Political leaders dodge accountability for health system failures

It seems inconceivable that after more than 2 years of everyone focusing on the health system failures that we are 2 weeks from a federal election and yet neither major political party has made any commitment for systemic overhaul of the system.

This week Australian Medical Association President Dr Omar Khorsid said “We’ve seen no clear vision about how the very clear challenges that are here with us now are going to be addressed by a future government”.

Whilst some of the system failures have been attributable to state governments, plenty is the remit of the federal government.

So how is it they can run campaigns without committing to the overhaul necessary to fix the system?

In part the answer is because certain entities with skin in the game have spent the last 2 years telling everyone that the systemic failures are the result of Covid. So, the voters belief is that once Covid is sorted the health system will return to ‘normal’ and all will be ok with the world.

This raises two questions:

  1. Is this true?
  2. Why did these entities blame Covid?

Is the health system broken because of Covid?

Covid pushed the health system to the point where it is failing but it was not the reason why it was destined to fail. If a car was driving along a road doing 200 kms per hour and then failed to take a sharp turn, would we blame the corner or the driver? In this case the argument has been that the corner was the cause of the accident and how could we have ever been prepared for the corner. In reality, if the car had been travelling at a safe speed it would have negotiated the corner.

In this example the car represents healthcare workers, the corner represents Covid, the driver represents AV, ESTA and the government and the accident is the health system failures

The health system has been in disrepair for many years and the Covid pandemic has made glaringly obvious the underlying issues that have now caused patient deaths and harm and have potentially scarred healthcare workers for ever.

To provide a specific example, from 2016 to 2019 I was working as a Senior Team Manager for Ambulance Victoria in a major Victorian regional centre. Part of my role was to manage daily resourcing and to ensure service delivery and the welfare of the crews on road. By 2018 the signs were obvious that the system was falling apart.  Crews were not finishing on time and were ramped at hospital for hours on end, shifts not filled and hundreds of thousands of people went hours each day not knowing that there was no ambulance within 40 kilometres.

So, when recently I heard a representative of healthcare workers telling the media that because of Covid, ambulance crews when logging on were now being sent straight to hospital to relieve another ramped crew, my response was that was happening in 2017, 2018 and 2019. And how do I know? Because it was my job to organise relief for those crews that were ramped for hours.

Why is Covid blamed for the systemic failures?

In answering the question of why Covid has been blamed for the health system crisis we need to consider who benefits from blaming Covid. In simple terms it is those that had skin in the game pre-Covid and failed to respond to the indicators which pointed to a health system on the brink of collapse. To use the car example from above, by blaming the corner they detract from their own failure to ensure that the car was driving at a safe speed in the first place. So not only does the driver avoid responsibility but so do those whose job it is to make sure the driver is acting safely and responsibly.

The consequence of this neglect is that the health sector is seen as going through a difficult period because of Covid and that eventually everything will be great again. So, no need for the major political parties to make substantial commitments. The consequences of this neglect will be felt by patients and the healthcare workers for many years to come.

As health economist Dr Angela Jackson said this week “These reforms are long overdue, and we really need to get going if we’re going to beat the wave of the ageing population that’s coming.”

For this to happen it is time for those parties that have the power to force change to stop allowing the decision makers to blame the corner. There will be more corners to navigate in the future and the health system is not equipped to negotiate them.



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