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Transcript – Interview with Dr Christine Bennett, National Health and Hospitals Reform Commission, to discuss their visit to Canberra

Station: ABC 666 Canberra
Date: 24/07/2008
Program: Morning
Time: 09:39 AM
Compere: Alex Sloan
Summary ID: C00031499144
Item: Interview with Dr Christine Bennett, National Health and Hospitals Reform Commission, to discuss their visit to Canberra.

Interviewees: Dr Christine Bennett, Chair National Health And Hospitals Reform Commission

ALEX SLOAN:
And the National Health and Hospitals Reform Commission, the NHHRC, is holding consultations this week in Canberra with Canberra's frontline health workers, ACT Government agencies and members of the community. And the Commissioners are wanting to hear local stories about how well the health system is working and what people think can be done to build a better health system for the future. And the chair of the National Health and Hospitals Reform Commission, the NHHRC, is Dr Christine Bennett, who joins me this morning.

A very good morning to you, Christine Bennett.

CHRISTINE BENNETT:
Good amorning.

ALEX SLOAN:
Now, you're making your way around Australia doing this, aren't you?

CHRISTINE BENNETT:
Well actually we've been on the road for seven weeks now and we've left the best for last here in the ACT. So we're wrapping up the - wrapping up the tour here. So we've done a lot of listening.

ALEX SLOAN:
Okay, so can I ask about some of the issues from around Australia before we get to the ACT? What's coming through?

CHRISTINE BENNETT:
Sure, yeah. Look it's been an amazing consistency, obviously a bit of different local colour and a few specific issues. But what we've been overwhelmed with is people wanting to see more care in the community. They want better access to their GP at the primary care end. And they're wanting care in the home and options that are outside hospitals, which is seen as a real gap. And of course they are concerned about morale and low numbers in the workforce; there's a lot of concern about that.

They're also very concerned about prevention and wellness and wanting a health system that isn't just about sickness, that's also about how to help keep them well. And when it comes to our acute hospitals, which I think one of the surprising elements is that we didn't hear a lot about waiting lists, in fact; we heard more about waiting for access to general practitioners or not being able to get into allied health professionals in the community.

But when it came to our hospital system, the key issues were really around the acute hospitals not really connecting with their primary carer, their GP, or the aged care shortage as well.

ALEX SLOAN:
So you are surprised because hospital waiting lists have been, you know, so much in the media and so much in the news. So you're surprised that that wasn't sort of top order?

CHRISTINE BENNETT:
Well that's right. I mean, obviously if you're on a waiting list or someone, a family member, it's a very big issue.

But the volume of issues, the common concern, was really we can't get to see our GP; we can't afford to get to an allied health professional; we're not getting access to a dentist; or that, look, we know we need extra care but we don't really want to be in a hospital, we would rather have that support and care at home.

Particularly for older Australians who just need that extra bit of support but don't really need to be in an acute hospital bed.

ALEX SLOAN:
So I suppose this goes to the whole sort of skills shortage area as well, Christine?

CHRISTINE BENNETT:
Yes. Look, I think that there are definitely workforce shortages across the board, general practitioners, but also nursing, and of course people in rural and remote areas getting access to health professionals is a challenge across the board.

But it's also, I think, different settings of care. I think that with chronic and complex disease, you're not always needing an acute hospital bed, but you are needing regular support or an additional level of care.

So maybe we're missing an element, a link in the chain, of, you know step down and supported accommodation for respite or for when you're not that unwell but you need that extra level of nursing support, or in fact nursing care and other professionals going into your home.

ALEX SLOAN:
Because that's been very much an issue that we've talked about is nurses being able to step up as well as that link in the chain.

CHRISTINE BENNETT:
Yes, and this is one of the things that we heard about at the consultation last night here in Canberra. Big support here in Canberra for nurses to assist with care, particularly in the community.

And we had some people from a Parkinson's disease group that were very keen to see nurses being able to specialise in supporting people with different sorts of conditions.

ALEX SLOAN:
Tell me about the meeting last night. Let's bring it home to Canberra.

CHRISTINE BENNETT:
That's right. Well we've been dividing and conquering here so a number of Commissioners were at different forums yesterday so unfortunately I wasn't with the consumers last night.

But my colleagues have let me know that hot on the agenda was oral health, so access to dental services, particularly for the elderly and low income.

And a big one from Canberra was also the need for respect for consumers and their wishes, so they're wanting the health system to involve them more in decision making. They want extra - they need help in navigating the health system but they want to do it on their terms.

ALEX SLOAN:
What's an example of that?

CHRISTINE BENNETT:
Well things like end-of-life care, advanced care planning, sort of where you're older, you know you've got - you don't know how much time but you know how you'd like to depart this life. You know you really don't want to be in intensive care with lots of tubes attached.

