Publications

Reflections from the Online HCCA Election Forum with Canberra Liberal’s spokesperson Leanne Castley MLA (2024)

4 October 2024

HCCA recently held a series of online forums in preparation for the 2024 ACT Election. In the third forum, ACT Opposition Health Spokesperson, Leanne Castley MLA joined HCCA members to talk about the Liberal’s  policy platform and what they see as priority issues in the ACT health system.  

HCCA has developed our own priorities for health for the ACT Election and you can read our statement of priorities on our website (https://www.hcca.org.au/publication/hcca-statement-of-priorities-for-the-2024-act-election/)  

HCCA members and guests submitted questions they have about health issues and services in the ACT to be asked during the event. 

 

Canberra Liberal’s Health Priorities 

Leanne Castley MLA opened the session declaring her commitment to a positive and constructive approach to health service improvement. She is taking a ‘positive, visionary approach’ without negativity.  

Ms. Castley discussed her personal experiences of the health system and the significance of health setbacks for vulnerable populations.  

Given the size of the ACT’s investment in health – 33% of the ACT budget – the Canberra Liberals think we should be achieving better outcomes. Although their election policies are yet to be released, some of their health priorities include:  

• Access to timely care 

• Provision of evidence-based care and services 

• Strategic wait list management,including a focus on consumer centered triage and prioritisation 

• Preventive and primary care, including repealing the GP payroll tax   

• Workforce support, including culture improvement 

• Support to access assisted reproduction, 

• Wise expenditure, and 

• Transparency in decision making. including a Royal Commission into the Calvary Hospital take over and public access to health service performance data. 

Ms Castley stated that our Emergency Department shouldn’t be struggling, primary care should not be so expensive, and people should not have to wait so long for outpatient care. She committed to putting  clear, actionable steps on these and other issues to take immediately after the election, if they are elected to government.  

Note: Darlene Cox commented that activity and performance data is needed in the public domain if we are to be able to monitor whether a new government will achieve better outcomes. HCCA is keen to talk further with Ms. Castley about transparency and public access to important information and data.  

 

Questions from the audience 

The questions from the audience focused on a range of issues including access to continuity of midwifery care, systemic change and governance principles, timely access to specialist and primary care, and barriers to safe and inclusive health care.  

Darlene Cox moderated this discussion and provided context to consumer experiences and current services.  

A selection of the audience questions and a summary of Ms. Castley’s responses are shared here.  

 

How can we get better access to womens’ services across the lifecycle including midwifery continuity of care and menopause support? We hear from consumers that the waiting time for the menopause clinic at SHFPACT is currently five months. 

Answer: Support needs to address the whole person and their wellbeing. This should include food, exercise, preventative health advice and support for families. Ms. Castley reflected on her own challenges with accessing support for health issues. Ms Castley shared the experience of her daughter-in-law who recently came home within 24 hours of her recent birth and had visits daily from a midwife. This was a positive experience, including having the support of a midwifery student who provided continuous support. She has been engaging with midwives who support a free-standing birth centre. 

 

If you formed Government, what would you change in the ACT health system? What would be your governing principles in any reform? 

Answer: Workforce is the most important part of any organisation. The health workforce needs the right resources and to have their contribution valued. Ms Castley understands that health service staff have been unhappy over a long period – and that the turnover of both junior and senior front-line staff shows this. There is a disconnect between front line experience and management/government. 

Darlene asked about practival steps Ms Castley could take to address the long standing cultural issues the Canberra Liberals have talked about. Ms Castley responded that she believes we need significant, bold change focussing on the needs of workers. Patient focussed changes would follow workforce focussed improvements.  

Darlene asked about the approach to reduce waiting times for elective surgetry and outpatient clinics and noted that some people have extended waits, well outside the clinically recommended period. Ms Castley acknowledged that the community is distressed by waiting times Ms Castley suggested that the private sector could be engaged help to get Canberrans off waitlists.  

 

What would a Liberal Government do to make primary healthcare and non-acute specialist care more available to consumers in the ACT? How can we do this better – provide access consistently and equitably?  

Answer: The Canberra Liberals believe a Royal Commission may be the best way for ‘outsiders’ – including opposition MLAs and consumers – to get information about the system. Information should be able to be easily shared between systems (public and private). There may be liaison opportunities for the systems to provide integrated care.  

 

How can specialist and acute care work together better?

Darlene Cox suggested that the Digital Health Record (DHR) has a role to play in this and that HCCA sees it is important to think about holistic care, across the system (public, private, primary).   

Ms Castley agreed that DHR should be helping with this. She believes that the records system needs to be integrated with primary and private specialists to be most effective.  

There may be opportunities for utilising private insurance better in order to free up capacity in public services. 

Note: Darlene Cox advised that currently there are loopholes which facilitate consumers seeing a clinician privately in order to jump the list for procedures undertaken in the public system.  This is an issue that needs to be addressed to improve health equity 

 

What are your thoughts on the potential for the government adopting a ‘Fragrance-Free’ policy within healthcare facilities to reduce barriers and improve inclusive healthcare? 

Answer: We need to bring information together to understand what people struggle with and to ensure everybody can be as comfortable and services as inclusive as possible. Ms Castley said Canberra Liberals will not leave neurodivergent people behind. Infection control is important, but where there are options for fragrance free cleaning chemicals we should be using those.  

It has previously been a requirement to wear no accessories (watches and rings) when working on the ward and it should be achievable to include a ban on consumer facing staff wearing fragrance. 

 

What are your party’s policies on improving waiting times in ACT hospitals? 

Answer: The Canberra Liberals  approach will be to reduce the waiting list. The party will look at how to use capacity within the private system to achieve that. Ms Castley wonders what the impediments might be to working with the private system to work through the backlog of people on waiting lists. She has heard from the private sector that the sector is keen to do this but not at the expense of their core business. Ms. Castley stated her belief that it is unacceptable to wait 1000 days for treatment. .  

  

 

What actions are you going to take to support healthcare workers in hospital care, such as improving tertiary-level sociocultural education and fixing the massive gaps in health communication between individuals and institutions? How do we improve and change culture? 

Answer: Ms Castley believes it is a priority to retain junior doctors. It takes years to change culture, identify the cause and address the issues. Staff turnover is a problem.  

The Liberal party plans to be more agile and try new things even if they are difficult. Ms Castley will listen more to front line workers who have ideas. Staff need to be able to trust the process, have the confidence to ask what they need and expect that what they share will be acted on. 

Canberra has grown and the health system needs to grow with us. Ms Castley shared it is worth taking risks and doing things a bit differently.  

 

What is your stance on Voluntary Assisted Dying (VAD)? What challenges can you see in implementing VAD? 

Answer: Ms. Castley voted in favour of the VAD Bill 2024 but remains concerned about strict eligibility. Nurses have expressed concerns about the legislated requirement to refer on within two days. Ms. Castley also has reservations about the potential for scope creep – including the potential for access for young people.  

Note: Darlene Cox noted that VAD is a cross-bench achievement of this term of government.  

 

Volunteer-based organisations could benefit from funding to help people. Commissioning is an ongoing, protracted process, what are we doing in the interim? 

Answer: The Canberra Liberals is aware that funding for community organisations has not increased and organisations are increasingly expected to do more. This is on the radar for consideration and action.  

Note: Darlene Cox highlighted that there has been an increase in the prevalence of chronic conditions and no funding increase to match. HCCA invited Ms. Castley to connect more regularly post-election.  

 

Since this discussion the Canberra Liberals have released their health policy. It is on the Canberra Liberal’s website: Caring for Canberrans – Canberra Liberals (freshopportunity.org).