There is something different about the provision of medical services in the ACT compared to the rest of Australia. This much we know from figures issued this week by the Australian Institute of Health and Welfare. On the face of the figures, the ACT spends far more and has far more medical workers than the rest of Australia. That may not be such a bad thing. Perhaps we are delivering better and more services to more people resulting in better lives for residents of the ACT. Perhaps we look after ourselves better, seeking medical attention more often.
On the other hand, perhaps we are wasteful in the provision of medical services, spending too much for each service and providing too many unnecessary services.
Alternatively, the statistics might be the result of some aberration or some unaccounted-for factors and the reality underlying them might not be so much different from the rest of Australia.
Overall the ACT, had 351.3 doctors per 100,000 population compared to the national average of 269.4.
The Australian Medical Workforce Advisory Committee noted, “”Medical supply well above the national average in a state, or even a region within a state, is regarded in international benchmark methodology as evidence of a workforce surplus.”
But how does this fit with a popular perception that it is difficult to get some medical services in the ACT.
Part of the explanation lies in the fact that Canberra’s hospitals and other medical facilities service a large area outside the ACT. Moreover, the ACT is servicing the nearby region in NSW in precisely those areas where there is a perception of shortage: the specialities. The ACT has 112 specialists per 100,00 compared to the national average of 84.
It may be, therefore, that the notional over-supply of specialists is in fact a shortage, or about average.
That cannot be said for GPs. The ACT has 151 per 100,000 compared to the Australian average of 116. There would not be a great deal of NSW servicing by GPs, compared to specialists. Most of the regional centres in surrounding NSW have a reasonable number of GPs to service their communities, but for speciality treatment patients have to go to a larger centre. The ACT also has a younger population than the rest of Australia and so should require fewer GPs than average.
There is some evidence that we are not spending efficiently. The ACT Minister for Health, Michael Moore, said that Canberra Hospital costs 30 per cent more to run than the Australian average for similar hospitals.
Also, the ACT has 10.3 medically trained administrators per 100,000 people compared to 4.2 nationally. Perhaps that includes a large number of people in the Federal Public Service. None the less the raw figure is alarming.
The ACT’s high health expenditure might be explained by two other factors. We have higher average incomes than the Australian average. The higher the income, the more is spent on health. Also we are more urbanised than other states and territories and people in urban areas spend more on health than the national average.
Maybe international benchmarking methodology is meaningless rubbish. Why should we strive to be average and be measured against the average? But if we are above the average in the cost and amount of medical services we need to demonstrate that we are getting value for money. Given the disparity, we need an ACT-focused investigation.
That said, there was one pleasing aspect to the statistics. More people in the ACT rated their health as excellent than anywhere else, and more rated their health as very good than anywhere but Hobart. Maybe we are getting above average health care for above average expenditure.