Page 2677 - Week 08 - Thursday, 24 August 2006
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solution. There is talk of increased efficiencies, but the estimates committee was concerned at the lack of detail of how the government intends to reduce the growth of health funding in this and subsequent budgets. The committee was also concerned about the number of discrepancies in different parts of the budget paper. Does ACT Health really know where it is going?
More money in this budget is going into acute rather than community-based services. There is projected growth of eight per cent in acute care service funding but only 2.5 per cent for community services and three per cent for public healthcare services. There is no net increase in the funding for early intervention and prevention strategies, but we all know that a greater focus on early intervention and prevention strategies would relieve the pressure on the emergency department, hospital beds and elective surgery waiting lists. As the chief health officer has said, disease prevention and health promotion activities are a mainstay for future health gain. A major way in which rapidly increasing health costs will be constrained will be through a greater focus on prevention and community education.
We must also consider recovery focus models in this debate. Evidence from around the world shows that improved support beyond acute episodes is better for the patient’s recovery and cheaper in the long run. Maternity services and mental health are two clear examples where we can cut our costs for better outcomes.
Midwife-led care overall has better outcomes and costs less than obstetrics-led care. But the shortage of midwives is leading to fewer options for women and greater costs to the ACT budget. We already have the highest rate of surgical interventions and, unless something is soon done to assist women wanting natural childbirth, our health costs in this area will continue to grow.
The Canberra Birthing Centre is often unable to meet demand and, as the Minister for Health has pointed out, an expecting mother must book in before she is five weeks if she is to gain a place. Independent midwives are also unable to practise, due to the incredibly difficult insurance costs. Until now, the ACT government has refused to provide support for independent midwives, making home births more difficult to arrange. It has also rejected other key recommendations of A pregnant pause, the Assembly committee inquiry into maternity services, such as a more comprehensive and better coordinated approach to midwife-led birth. This is unfortunate, as midwife-led care is both preferred by many women and is much less expensive than the medical model, as the New Zealand experience shows.
I was certainly pleased to hear that the Minister for Health is going to take some action on these issues and that a working group has been established to provide her with advice. I hope that in next year’s budget we will see a proposal by the minister on how to rearrange our services to assist the demand for natural childbirth and minimise our increasing health costs.
Dental health received no attention in this budget, yet it is a major issue for people on low incomes who have to wait up to a year for service. The growing waiting list for dental services is appalling. There is an urgent need for increased services to improve dental health. We all know now that poor dental health has strong links to general health
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