The people of Western Australia go to the polls on Saturday, March 13, to elect a new state government. The incumbent Health Minister (and Deputy Premier), Roger Cook, and the opposition health spokesman (and leader of the parliamentary Liberal Party) Zak Kirkup address the pressing health issues that face WA in 2021 and beyond.
Roger Cook
MF: COVID-19 had an enormous impact on the WA community, particularly health services, in 2020. How confident are you that the state can manage the pandemic in 2021?
RC: I am quietly confident, but we must be cautious and vigilant about the year ahead. The fact we have been regarded as one of the world’s safest places in 2020 is testament to the quality of the teamwork and decision-making under pressure. This extends right across the political and health sectors, from the outstanding work in our hospitals through to the quarantine hotels and beyond. It has not happened by chance. The expertise honed during 2020 will continue to evolve and adapt during 2021 for whatever new challenges come our way.
MF: If effective and safe COVID-19 vaccines are available, what is your view on making them mandatory for all Western Australians, or in some specific settings?
RC: We strongly encourage people who are eligible and able to, to receive COVID-19 vaccines that are approved by the TGA.
MF: COVID-19 aside, what do you consider will be another major priority for the health portfolio in 2021?
RC: One of the most difficult challenges of 2021 will be mental health. We know this is not just specific to WA. We are seeing a sharp increase in both the number and acuity of cases and patients are also younger. The priority is ensuring that we have the right balance and resourcing in mental health services across the WA community. We need to make inroads in preventing mental illness and providing the right level of care in the most appropriate setting.
MF: Do you support the push by WA pharmacists for a greater role in administering vaccines, including a COVID-19 vaccine?
RC: There is a role for pharmacists administering some vaccines where they are on the lower spectrum of risk, as they already do. With respect to COVID-19 vaccines, as we better understand the complexity and precautions required to safely administer them, we can determine any role that pharmacists may or may not play.
MF: Voluntary assisted dying legislation will come into effect in July. What do you say to people who still have strong reservations about its potential for harm or misuse?
RC: The Voluntary Assisted Dying Act 2019 includes rigorous criteria and safeguards throughout the process that prevent a person from being coerced or manipulated into engaging in the voluntary assisted dying process. In addition, the Act establishes a statutory board to ensure proper adherence and to recommend safety and quality improvements. The primary purpose of the legislation is a compassionate one, of giving people who are at the end of their lives the right to choose the timing and circumstances of their death, whilst ensuring strong safeguards against any possible undue influence or coercion.
MF: Ambulance ramping at WA hospitals hit high levels in 2020, despite relatively stable patient demand. How can this be turned around?
RC: Our public emergency departments are under pressure currently, with higher than usual patient demand. Compared to the same three months last year we had an extra 3500 patients arrive at EDs. There has been an increase in mental health presentations, an increase in acuity and an increase in respiratory illness more common in winter months. As a result, the Department of Health has met with key stakeholders including St John Ambulance and is implementing a number of strategies. These include an extension of health liaison managers to assist patient flow, joint secondary triage initiatives, mental health peer support workers deployed in EDs and mental health community outreach to mental health patients to help prevent re-admission via ED.
Emergency departments are for emergencies. Recently, I was told about a presentation at a busy ED for a repeat prescription, which is a good example of why we are rerunning our advertising campaign for Urgent Care Clinics. In addition, 77 new ED beds are either under construction, or soon will be.
MF: Some health experts are worried that COVID-19 has created a ‘syndemic’ or perfect storm for rising rates of non-communicable diseases such as obesity, diabetes and heart disease. How can this be addressed?
RC: Non-communicable diseases have and will continue to be an issue of great concern. In addition to many health promotion and primary prevention interventions that the government currently employ and looks to expand, there is extra focus on providing support for people with chronic conditions to access care in the community so they can manage their health without needing a more intensive level of care.
MF: Mental health problems are also on the rise. How do you think this is best tackled?
RC: The WA Government has invested more than $1 billion in mental health and AOD service delivery but there is more to do. Prioritisation of investment will be focused on the areas and services of greatest need first as determined through previous consultations and reports. The WA State Priorities Mental Health, Alcohol and Other Drugs 2020-2024, highlight our immediate areas of focus and will form the priority work of the Mental Health Commission, Department of Health and health service providers.
MF: What is the thinking behind the WA Government moving away from the privatisation of services in the hospital sector?
