What defines a strong health system?

What defines a strong health system?

Doctors have been frustrated by politicians’ claims that the health system is strong and coping when there are clearly so many issues that need to be addressed.

Some years ago, I had to do a radio interview to explain the concept of hospital bed availability and system capacity. The interviewer was perplexed by the idea of non-surgical beds. He struggled to understand that there were patients in hospital who were not getting surgery. While this is hard to comprehend, pre-COVID, it was not surprising because most public discussion of healthcare relates to elective surgery waiting times and emergency department performance. The reason for this is because they are the easiest metrics to measure and the easiest metrics to report. The AMA has been reporting these measurements every year for more than 20 years as part of the annual Public Hospital Report Card.

With COVID, we suddenly now define our health service in terms of ICU capacity and COVID admissions.

However, neither set of metrics – ED performance/elective surgery or ICU capacity/COVID admissions are true and appropriate reflections of the strength of our health system, or our ability to cope with the current Omicron crisis.

We know how distressing it was for doctors to hear politicians continue to claim that our health system was strong because it was not yet overwhelmed. It was distressing to see claims that our health system was strong when GPs were struggling to provide care to their patients because the system was not connected and does not support them. It was distressing to see elective surgery cancelled, as if that was an optional part of our health system and not something critical to so many lives. And it has been particularly heartbreaking to contemplate a third year in which our doctors-in-training and medical students have had their training interrupted – time and experiences they will never get back.

So, if we don’t want to define our health system by numbers, what should we be defining our health system by? 

There are many views, but I think key measurements should be: Is it inclusive and connected? Are all parts of our system able to work together to provide the best possible care for patients? Secondly, do those working in the system feel valued? Lastly, (but not least and based on the first two) is the system able to care for patients? 

Only when the health system is supported by Governments to achieve these metrics, can politicians truly declare we have a strong health system.