ALEX SLOAN:
If you can, you'd like to die at home?

CHRISTINE BENNETT:
If you can, you'd like to see out your time at home. And that home may in fact be a nursing home, which is, you know, residential care is your home, and you'd rather have your family. But you will plan that through with your health professionals, and with your loved ones, so that they know and you've had time to think about it and they know and can respect your needs. That would be one example.

ALEX SLOAN:
And so Canberrans are saying look, you know, respect for that kind of desire is not being met?

CHRISTINE BENNETT:
Yes, and even just informed decision making on, you know, what your treatment options might be for anyone. Yeah, I think they're feeling that they want a greater - a greater say in their healthcare and what happens.

ALEX SLOAN:
There's a huge load on the GPs here. We've been highlighting, you know, we've got an incredible shortage of GPs in the ACT.

CHRISTINE BENNETT:
Yes. And I think that's one of the reasons perhaps there was a strong support for nurses taking a stronger role in the care, particularly say for a particular condition like diabetes or breast cancer or Parkinson's.

ALEX SLOAN:
But whether or not the doctors are going to agree to this, whether it comes down to turf wars, Christine?

CHRISTINE BENNETT:
Look, interestingly the issue of multidisciplinary teams, if I can put it in that way, in primary care has been very much highlighted around the country. And from frontline medicos we're certainly hearing that there's a lot of support for practice nurses and other health professionals working with them in their practice.

So it's, you know, there are a lot of excellent examples of nurse practitioners, which are nurses who have a specific role and a specific area of clinical care, as well as practice nurses who have an advanced role in a general practice, where it's working incredibly well already.

ALEX SLOAN:
So, Dr Christine Bennett is my guest this morning, chair of the National Health and Hospitals Reform Commission.

And bringing it all home here to Canberra and hearing from health professionals about the issues here. So those issues of oral services, respect for consumers and their wishes. What else is coming out here in Canberra?

CHRISTINE BENNETT:
Well, also this week we're in fact in the middle of meeting with 26 peak bodies, yesterday and today. And we've also had a meeting here with the health ministers from all around Australia. We've got the frontline health workers that we'll be meeting with tonight. I'm sure we'll hear a lot of views from them. We're expecting around 70, so that's a good group.

And we run these, Alex, in a way where it's a kind of workshop. So it's not just people listing what is wrong with the system. What we're really about is getting people's ideas for how they'd like it to work better and ideas that we can actually action. So, you know, what steps would it take to get to this health system you'd like to see.

And by the way, I should mention that we also hear a lot of very positive things about our health system.

ALEX SLOAN:
Okay, we'd better talk about those before I let you go. So what are the positives?

CHRISTINE BENNETT:
Look, people really value the fact that we have universal access. And they recognise that we've got some of the best healthcare in the world, including very well-trained health professionals for whom there is still a lot of respect.

So, although they're wanting - patients and consumers are wanting more say, but they also recognise that we've got excellent health professionals in this country but we don't have enough of them or they're not distributed in areas of need.

ALEX SLOAN:
So you're here in the ACT, this is after seven weeks around Australia. What happens now?

CHRISTINE BENNETT:
Well now we've been paralleling that with a sort of early deliberation. Now we're into - we've called this our accumulation phase, which also, by the way, had over 500 submissions. And with these peak industry bodies today all that accumulation is now in our heads and on paper. And we're now in serious deliberation and design mode for the next month.

Then we'll be moving into sort of some testing of ideas so that we can wrap this up into say a first report, an interim report, for government at the end of November.

Now, that report will give our thinking but it will also - we will then move into another phase of consultation on that to finalise and provide a road map for implementation for our final report for June next year.

ALEX SLOAN:
Okay, it's a huge job. But this was a key government commitment, wasn't it? That's what you're fulfilling.

CHRISTINE BENNETT:
Yes, and look, I've got some colleagues and myself and a team, a secretariat that are working around the clock at the moment. And it has been incredibly enriching to have gone around Australia and heard from community frontline and health professionals. So it has been great.

ALEX SLOAN:
Dr Christine Bennett, actually coming up after 10 o'clock this morning, we're talking about the fact that women perhaps will no longer need to visit their GP to get the contraceptive pill. So I suppose this all sort of taps into the area you're looking at as well.

CHRISTINE BENNETT:
Well, I think the role of other health professionals, you know, whether they're optometrists, pharmacists, nurses, exercise physiologists, paramedics, all sorts of things. As we've heard around Australia, there's perhaps the opportunity to tap into those health professionals in a different way in getting our healthcare delivered in a timely manner.

End

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