“It is now 40 years since the introduction of Medicare and the Grattan Institute report recommends changing how doctors work and are paid, replacing a system that rewards doctors for ‘quick consultations’,” writes MICHAEL MOORE.  

“IT was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity”. 

Charles Dickens’ reflection, in the opening paragraph of “A Tale of Two Cities”, effectively describes the management of our health.

On the best of times, the Canberra Hospital was finally accredited and the restrictions from the pandemic lifted. People have been able to gather together, to travel widely and to make healthy connections. The government in the ACT has invested in protection, prevention and health promotion.

However, regarding the worst of times, the pandemic is not over. Last week marked a thousand days since the pandemic was declared by the World Health Organization. COVID-19 is still rampant. Incredulity regarding the importance and efficacy of vaccines, the challenge to election outcomes internationally, and the role of government generally, have cast a dark shadow over the broader health of the population.

Wisdom was displayed by Canberrans in electing David Pocock and Katy Gallagher to the Senate while rejecting the ultra-conservative policies of Zed Seselja. Wisdom was displayed in rejecting Scott Morrison and electing the very effective Andrew Leigh along with Alycia Payne and David Smith.

Some effort has been made to keep people healthy such as the program for babies in the first one thousand days. Federally, there is commitment to an Australian Centre for Disease Control. Hopefully, following consultation, to be a Centre for Disease Control and Prevention.

However, it was also an age of foolishness as half-baked measures and actions have allowed the pandemic to keep spreading. Foolishness has been seen in the cutting of hospital budgets and consequent increases in waiting times.

Although the Canberra Hospital has been accredited, this is the year in which youngsters have died when lives ought to have been saved. The most recent report from the Australian Institute of Health and Welfare paints a damning picture where the ACT median emergency department (ED) wait time was 47 minutes. The national median is 20 minutes and in NSW it is 14 minutes.

Shadow health minister Leanne Castley pointed out that “this is the fifth year in a row that Canberra has recorded the worst ED wait times in the country”. 

“Each year the Labor-Greens government tells Canberrans that they are implementing new models and reviewing their practices, yet they continue to languish at the bottom of the list for ED performance in the country,” she said.

Ms Castley was scathing about the “more than 3300 Canberrans leaving ED without being seen because of excessive wait times”. She suggested the “Labor-Greens government has not been able to deliver reliable assistance to patients who require urgent and specialised care for the community since 2017-18”.

At the Federal level, the Grattan Institute has identified that Medicare is no longer fit for purpose. The “fee-for-service” model of care in general practice is not suitable for chronic conditions that impact on so many Australians. Failures of the primary care sector adds pressure to hospitals.

It is now 40 years since the introduction of Medicare and the Grattan report recommends changing how doctors work and are paid. According to Grattan, it is time to replace a system that rewards doctors for “quick consultations”. 

Looking into next year, the pandemic will loom large. On the worst of things, there are a million COVID-19 cases every day worldwide with 5000 fatalities. On the best of things, the fatality rate has fallen now from the original 6 per cent to 2 per cent a year ago and now to 1.03 per cent. A combination of immunisation and useful treatment has been a huge benefit to many people.

The last few years have been an odyssean journey. However, there is the hope for better things ahead. The pandemic may still be raging, but for those who are fully vaccinated and those able to access antiviral drugs hope remains. 

According to Dickens: “It was the spring of hope, it was the winter of despair, we had everything before us, we had nothing before us”. Dickens began his book as both the optimist and the pessimist. In Canberra it is a time to bury the pessimism and look forward with optimism.

Michael Moore is a former member of the ACT Legislative Assembly and an independent minister for health. He has been a political columnist with “CityNews” since 2006.