitals, and private health with an emphasis on universal access to healthcare and harnessing technology for a future sustainable system.

“The budget and budget reply gave us some indication of where the next government will direct health dollars, but we’re yet to see meaningful commitments on primary care and any willingness at all from either party to rethink current funding arrangements which are failing our public hospitals, as our clear the hospital logjam has so clearly shown,” Dr Khorshid said.

“The AMA has done its homework. We know there needs to be a focus on prevention, equity, access and technology, with general practice and primary care at the heart of the health system to deliver world-class health to all Australians,” Dr Khorshid added.

AMA (NSW) has been very supportive of the Clear the Hospital Logjam campaign and calls for increasing the Commonwealth government’s contribution to 50 per cent for activity.

“The current funding formula for public hospitals is short-changing patients and the funding split between the Commonwealth and states and territories has resulted in a blame game that distracts from the real job at hand – creating a well-resourced, well-staffed hospital system that is integrated with a well-supported general practice sector,” stated AMA (NSW) President, Dr Danielle McMullen in a statement calling on the Commonwealth to pay their fair share for public hospitals.

But what are we specifically looking for in NSW? In addition to the platforms announced by the AMA, looking ahead to the State election AMA (NSW) will be focused on:

• Workforce 

• Medical salaries

• Health expenditure for non-COVID care

• Payroll tax

Workforce

Building the health workforce in NSW is central to the resilience and sustainability of the health system going forward. Senior doctors are facing workplace stress, which was exacerbated by the pandemic. The AMA (NSW) Senior Doctor Pulse Check published last year, revealed that eight in 10 doctors are experiencing workplace stress, with the majority citing excessive workloads (60%) and lack of resources (69%).

And while the pandemic is easing, the pressure on doctors is not. NSW has a growing and ageing population that is increasingly presenting with complex, chronic health needs. Australia’s Health Reimagined, a report produced by Deloitte in March 2022, found that expected shifts in the age profile of the health workforce, combined with the increased demands of an ageing population pose a significant challenge over the next 30 years.

Australia’s population is estimated to be 35.9 million by 2050, and the proportion of people over 65 years of age will increase by 6% to almost a quarter of the population. During that same period the workforce participation rate is expected to decrease from 66% to 64%. Based on figures from the ABS and the National Health Funding Body, Deloitte modelling found that if the system doesn’t change, the health workforce must become four times more productive by 2050 to meet forecast demand. Or, as the report identifies, the health workforce would need to grow from 11% to 45% of the total Australian workforce. 

Whilst training more doctors isn’t the only answer to this developing issue, there does need to be an emphasis on attracting and retaining doctors in NSW to meet the needs of the most populated state in the country.

Medical salaries

A number of NSW health workers, including ambulance paramedics, pathologists, hospital cleaners, as well as nurses and midwives have been vocal in their demands for a wage increase this year.

The same factors that have driven other healthcare workers to strike also exist for our members.

Healthcare workers have borne the brunt of COVID stress over the last two years, and doctors were already under significant pressure prior to the pandemic. Inflation, which has grown 5.1% over the last 12 months, is outstripping the state’s public sector wage cap of 2.5%. 

About 60% of wages in the healthcare sector are directly tied to agreements or awards and workers in outdated agreements are falling behind. 

Doctors may choose not to strike, but that doesn’t mean their contribution should be ignored. 

AMA (NSW) will be calling on the NSW Government to ensure doctors receive the same wage rise it gives to other healthcare worker groups. The NSW nurses and midwives union is seeking 4.75% wage increase, while the HSU is pushing for a 5.5% pay rise.

Health expenditure for non-COVID care

AMA (NSW) is calling on the NSW Government to deliver a Budget that includes more than the usual recurrent spending and planned growth. We desperately need a cash injection that meets the non-COVID needs of the community.

The latest Bureau of Health Information’s quarterly report (October to December 2021) found overall activity returned to near pre-pandemic levels and triage category 2 presentations continued a gradual upward trend over the past five years. Meanwhile demand for ambulance responses was high, with more ambulance responses than any final quarter on record, and almost 95,000 patients were on the waiting list at the end of the quarter, with 10,770 patients waiting longer than clinically recommended.

It is clear that emergency departments are full and ambulances are ramping, while elective surgery waiting lists are blowing out.

We need a Budget that addresses these critical problems facing the health system.

Payroll Tax

Payroll tax threatens the financial viability of medical practices across NSW and risks exacerbating the challenges patients already face, particularly in rural and regional NSW, in accessing healthcare services.

Payroll tax has implications for all medical practices, but general practices have the potential to be hardest hit. The financial stability of general practice has been under threat for years and recent payroll tax decisions will push some practices to consider whether they can continue to remain open.

NSW is already facing a GP-shortage, particularly in rural and regional Australia. Payroll tax will exacerbate challenges to healthcare access if some practices are forced to close their doors.

Healthcare professionals have worked tirelessly and with little financial reward to assist the NSW Government with the vaccination roll-out and to protect the health of the community throughout the pandemic.

The application of payroll tax in light of these sacrifices is particularly disappointing.

AMA (NSW) is seeking a payroll tax exemption for medical practices.

For more information about our campaign, Your Quality Care – Taxed, please see the feature below.