Tasmania’s health system is broken and needs to change. The Hodgman Liberal Government is committed to fixing the broken system to ensure Tasmanians have access to better health services.

The release today of an exposure draft of the White Paper on delivering safe and sustainable clinical services continues what is already the most extensive and open conversation a Tasmanian government has ever had with the community about health.

The exposure draft outlines proposals for a significant increase in health services available in the North West and an increase in the complexity of cases which can be treated at the Launceston General Hospital.

As a result of the proposed changes outlined in the White Paper, our health system will operate as one single statewide system with each hospital having an important role to play. Hospitals will specialise in the procedures they are best suited to provide, and patients will have equal access to the hospital that is an expert in the treatment they need.

We all know the problems that have been evident in our health system for many years – long waiting lists, too many adverse outcomes from procedures, preventable re-admissions and services which are operating without sufficient regularity to ensure safety.

Many of these problems can be eliminated by getting our hospitals working together and ensuring each delivers the services which, based on evidence and clinical advice, it can safely deliver.
The White Paper takes the community feedback and clinical advice received through the Green Paper process to outline what services each of our major hospitals can safely deliver (see www.dhhs.tas.gov.au/onehealthsystem)

This is not about saving money, it’s about providing better care for patients – ensuring that patients get quality treatment in the right place at the right time.

We want to see more specialists travelling to patients for consultations and treatment. A strong patient travel assistance scheme will also be required as part of ensuring all Tasmanians have access to better services through one statewide health system. However, we anticipate that rather than a greater transport burden, far fewer patient journeys will occur.

In a number of instances, we have identified that additional specialist services can be safely delivered.

The Mersey Community Hospital is well placed to become Tasmania’s dedicated Elective Day Surgery Centre, delivering a range of surgeries (including some which are not currently available at all on the North West), and for which patients all around the state are currently having to wait far too long.

This will help to tackle the unacceptable elective surgery waiting lists, a problem often exacerbated by elective surgeries being cancelled due to emergency cases.

A dedicated Elective Day Surgery Centre at the Mersey will provide a full-time, specialised centre to get people into treatment earlier by enabling a high volume of elective surgeries to be carried out safely and efficiently.

It will alleviate pressure on other hospitals around the state and enable them to focus more heavily on emergency surgery as well as more complex and specialised services they are equipped to provide.
Clinical experts and the Government have for some time been concerned that some services are being provided at volumes that the evidence shows are too low to support their safe operation.

Emergency medicine will continue to be provided at both the Mersey and the NWRH, with the NWRH retaining an Intensive Care Unit and a reconfigured Emergency Department operating at the Mersey.
However, the High Dependency Unit at the Mersey currently caters for an average of only six patients a year who have required urgent ventilation. With these volumes, the HDU at the Mersey is not a sustainable service and critically ill and injured patients requiring higher levels of treatment are more safely and efficiently managed at a higher level facility.

The clinical advice shows that the emergency department at the Mersey is better equipped to stabilise and prepare patients for transfer and to manage critically ill patients than the HDU.

The North West Regional Hospital will also retain its role in providing a range of low and medium complexity surgical services cases. This means surgeries such as general surgery (eg. removal of an appendix or hernia repair) and low complexity orthopaedic surgery (eg. basic knee and hip replacements) will continue to be available at the NWRH.

Evidence shows that, for many high complexity services, outcomes are better when larger volumes of service are provided – that is, if it is done more often, the quality and efficiency of the service improves.

Therefore a small range of highly complex surgical procedures such as complex ear, nose and throat surgery (eg. complex throat cancer) and upper gastrointestinal surgery, which are currently being performed at the NWRH, will need to occur at a higher level facility. We cannot ignore the clear evidence that surgeries of that complexity should not be carried out at the low volumes which occur at the NWRH.

Importantly, the North West Regional Cancer Centre at Burnie will deliver radiation therapy on commissioning of the Linear Accelerator and will operate with close links with specialists based at the Holman Clinic in Launceston.

The Liberals have been long-time advocates for radiation therapy to be available on the North West and we are very pleased that this is coming to fruition.

The links with the Holman Clinic are a great example of how a truly statewide health system will benefit people in regional areas by making specialists based elsewhere in the state available to patients in the North West.

Ensuring specialists are available to consult and deliver services in the North West will also allow specialist rehabilitation, palliative care, and geriatrics to be added to the current mix in the North West, without increasing the costly practice of using locums.

The Role Delineation Framework finds that the Launceston General Hospital can deliver a range of clinical services at a higher level than currently occurs.

There is the demand across North and North West Tasmania for the Launceston General Hospital to deliver a higher level of endocrinology, infectious diseases, neurology, respiratory diseases, rheumatology and pain management, oral health, and Children and Adolescent Mental Health to patients across both regions.

The LGH is currently set up to provide these services at moderate complexity, but the White Paper proposes that the LGH can safely deliver these services for cases with a medium to high level of complexity. In a number of cases this will also allow specialists in these areas to visit the North West to deliver services to that community.

The Royal Hobart Hospital will continue to be the principal referral hospital for the South and will also provide a number of tertiary services for the whole state, including neurosurgery, cardiothoracic surgery and vascular surgery.

It will have an increased capacity for trauma patients, including a $10.5 million helipad.
There are already Tasmanian patients who need to go to an interstate hospital to access highly specialised procedures that can’t be delivered safely and sustainably in Tasmania. The exposure draft recognises that this may need to occur for some pelvic fracture reconstructive surgery and some sub-specialty paediatric or neonatal trauma and burns currently delivered primarily at the RHH. We will continue to utilise interstate expertise where it is in the best interest of the patient.

This Exposure Draft of the White Paper released today outlines a health reform package that will deliver improved safety and quality of services, together with greater efficiency. It is based on the community feedback and clinical advice received through the Green Paper consultation.

We thank clinicians, health professionals and community members who have contributed to the discussion so far and look forward to further feedback about the proposals in the Exposure Draft to provide better health outcomes for Tasmanians.

Download the paper here: Health White Paper

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