Public Health

The COVID-19 pandemic may be a once-in-a-century global emergency, but it has exposed longstanding problems and inequities in Australia’s public health system.

The Morrison government is resisting growing calls to reform the way public health care is funded in Australia.

State governments, public hospitals, and nurses’ and doctors’ unions all say reform is needed to withstand pressure placed on the health system by the COVID-19 pandemic and fix underlying weaknesses.

As the Australian Nursing and Midwifery Federation (ANMF) says, many pandemic-related problems are the result of “longstanding issues that prevent safe, appropriate, effective and affordable care for all Australians.”

The states and territories have called on the federal government to abandon a 6.5 per cent cap on the growth in health funding, which has been blamed for eroding the viability of the hospital system.

They also want total health costs, including those incurred as a result of the pandemic, split 50-50 between the states and Commonwealth.

Under the current arrangement, the federal government contributes only 45 per cent of hospital funding.

Victorian Health Minister Martin Foley has called the current funding arrangement unfair and unsustainable.

Meanwhile, a spokesperson for Federal Health Minister Greg Hunt effectively conceded that hospitals are indeed underfunded.

He said, “There is nothing stopping the states and territories matching the Australian Government’s investment in public hospitals and if they did, hospitals would be adequately funded.”

NURSES AND MIDWIVES’ VIEW

The ANMF says the federal government must commit to a permanent 50-50 funding split as part of a commitment to deliver a “high-quality, well-funded and sustainable health and maternity care system.”

The ANMF agrees the 6.5 per cent cap on funding growth should be scrapped “so funding can meet community health needs based on realities on the ground.”

At the same time, the ANMF wants states and territories to reinvest the 5 per cent of ‘freed-up’ funds to improve performance and capacity.

That view is shared by the Australian Medical Association (AMA), which represents doctors.

AMA president Omar Khorshid strongly supported the push for a 50-50 share of hospital costs, but stressed an increase in federal funding should not allow the states to pay less into the system.

“The reality is health care is more expensive because of COVID; that includes things like PPE and testing, and we are likely to be living with these costs for years,” he said.

“And then there is the cost of deferred care, the diagnostics, the surgeries that happen later. There’s an additional cost if cancer is detected and treated later, for example.”

In a federal election statement, the Australian Healthcare and Hospitals Association (AHHA) also called for funding reform.

The AHHA is the national peak body for public and not-for-profit hospitals, primary health networks, and community and primary healthcare services.

“Expectations of reverting to ‘business as usual’ are unrealistic if health outcome and inequities are to be improved,” the AHHA said.

Increased funding needed to fix a broken system

Health experts, including the ANMF, are calling on the federal government to:

Abandon a 6.5% cap on the growth of health funding so resources can meet community health needs based on realities on the ground.

Commit to a 50-50 funding split between states and the commonwealth to deliver a high-quality, and sustainable health and maternity care system.

Where the parties stand on public health FUNDING

Coalition

The Coalition says it is providing record levels of funding for hospitals, 
medicines and Medicare.

It also says it has “taken steps to make private health insurance simpler 
and more affordable.”

Despite bungling its response to the pandemic, including failing to secure 
enough vaccines and test kits, the Coalition describes its response to COVID-19 as “world leading”.

Labor

Leader Anthony Albanese says:

Labor “will always be better” on health than the Coalition, and promises a “strong, properly funded public health system, with Medicare as its backbone” (The ALP had not released detailed health policies when The Lamp went to print).

In January, Albanese said health workers “are paying the price for some of the most serious public policy failures our country has seen. They are overworked. They are exhausted.

He said Australians “owe it to them (health workers) to study what the pandemic has revealed about the vulnerabilities of our public health system – and strengthen it for the future.”

The Greens

• legislate equal funding of hospitals between the Commonwealth and states to put an extra $8 billion into public health
• cancel the private health insurance rebate and put the saved $7 billion into the public system
• get more tax from big companies and billionaires to expand Medicare to include free dental and mental health care
• boost primary health care and preventive measures such as health promotion, disease prevention, risk reduction and early intervention, in order to manage chronic disease, reduce ill-health and reduce avoidable hospital admissions.