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Transcript - Dr Christine Bennett with Madonna King, ABC Radio Brisbane, 18 June 2008

Station: ABC 612 Brisbane
Date: 18/06/2008
Program: Mornings
Time: 08:34 AM
Compere: Madonna King
Summary ID: B00031072815
Item: King says there are few things more important than our health, and that the national health and hospitals reform commission has been travelling the country to investigate the ways our health system can be improved.
Interviewees: Dr Christine Bennett, National Health and Hospitals Reform Commission

Madonna King:
Few things more important than our health, and a big new reform plan for the national health system is being nutted out now.

Federal Cabinet approved the setting up of a commission, it's called the National Health and Hospitals Reform Commission, early this year. It's headed by Dr Christine Bennett and it's been travelling the country trying to work out the new blueprint for our health system. And today the commission is in Brisbane.

Dr Bennett, welcome to Brisbane and 612 ABC.

Dr Christine Bennett:
Thank you, good morning.

Madonna King:
How wide is your brief?

Dr Christine Bennett:
Well, we've got a very unique and special role looking at the whole health system in its entirety and taking a long term view as to how that system should be structured, governed, financed, and ultimately what sort of services we want to deliver to our community.

Madonna King:
Can you tell me something about yourself? You've worked in the public hospital system?

Dr Christine Bennett:
Yes, well I've got a good helicopter view, actually, because I've been a paediatrician in a former life as well as run major public hospitals; been in public health planning, but also worked in the private sector with private companies and I’m currently the Chief Medical Officer of BUPA Australia. So I've seen all dimensions, plus I'm a strong advocate for medical research.

Madonna King:
How did you find the public health system from the inside?

Dr Christine Bennett:
Look, there are some fantastic people working there, it's a really inspiring system. And, frankly, some of the best healthcare in the world is delivered in the Australian public hospital system and public health system as a whole. So it was a very, very positive experience.

However the system is under pressure and a lot of our very committed staff are feeling that they're not being able to provide the level of care that they want for their patients, and the level of human care, as well as medical care. So it certainly has a lot of frustrations and has a good deal of opportunity to improve.

Madonna King:
Well what have people been telling you as you travel around - patients?

Dr Christine Bennett:
Yeah, well actually we've been speaking to community groups - the sort of, you know, ordinary punters, really - as well as those who actually use the health system. And we've been talking to frontline workers which, I think, is a really important dimension of what we're doing. It's not just talking to the senior managers but the actual people at frontline...

Madonna King:
Yeah, but what have they been telling you?

Dr Christine Bennett:
What they've been telling us is that access obviously is a major issue...

Madonna King:
Is this waiting lists, access to get into hospitals?

Dr Christine Bennett:
Well, interestingly it's, yes, hospital access is obviously the hot point, but they're actually saying we want more community-based care, and care in the home. Care in what we'd call sub-acute environments, which is where you've still got supported accommodation but it's not a hospital bed, is really not happening for the Australian community.

Madonna King:
What is community-based care, what would be an example?

Dr Christine Bennett:
Well an example would be currently - in our current model - a general practice, the multi-disciplinary general practice; a community health centre. It might be home nursing visiting. So anything out of hospital based in your home or in your local community, not actually in a hospital institutional setting.

Madonna King:
Isn't it jumping the gun for a lot of people who are on these really long waiting lists just waiting for an operation?

Dr Christine Bennett:
Sorry, jumping the gun?

Madonna King:
Yeah, jumping the gun on the primary problem. A lot of these people can't have the initial operation to get fixed.

Dr Christine Bennett:
Well, I think what people are also saying, though, is - and, look, obviously that is an issue. But, I have to say that in moving around the country the people are - what they're talking about is they want better access to their general practitioner and - this is what the people are actually saying - and they want to only be in hospital when they have to be in hospital and there aren't options for them to be out of hospital.

So we are actually here in Brisbane tomorrow having a specific industry workshop on the acute care part of the system with both public and private providers. So that should be a very interesting workshop.

Madonna King:
What's better access to a GP mean? It's too long to get in, too long a waiting period to get into see your GP?

Dr Christine Bennett:
Yes. The things we've been hearing are the - wanting to have a relationship with a specific general practice or practitioner; being able to get timely access and being able to contact those general practitioners or that practice out of hours. But also wanting to have access to other allied health professionals in that environment...

Madonna King:
So they want to go to the one medical practice where there's a physio, a speech therapist as well as their GP and nurse. Is that what you're trying to describe?

Dr Christine Bennett:
Yeah, the one-stop shop kind of suggestion. Although they're also wanting specialist care in the community as well. So a lot of people, for example, who are recovering from cancer or who have mental health issues are wanting that sort of specialised care but in a community setting rather than in a hospital setting.

Madonna King:
So what you're saying is broadly - and I know we're being a bit generic here - but broadly people are wanting not so much a change to our hospital system but the delivery of services outside the hospital system?

Dr Christine Bennett:
Yeah, people are seeing that as a gap. We're not saying that's the only solution to hospital care. I mean obviously there are issues of capacity, and as we age we're going to have to look at the hospital end. It's not to say that isn't a major issue but people are suggesting that the real gaps are lying outside the hospital but because they aren't the hot-point - it's not where the waiting lists are appearing - it's that it's not getting heard.

Madonna King:
A lot of concern seems also over what the Commonwealth does and what the States do. Are you looking at that break-up?

Dr Christine Bennett:
Yes, definitely. I think that has been a strong message too. People want a nationally consistent health system...

Madonna King:
Could that mean at the end of the day you recommend the Commonwealth take over health?

Dr Christine Bennett:
Look, we're not going to pre-empt any particular outcome because I think there's many models that could work here, and we are exploring those at the moment through both the consultation and also some specific workshopping we're doing.

But the message of national consistency, the end-to-end continuum and integrated care is what the system should look like, whatever the government structure is.

Madonna King:
I'm surprised waiting lists isn't a big priority or a big concern, given the number of people who call this program nominating it as their number one issue.

Dr Christine Bennett:
Yeah, look, we're talking to frontline workers across the system, even those in hospitals and the emergency departments, for example, and they are saying, you know, there are innovations - because, by the way, we're looking for answers not just issues here - but the innovations are where they've got effective relationships with nursing homes, for example.

So an emergency department can create protocols with the nursing home so that only those patients who need to come to the acute environment come, and then support is provided to those nursing home patients.

Madonna King:
When do you report back to the Prime Minister and the Health Minister?

Dr Christine Bennett:
Our next reporting date is in November, and our final report mid-next year.

Madonna King:
Dr Christine Bennett, thank you.

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