ARRCH Responds to the Bail Out of Victoria’s Hospitals

As we mark 50 years since the Whitlam government’s launch of the Community Health Program, the conversation is perhaps more relevant than ever before, as the severity of Victoria’s hospitals’ budget deficits is revealed.

The Alliance of Rural and Regional Community Health (ARRCH) responds to recently published headlines regarding multiple bailouts of several Victorian hospitals as concern over severe budget deficits mounts.

While ARRCH recognises the complexities of providing high quality health care and maintaining costs associated with that care, the alliance continues to seek opportunities to meet with government ministers and decision makers to construct a positive dialogue about how registered Community Health services across the state can alleviate some of the burdens the current health system continues to face.

By looking at ways to invest in preventative health measures that keep people healthier for longer, we can alleviate the existing pressures on hospital emergency settings by decreasing the number of people requiring acute health services.

One of the fundamental findings from the most recent systemic review of Australia’s health system (October, 2023), is to ‘take things to the next level by developing optimal models of care that seek to deliver care in the right place at the right time, often in community or through virtual settings’.[1] Continuing to invest more than 99% of funding into hospitals, ‘tends to drive more care into hospital inpatient settings.’[2]

The report concludes the current funding of the hospital system has been ‘less successful’ at delivering the right care in the right place to respond to the needs of an ageing population and one with higher rates of chronic and complex conditions… ‘[3]

Despite the strong call for action to address the causes of escalating hospital costs, there was no new investment in the 2024/25 budget for innovative community health solutions to address the unsustainable cost of acute health demand.

Community Health First, an initiative represented by all 24 stand-alone community health services across the state, presented a range of evidence-based solutions to the Victorian Government and Department of Health ahead of the 2024 budget. These solutions would keep people out of hospitals, improve patient’s lives and reduce the financial cost of acute healthcare through an upstream investment, which would fund community health interventions to improve health outcomes and avoid acute health service presentations and utilisation.
Examples of upstream community health led investment opportunities that are proven to reduce acute health system utilisation and costs include:

• The GLA:D® program, which improves the lives of those living with knee and hip osteoarthritis and prevents significant numbers of patients from entering the hospital system, and for those that do, their hospital stay is proven to be a shorter stay with better recovery outcomes.
• The renowned CP@Clinic program places paramedics in community settings where people with some of the most complex health needs and the most significant health inequities live. This program shines, particularly in rural and regional Victoria, where there is limited or no access to a GP. Results show CP@Clinic reduces hospital admissions and improves people’s ability to manage their health in the community.

The solutions proposed by community health are better for patients and reduce health costs as they:

• Alleviate the burden of chronic disease on hospitals by providing tailored support to reduce hospital presentations and bed days for patients with chronic conditions.
• Deliver on the planned surgery reform by optimising community-based non-surgical pathways through evidence-based support for osteoarthritis patients and prehabilitation for high-risk planned surgery patients.
• Reduce the number of emergency department presentations by engaging frequent users and connecting them with necessary preventative supports.
• Alleviate strain on regional and rural health services by expanding access to preventative health services for communities that need it most.

Registered community health services are embedded in all Victorian communities. The time for systemic change is now. This is not about criticising the government or hospitals, but rather how we work together to transform health in Victoria, improve patient outcomes and create a more sustainable Victorian health system.

[1] https://www.health.gov.au/sites/default/files/2023-12/nhra-mid-term-review-final-report-october-2023.pdf
[2] Ibid.
[3] Ibid