VICTORIAN Healthcare Association CEO Tom Symondson visited Warragul in July. The Warragul & Baw Baw Citizen caught up with him to discuss the health issues faced by the region.
Above: Tom Symondson and West Gippsland Healthcare Association CEO Dan Weeks at Warragul Hospital.
First published in the 24 July 2015 edition of the Warragul & Baw Baw Citizen. All dates relative to then.
WBBC: What are your thoughts on Victorian Labor’s review into health service provision in the region?
TS: What we want to see is a proper investigation into the existing capacity and the required capacity of the health system. The Travis Review, the first bit of it has provided some money for some services and some of that money has come here, the second part of that review is about looking at longer-term planning. Dr Travis recommended a 20 year capital and service plan for the entire state and the government accepted that recommendation so now we want to make sure that actually happens and is a real planning exercise that has meaning.
WBBC: You have previously mentioned a long-term health plan being required.
TS: That’s what we hope will come out of the Travis review. The Travis review just recommended that we should have this long-term plan, so now we’re hopeful that will happen because at the moment, capital investment into health in Victoria is not planned on a long-term basis. We need to make sure that is the case in the future because we have a very fast growing population, and in places like Warragul the population is growing faster than it is even in the rest of Victoria. We need to make sure that we understand that growth, we understand the demographics of the population moving into the future so is it ageing, is it becoming more medically complex, which generally it is, and how do we ensure we meet those demands.
WBBC: Don’t we already know we have an ageing population?
TS: We do, but we do not link planning of healthcare to that information. We know what the population will be to a fair degree of accuracy in 10, 15, 20 years time, but we do not have a 10, 15 or 20 year health plan to link capacity to that growing population.
WBBC: That seems a bit common sense. Is this something new for Victoria to be doing?
TS: Yes. There is currently a broad plan that the previous government put in place, but it doesn’t have numbers in it, it doesn’t have capital within it, it’s talking about the way we might deliver services. It actually would be quite new to have a 20 year plan which maps out capital, maps out demand growth, and links the two together.
WBBC: What are the other issues that affect this region in particular?
TS: You’ve got the fact that Warragul and the surrounding areas are actually very close to the far edge of Melbourne, which gives an additional layer of complexity because people on the outskirts of Melbourne can actually choose to go into the city or out to Warragul. So it’s not just the growth in population around the hospital, it’s much broader than that. You’ve also got the fact that Gippsland is sort of a long, narrow region with hospitals dotted along the highway, essentially, which means that you’ve got no clear population centre in Gippsland. If you go to the Grampians you have Ballarat or Bendigo. You don’t have that to the same extent in Gippsland, which means it is a lot more complex to come up with a service model that fits for the whole of the region because it’s not as simple as saying ‘there’s a town, and everything feeds into it.’
WBBC: It does seem this hospital covers a larger region than might be expected.
TS: As are a number of the health services in Gippsland.
WBBC: Is centralisation the goal?
TS: It’s not necessarily a goal, it’s just something that naturally happens if you have a Bendigo or a Ballarat or an Albury. We don’t have any community that is as big as any of those in Gippsland and also we don’t have a load of towns feeding into another, we just have a highway with mid-sized towns all the way along it. That means the service delivery in Gippsland is completely different to any other part of the state except, perhaps, the south west.
WBBC: What are the other gaps in the system at present?
TS: The thing we always talk about is investment in community care and prevention. The ideal is people will only turn up in a hospital if it’s the right place for them to be. But because of the lack of investment over a long period of time into community-based services, whether it be for older people or mental health and drug abuse, people tend to end up in hospital who could have been treated in a different way. We have very good services… but we need to spend significantly more on that model than we have done because the cost of acute care is going to keep going up and up.
WBBC: The Gippsland Medicare Local recently became a Primary Health Network, and as a result some groups like Headspace cannot be funded like under the old model. Was that an oversight that should’ve been addressed sooner?
TS: The change… is something that is still really a work in progress. Those organisations are still establishing themselves and the federal government is still working out exactly how to fund things like Headspace.
WBBC: Shouldn’t that have been decided before this all went ahead?
TS: Our view is these kinds of transitions, and we’ve seen it before… are always difficult, and we would like to ensure that the PHNs are the last time it happens. Any sort of change like that causes difficulties and complexities, so as far as possible let’s do it less often.
WBBC: What could be done to address community engagement issues, especially with youth?
TS: You have to have a very sophisticated way of communicating. The risk is that you put so much pressure on health services to do that, they end up taking their eye off the ball of what they’re actually here to do. So it’s not just for health services to engage those groups, but also local government, schools, everybody. It’s fair to say it’s a complicated space.
WBBC: What role should local government, councils, be playing?
TS: Local government has a massive role in prevention and health promotion. They have a legal duty to put together a health and well being plan for their area. The problem is they don’t receive significant funding for anything underneath that plan.
WBBC: Is the funding currently in the system enough for everything we need it to do?
TS: I think the plan that I mentioned needs to happen first, because otherwise we can’t answer that question. We need to work out what is the capacity we have… in hospitals, in community health, in prevention, and where does that link to population growth because that capacity might be in the wrong places, and then make sure you have a plan to deliver that. Until we’ve got that, nobody can answer that question.
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