Mike Roberts – Hospital administration

Our guest speaker Mike Roberts started his career in health in the mid-70s and has pursued a varied career in many facets of health care since that time.

Key points of Mike’s talk:

• Current expenditure on health in Australia is $140 billion per year, about the same as other Western nations. Highest expenditure is on cardiovascular.
• Health care is funded by a mix of federal and state government, private insurance and individual contributions.
• We face a major challenge . . . Ageing population = rising health and aged care needs.

Challenges to fixing the health system:

• Health services are the most complex organisations devised by humans,
• Diversity of functions, e.g. a mix of up to 50 specialist clinical services (growing),
• The system is messy,
• Governments have an idealised view of the system – a patient’s view can be different,
• People navigating the system experience different time frames, priorities & queues.

So why isn’t the system “fixed” yet?

• Changing complex systems is like “trying to make a tram do a U-turn
• New service capacity and efficiencies are quickly absorbed by growing demand,
• The approach to understanding and solving problems hasn’t been systemic.
• Health is the same as the rest of our community: Even when we know what’s coming we are not good at planning for the future.

Things that give optimism:

• Despite frustrations many improvement activities are showing results,
• High quality people everywhere,
• Made huge improvements in terms of quality and safety,
• Growing interest in using design approaches to solving healthcare,
• Increasing focus on team and leader coaching,
• Great results in some services, e.g., integrated acute medicine, aged and community care,
• New organisational models promise hope,
• Disruptive innovations,
• New treatments, ways of providing care, technology, home support.

Still to do:

• Indigenous health gap,
• Rural health gap,
• Alcohol and drugs,
• Sensible planning cycles,
• Hospital builds and upgrades,
• Implement Aged Care and Community Care reforms,
• Disability care.

Don thanked Mike for a most interesting and informative talk.
Reporter (Acting): Ron Dickson