A virus epidemic may push us towards healthy reforms

There are already reports of overworked emergency departments and long waiting lists to see specialists, and for admissions for elective surgery in public hospitals, even in affluent places like Canberra.

The pressure on public health services is symptomatic of risks to the sustainability of our health system nationally and particularly on elderly and low-income Australians.

The vision of hospitals struggling to meet a potentially large and different challenge posed by COVID-19 is already prompting consideration of changes to meet the hazards of widespread contagious disease.

Such measures might include reforms that have been long suggested, including Medicare-financed telehealth for GPs.

If patients could consult their GPs by telephone, Skype or other video means, that would reduce the need for unnecessary visits by patients. And wider government use of available beds in private hospitals for elective surgery could also lighten the heavy load on public wards.

We must hope that the optimism expressed by authorities that Australia is well-placed to meet a potential "surge" of cases triggered by COVID-19.

That may be so. The fact is that too often there are pain points in the system that mean people are not taking up referrals for treatment because of high gap fees, and many people who have private treatment then face excessive out-of-pocket costs. The result is that the impact of poor access to specialists is that people are getting sicker and their illnesses more chronic, and when they finally get to hospital they are often more expensive to treat.

The overall cost to the taxpayers of our delay-plagued hospital system is not just in additional or longer treatment and hospital stays.

People of working age who may need elective surgery, perhaps a hip replacement or cataract procedure, often end up having to stop or reduce their work - at significant cost to themselves and to economic productivity.

Yes we need more specialists in public hospitals, but state and territory governments are reluctant to bear the additional expenditure and there seems little will to resolve the limits on the supply and demand of specialists.

We need to look at better triaging of elective-surgery public hospital patients, given there appears to be capacity available in private hospitals to treat them, provided the government funds such cases. That in turn could free up public hospital resources temporarily to accommodate urgently affected patients.

Consumers, doctors and administrators should be getting together to work out solutions.

Even small steps forward would make the system more sustainable and demonstrate the benefits of change.

Primary Health Networks and local hospital networks working together are a way to drive change. Another avenue that might be opened by the influx of COVID-19 cases is a move towards steps that stem the flow of people into hospitals.

As it is, avoidable admissions to hospitals place significant strains on the system.

So many of these cases could be reduced by improved support for GP-led team-based care that could short-circuit or alleviate chronic illness in patients who would otherwise end up in hospital.

And now, more than ever, we can all acknowledge and practise preventive healthcare - washing our hands regularly and avoiding touching or close contact with strangers.

That might also help all of us to understand the wider benefits of preventive health - that there is much we can do personally to remain healthy by improving our lifestyles.