Patient-centred care? At what cost?
The federal election is upon us. Everyone knows money is tight, and the government must continue to focus on making careful choices about where to spend the available health dollar
I constantly hear that the focus needs to be ‘patient-centred care’. But at what cost to clinicians? We need to have a close look at the working circumstances of physios in the bush.
There are 3.3 times the full-time equivalent physiotherapists in major cities than there are in outer regional areas in Australia. Although the rate dropped 17 per cent in major cities between 2011 and 2014, it dropped 38 per cent in outer regional areas during the same period.
Each year in physiotherapy there are 22 serious workers compensation claims that have resulted in one working week or more being lost (excluding journey claims and fatalities).
We need to tackle the underlying issues that contribute to workplace safety. This means we need enough physiotherapists ‘on the ground’. We need to ensure that two people work together and travel together in all necessary circumstances when they tackle ‘on-call arrangements’.
We need to tackle turnover. High turnover in the bush reduces the building of informal networks at individual and community levels. We want people to notice when we aren’t around, but should be. We need to ensure that there is enough funded time for orientation, so that physiotherapists understand local policies and use them effectively. We need to increase the incentives for experienced, smart managers to stay in rural locations—they build strong, safe teams.
We need urgent action to fast-track the national program for reducing mobile phone dead spots throughout rural and remote Australia. We want to consider a policy where all vehicles are fitted with effective tracking devices.
Minister for Rural Health Fiona Nash has said that we should be doing all we can to ensure remote health workers are safe.
In this federal election, it is time for the political parties to make access to safe, high-quality physiotherapy care for rural Australians a sustainable reality.
Let’s see the regulation for private health insurance create incentives for real access among fund members in the bush. Let’s see Primary Health Networks funded to offset the real costs of lost time travelling in rural settings.
We need to strengthen, not weaken, the professional communities in rural towns, so that effective services can be safely delivered.
If we want to be patient-centred, let’s be physio-centred. It works.
Marcus Dripps, APAM
APA National President
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