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The Canberra Times
The Canberra Times
Lucy Bladen

ACT can't fix health system alone, Barr says

Chief Minister Andrew Barr. Picture by Sitthixay Ditthavong

Chief Minister Andrew Barr says changes to primary health care is the "number one agenda item" for the national cabinet but the ACT cannot fix the system alone.

Mr Barr said the onus was on the Commonwealth to work with the state and territories to repair the health system.

The ACT's health system has been struggling with a litany of issues including staffing shortages, the nation's longest emergency department wait times and concerns about the quality of paediatric care.

But the Chief Minister said while there were local issues, health systems were struggling across the nation.

"This is an issue everywhere. You look at the front page of the newspaper in each Australian capital city and each declare regularly that their health system is the worst in Australia for various reasons," Mr Barr said.

"It's very, very challenging. There are a range of issues, mostly they are national. That's not to say there aren't local variances and things that can be improved, but the point I would make is: it's not as if the ACT is the only jurisdiction facing these sorts of challenges."

Mr Barr said reforms to primary health care were essential to easing the burden on the emergency department and this had to be led by the federal government.

"Solutions will only be found within the federation and with the Commonwealth working with us. But the happy news is they understand that, they're putting some resources into it in both the short, medium and long term," he said.

"As far as I can see the best solutions will need to include more than just augmenting hospital services, they need to include holistic reform of primary health care, and boosting capacity."

Victorian Premier Daniel Andrews made similar comments this week, saying the system was broken and this needed to be a key priority for national cabinet this year.

The federal government has plans to establish 50 Medicare urgent care clinics across the nation as part of a pilot, aimed at reducing the pressure on the hospital system.

The centres would treat patients with less serious injuries such as broken bones, wounds needing stitches and minor burns.

There was $235 million in the October budget for the centres which will be located at GP services and community health care centres.

Mr Barr said this was a top priority for states and territories.

"There is a really important national cabinet project that's underway now where the Commonwealth have put a fixed amount of money to support a range of primary health care pilots in each jurisdiction," he said.

"I think it is universally recognised that the extreme pressure on emergency departments and hospitals is one of the major factors driving that. The structural weakness now - would be the nicest way to put it - is primary health care. Others describe primary health care as being in crisis."

Australian Medical Association ACT president Walter Abhayaratna said issues with the ACT health system were not only the responsibility of the federal government. He said there needed to be a shared responsibility between the Commonwealth and states and territories.

Professor Abhayaratna said he did not believe urgent care clinics would make any difference. He said it was a short-term change that would actually be a barrier to longer-term solutions.

He said primary care was in desperate need of reforms to better integrate the health system. Professor Abhayaratna said under the current approach there were too many silos that did not connect well.

"The federal government's goals for these urgent care centres are to reduce the entry for non-emergency cases or occasions of service in hospitals so they are trying to reduce the burden in emergency departments," he said.

"What it is doing by incentivising these centres is drawing away from integrated care because these urgent care centres are not providing the primary care, the ongoing care and the integrated care that patients need.

"It's creating other silos and it is similar to the silos that have been created at the moment in the community health care services such as the community centres, the nurse-led walk-in centres - all of those are now silos that don't connect well."

The ACT's nurse-led walk-in centres already offers a similar model of care to the proposed Medicare urgent care clinics. There are five walk-in centres across the territory with the first built in 2010.

Over that time emergency department wait times have increased in the nation's capital.

Canberra has the longest wait time of any state or territory and the latest report from the Australian Institute of Health and Welfare showed the median wait time was more than double the national average.

ACT Health's most recent report into the territory's emergency departments showed only 39.7 per cent of patients were seen on time.

Opposition health spokeswoman Leanne Castley said the ACT government needed to take responsibility for issues with the system. She said the government was out of touch and out of ideas.

"State and territory governments are responsible for managing the health system and it is clear Mr Barr has failed that responsibility," she said.

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