At the time, the AMA ACT president, Professor Steve Robson, said he preferred the Liberals' plan as ACT Labor's proposal was on a much longer timeline and there was a "rapidly closing window of opportunity to move forward with the Canberra Hospital expansion, before the existing facilities would be overwhelmed."

Fast forward to 2020, and those concerns seem all too real.

Either way, I have a sneaking feeling that, even if the Canberra Liberals had won the last election, we could still be in a similar position today - waiting for a new hospital to open. Such are the vagaries of election promises for big-ticket items. Costs blow out, people get nervous, other priorities fly in - some excuses are acceptable, and others not. I'm coming up to five years of being much involved with ACT Health, and in that time have developed admiration and respect for our many of our Health leaders - but there is much in this campaign that we as a community must ask of them, and demand answers to those questions.

The fact is, our healthcare system is incredibly complex and spans the range from major public hospitals to general practice and allied health workers through to the compassionate touch of a loved one or carer. It can be incredibly daunting for patients and their families, and it can be incredibly rewarding for the people who work in it.

So, what is it about Canberra that makes our local healthcare system the subject of both criticism and praise, and what can we do about it? To start to work towards an answer, the AMA ACT believes we need to: firstly, find out what's really happening with the way we fund our public hospitals, secondly, work towards better integration of our local healthcare system, and thirdly, look after each other and focus on mental health.

For many years now, the AMA Public Hospital Report Card has shown our ACT public hospitals to be falling behind the rest of the country in waiting times for both emergency department treatment and elective surgery.

The question is: why are we seeing this underperformance from our public hospitals?

Former ACT chief minister Jon Stanhope and ex-ACT Treasury official Dr Khalid Ahmed believe a significant part of the answer lies in the special characteristics of the ACT public healthcare system, and a consequent unwillingness by government to properly fund our public hospitals.

Stanhope and Ahmed claim that the main factors contributing to the relatively high cost of the ACT public hospital system are the small scale of the local operations and the cross-border patient flows from NSW.

While this makes sense for those of us who live and practice in the ACT, their research explained how these factors lead to the need for relatively higher funding than other, larger jurisdictions. Tellingly, ACT Labor has not responded to Stanhope and Ahmed, while the Canberra Liberals have remained likewise silent.

Our community deserves a response from both major political parties because, if Stanhope and Ahmed are right, whichever party forms government after the October election will be faced with deteriorating public hospital performance and further delays in waiting times for emergency department services, elective surgery and outpatient appointments.

I challenge both major parties to tell us where they stand on this issue.

While it's important we get a better understanding of why our public hospitals are underperforming, we also need to focus on improving the way we deliver care. For some time, we've known that if we can better integrate care across our health system - from public hospitals, to general practices and on to allied and other healthcare services - better outcomes can be achieved for our patients.

In other words, patient-focused, GP-led integrated care.

We know it's a challenge to bring the various parts of the healthcare system closer together and get them working in harmony - particularly during a time of COVID-19. But that's where the big gains lie. ACT Health knows this, as does Canberra Health Services, as well as our local primary care network. GPs know it and, most importantly, so do our patients.

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This is also why ACT Labor's recent announcement of five new walk-in centres was so disappointing to me. At a time when we all should be working towards better integration of care, the new walk-in centres, where people are seen on a one-off or very short-term basis, carry with them the risk of further splintering that care. Instead of encouraging all Canberrans to have a GP and see them regularly, $30 million annually will be spent on running the new walk-in centres. It is vital as well to ensure that such walk-in centres, if co-located in a general practice, are done so with probity and transparent expenditure of public money in an open tender process - not, as has been announced, in partnership with one particular practice without opportunity for a competitive process.

I'm an optimist, and I believe it's not too late to persuade Chief Minister Andrew Barr and Health Minister Rachel Stephen-Smith to change their minds and come on board to ensure we push forward with patient-focused, GP-led integrated care for our Canberra community. In fact, whoever forms the next government will continue to hear from me on this crucial issue.

It might surprise you to know that about 80 per cent of all mental health issues are dealt with in general practice. Psychologists, psychiatrists and public hospital mental health facilities are a crucial part of the puzzle, but anyone with a loved family member going through a mental health issue is all too aware that the management is either with the GP and, if escalated and referred to specialists or hospital, is inevitably returned back to that GP, with complex requests for follow-up.

Thus mental health care needs to be co-ordinated back by that GP, often over decades of ongoing clinical care, with ongoing support and prevention. General practice, long-term and longitudinal, is the key to co-ordination of acute and chronic specialised input in a complex system, where patients need a central support. We have a network of 92 general practices in this town, and the majority of Canberrans see a highly trained, experienced clinician in their GP regularly. That highly skilled workforce does the mental health heavy lifting here and everywhere else in Australia, and the best way to ensure better mental health outcomes is to support those GPs to do what they do in the pre-existing network they have.

Our new COVID-19 world means that we will never look at healthcare in the same way again. But it also gives us an opportunity to look at the way we do things and how we can do them better. This is the challenge for all of us in building a healthier Canberra community.