A fit, strong, healthy community, that’s what every government wants. And the residents of that community want accessible, timely and safe health care. In the Canberra, the Nation’s capital, one could be forgiven for thinking that it’s entirely achievable. But assumptions can disappoint and after more than twenty years, the ACT Government has more than it’s share of challenges in delivering world-class health care to the residents within its boundaries, let alone any poor traveller who may find themselves unfortunate enough to need to call upon its services.
The safe, responsive system that has been envisaged (Annual Report, Strategic Objective 2) has fallen far short of the ACT Government’s own targets according to its 2022-23 Annual Report.[i] In three of the five measures, the result is poor. Notably a fire in the Calvary Public Hospital Bruce has, and continues to impact adversely upon figures for surgery, but is this sufficient to fully explain the result? What is driving the increased demand for emergency surgery?
Strategic Objective 1 indicates that the Territory’s preventive health aims outlined for the period 2020-2025[ii] are struggling to be realised. Concerningly, less than 49% of ACT adults report being mentally well and less than 47% of ACT adults their overall state of health as being very good or excellent (Annual Report, Strategic indicators 1.1 and 1.2). The pandemic has had an undeniable impact, but is to blame for such disappointing figures?
Implementation of the digital health record (DHR) is stated as the explanation for the lack of result reported against indicators including the number of surgical complications requiring unplanned return to theatre as well as avoidable readmission to hospital. Surely the department did not simply stop collecting data during this major operational change. More curiously, as the DHR rolled out across the ACT public health system[iii] and which can be assumed to include emergency departments, why could the Directorate generate data to report on emergency department presentations with a length of stay of no more than four hours? Strategic Objective 1.3 reducing the risk of femur fractures in residents aged over 75 years, also has no result, again because of the implementation of the DHR.
The report spends some time outlining the initiatives taken in 2022-23 to improve health in the Territory but the figures are not bearing out the positive outcomes in the report that one would expect. Looking to the future, it discusses efforts to engage in programs to address the mental health of various groups, including Indigenous people. The report ignores the fact that without addressing the glaring disparity in incarceration rates and the blatant racism within the ACT there cannot be significant improvement for the First Nations people of the Canberra or its surrounds, especially when it has shown that it will reach far across its border to continue to persecute Indigenous people.[iv]
Overall, the report is a disappointment for its poor performance or lack of transparency against keys strategic metrics. As with all things government, no less in the ACT than other jurisdictions, the report demonstrates the opacity with which the ACT Government operates. Having been led one political party for so many years, one would expect a better report card. Voters would be wise to consider all options at the ballot box.
[i] ACT Health Directorate, Annual Report 2022-23. Australian Capital Territory, Canberra 2023
[ii] ACT Health Directorate, Healthy Canberra ACT Preventive Health Plan 2020–2025. Australian Capital Territory, Canberra 2023
[iii] Stephen-Smith, R. Media release: A world-leading Digital Health Record system for the ACT. ACT Government, 27 July 2020.
[iv] Watershedd, Justice4Mullins, a black life that matters. BlakandBlack, 31 July 2020.