In 2017, the WA Government initiated the Sustainable Health Review to drive the next phase of public health system reform. Without bold reform, State Budget health spending is projected to increase to 38% by 2026–27, limiting funding available for other priority areas across government.
In 2017–18, 7% of hospitalisations, at a cost of $368 million each year, could have been prevented if timely and appropriate health care and management had occurred in a community setting. Addressing wider determinants of health, such as the built environment, can improve health and reduce demand on the health system.
WA’s health system is under increasing strain due to rising demand from factors such as an aging population and obesity, and the impacts of COVID-19. While the government has invested significantly to increase capacity, urgent reforms are needed to address underlying drivers of demand and stresses on the health system. With almost 75% of the health budget directed at hospitals, embracing new models of care that increase focus on prevention, more accessible community-based care, and advances in technology will be needed to improve health, reduce demand on hospitals and improve budget sustainability.
Sector challenges and opportunities
The focus on the COVID-19 pandemic has resulted in implementation of the Sustainable Health Review falling behind schedule, which will need to be expedited to reform health services and reduce demand on hospitals. Health service reforms to enable primary and community-based care to play stronger role, and investment in infrastructure may be required to expand these services and reduce demand on hospitals. Mental health care is also under significant pressure and investment in hospital and community-based facilities, such as supported accommodation, are required to meet demand.
Hospitals will continue to be a vital part of the health system and decisions are required on the future of aging facilities including Royal Perth Hospital, Sir Charles Gairdner Hospital, Graylands Hospital and Selby Lodge.
There are opportunities to utilise digital technology in transforming health care. Technology such as electronic medical records and telehealth are central to modernising and reforming the public health system.
The State Public Health Plan for Western Australia and public health assessment also have potential to drive greater whole of government action to improve health through increasing consideration of health in strategic planning, regulatory processes and infrastructure proposals.
For Aboriginal people, health facilities that support a holistic approach and delivery of services in a culturally safe and sensitive environment will be required.
The health and medical life sciences sector has potential to support WA’s economic diversification and growth. Investment in research and development infrastructure can support commercialisation of new products and elevate WA’s global standing in the field.
In 2007, the European country of Denmark initiated major reforms to improve the sustainability and effectiveness of its health system by focusing on moving treatment out of hospitals and into the community. Denmark was facing a range of challenges, such as an ageing population, increasing chronic disease, technological change and rising hospital costs. To respond, Denmark reorganised its health system by providing fewer but more specialised hospitals, increasing the supply and access to primary and community care, and investing in enabling technology, such as electronic medical records and telehealth. For further information, refer to: https://www.healthcaredenmark.dk/