RC: We want to put public health in public hands to put patients first. In 2020, we brought some Fiona Stanley Hospital services back into public hands from Serco, and now we are looking to end privatised public services at Peel Health Campus. This will turn Peel into a truly regional hospital with extra benefits and services that the public system can provide.
Zak Kirkup
MF: COVID-19 had an enormous impact on the WA community, particularly health services, in 2020. What would be your priority in managing the pandemic in 2021?
ZK: A Liberal government will continue to back the Chief Health Officer’s advice to help keep West Australians safe from COVID-19. We will make sure we follow the expert advice and go a step further and actually release it publicly. West Australians have done all the heavy lifting and have made so many sacrifices during the pandemic to keep WA safe, so they deserve to know the exact details of the reasons why the government is making its decisions.
MF: If effective and safe COVID-19 vaccines are available, what is your view on making them mandatory for all Western Australians, or in some specific settings?
ZK: The successful rollout of COVID-19 vaccines will require time, communication and trust. We will make all decisions based on what would undoubtedly be a nationally consistent approach, informed by the advice of the Chief Health Officer here in WA.
MF: COVID-19 aside, what do you consider will be another major priority for the health portfolio in 2021?
ZK: We need to tackle ambulance gridlock across our state hospitals. We have record levels, which is putting the lives of West Australians at risk. Health professionals are telling us that our health system would not cope with an outbreak of COVID-19 in WA, which is alarming given the government has had nine months to develop a robust plan to protect the State. It proves that under its watch our health system has deteriorated and is now in crisis. Ambulance gridlock is getting worse and the Health Minister needs to stop making excuses and fix it now. Our doctors and nurses do an amazing job, and it is appalling that they don’t have the resources they need to keep West Australians safe. The priority should be to make sure every single ward is open and that every single bed is available. Our health system needs to be better resourced, starting with expansion of our emergency departments.
MF: Do you support the push by WA pharmacists for a greater role in administering vaccines, including a potential COVID-19 vaccine?
ZK: All decisions in relation to the rollout of any vaccine will be dealt with in accordance with the advice of the Chief Health Officer.
MF: Voluntary assisted dying legislation comes into effect in July 2021. What is your personal view on VAD?
ZK: I was initially quite hesitant about this legislation because of not only the issue but also the significant undertaking with WA being only the second state in the federation to implement assisted dying as an option of end of life for the terminally ill. However, after speaking to thousands of people within my district and going over the legislation a number of times independently, it became quite obvious that the overwhelming majority of people in my community support voluntary assisted dying. Accordingly, I supported the voluntary assisted dying legislation.
MF: Ambulance ramping at WA hospitals hit high levels in 2020, despite relatively stable patient demand. If you were Health Minister, how would you address this?
ZK: We need to open every ward and make every bed available in our state’s hospitals. We will also acknowledge the issues facing our state’s hospitals and not continue to make excuses and fail to substantially address the problem like the current government. The continual ignorance of the WA Health Minister on this issue is a shame on the government. At a time when we need leadership, the government has gone missing. They are putting the lives of West Australians at risk. Our health system is in crisis now.
MF: Some health experts are worried that COVID-19 has created a “syndemic” or perfect storm for rising rates of non-communicable diseases such as obesity, diabetes and heart disease. How can this be addressed?
ZK: We need to double-down on our community and public health measures and campaigns to help respond to these concerns.
MF: Mental health problems are also on the rise. How do you think this is best tackled?
ZK: There needs to be a greater focus on community and preventative mental health services, and the government needs to fund these important areas accordingly. For example, the Auditor General last year revealed that investment in prevention of mental health illness had dropped to just 1% instead of the 6% recommended in the Better Choices. Better Lives: Western Australian Mental Health Alcohol and Other Drug Services Plan 2015-2025. We will be releasing our mental health policy and it will be comprehensive and a key part of our campaign going forward.
MF: Do you support recent decisions by the state government to move away from the privatisation of services in the hospital sector, such as Serco’s contract at Fiona Stanley Hospital?
ZK: Once the government has made a decision in relation to commercial operations of any hospital, we won’t be changing positions. More important than anything else is the certainty and continuity of decision making in WA when it comes to our health system.
MF: What is an area of the health portfolio that you would personally feel keen to make your mark on, and why?
ZK: We need to address ambulance gridlock and tackle the mental health issues in our community properly. These are serious issues which the government has neglected. We need to acknowledge these concerns and do something substantial to make them right.