Behind The News - 19 June 2012

MO asks experts for their opinions on the clinical or political issues making headlines.

A RECENT paper in the Australian Health Review claiming the benefits of community-based health care had been oversold touched raw nerves in both the community health and hospital care sectors.

The author, Northern Sydney Health senior staff specialist Dr Paul Cunningham, said primary care was winning the war of words for health funding at the expense of the hospital sector.

Dr Cunningham claimed the primary sector’s focus on public awareness gave it an advantage in the policy debate, as the whole primary health care ethos was about public awareness.

Dr Sally McCarthy
President, Australasian College of Emergency Medicine
“Further development of primary care is very important but it cannot directly substitute for hospital care.

The common ‘straw man’ put up is that people come to emergency departments unnecessarily, but that is not based on any of the evidence. That argument sounds believable, it is accepted anecdotally in the community, but the evidence is not there to support it.

It is not overcrowding in the emergency department waiting room that is the problem, it is the lack of acute beds in the hospitals.

The reality is there has to be investment in both sectors and better integration and communication between all parts of the health system.

It is often put up as an either?/?or argument but I think more and more we are all, as health practitioners, calling for the same things from government.”

Bob Wells
Director, Menzies Centre for Health Policy
“Every year you save in terms of the average age of patients needing to access hospital care, you also save millions of dollars.

The trick is to extend the period where they don’t need that hospital care as long as you can.

Community care can perform a lot of the functions traditionally performed by the hospital sector, but in a lot of cases the patients can be better managed. There is a lot we can do in the community care sector to keep people out of hospital longer, but it’s not true to say government is investing in community care at the expense of the hospital sector.

The mix has to reflect what’s best for the patient and the best treatment that we can offer is not always in hospital.

Nobody is saying we shouldn’t have hospitals, but we still need a stronger primary care sector which reduces the need for people to access those hospitals.”