Page 184 - Week 01 - Wednesday, 28 November 2012
they are being cared for appropriately by mental health staff or, in the pursuit of not having long-wait patients in the mental health unit, is it best to kick them out, or kick out someone in the mental health unit?
These are decisions that clinicians need to make. If the mental health unit is full and there is a person that needs to be cared for safely in the mental health assessment unit, which is a six-bed specialised unit within the emergency department, and they are going to ruin the numbers or have a long stay there, what is the option? Boot them out and make your numbers look good? Boot someone else out from the adult mental health unit to make them look good?
Mr Hanson: How often does it occur?
MS GALLAGHER: It happens—and, again, I guess it depends. I would have to take some advice on exactly how often it happens. But to my knowledge, where there are patients in the emergency department, the longest waits within the emergency department would occur in the mental health assessment unit.
MADAM SPEAKER: A supplementary question, Mr Gentleman.
MR GENTLEMAN: Minister, can you tell us what concerns you would have about just providing beds and not the community support services to go with them?
MS GALLAGHER: I think any health minister has to make sure that there is efficient use of the health dollar, and the most expensive part of the health system is the provision of beds. They are important, and you have to provide more of them as the health system grows. But you also have to be looking at how you provide your services. So that goes to the models of care, the partnerships in the community sector, the amount of care that can be provided in home. Increasingly, people are wanting care in the home. Hospital in the home is a very popular program delivering good results not only for freeing up capacity within the hospital but for people who actually want to be cared for at home with appropriate clinical support.
All of these are part of the new health system under health reform. They will continue. It is easy to understand the focus of people on beds as being the only answer, but it simply cannot be the answer because, one, there are issues around work force, two, there are issues around budget and, three, it never solves the problem. You open the beds and the beds fill up. It does not change what needs to happen in the health system to make it efficient and effective for patients. Beds in the hospital are not necessarily what patients want. They want access to care, and that care needs to be provided in a variety of settings.
MR GENTLEMAN: My question is to the Minister for Health. Minister, can you please advise the Assembly how your plans for health over the next four years will create a sustainable, modern health system?