The state’s public hospitals rely on a maintenance system that is underdeveloped, constrained and too reactive, a new report has found.
The audit undertaken by former Under Treasurer Michael Barnes and Dr Neale Fong, made public on 15 January, lays bare the condition of WA’s health maintenance.
The review was commissioned in August after numerous media reports highlighted ageing hospital facilities and an under-pressure health system. It focused on two providers – North Metropolitan Health Service (NMHS) and East Metropolitan Health Service (EMHS) – but handed down findings intended for all providers.
It came at a time the state was facing one of its worst winters with record flu cases and ambulance ramping. Pressure on the system saw some elective surgeries postponed as emergency departments struggled to keep pace with demand.
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The audit handed down 24 findings and eight recommendations, including that WA Health had limited data to benchmark asset performance, no systemwide targets for maintenance spend or maintenance planning, and poor procurement processes.
It found major metropolitan hospitals, including Royal Perth Hospital, Queen Elizabeth II Medical Centre, Osborne Park Hospital, Armadale Health Service, lack master plans, constraining long-term service alignment.
It also found around 75% of maintenance at NMHS and 77% at EMHS was reactive, compared to other jurisdictions like Queensland’s health services where there is a target of 65% planned maintenance.
The state government has accepted the findings and recommendations in full.
In response it has promised to:
- reduce red tape for lower value maintenance projects, while still ensuring appropriate compliance controls for all procurement
- develop a health-specific trades and services panel to make it easier for the Department of Health to procure work
- establish key performance indicators to clear expectations for maintenance activities across the Health Service Providers
- provide further transparency of maintenance expenditure in future state budgets.
A $50 million investment fund was also announced to support maintenance completion at Sir Charles Gairdner Hospital, Royal Perth Hospital, and Armadale Health Service.
AMA (WA) President Dr Kyle Hoath, who has repeatedly warned of a public health emergency in the state, said it was an “I told you so moment”.
“These problems in our health system are there; it’s not a world-class health system. We deliver world-class care thanks to our frontline workers and our tireless hospital staff, but our facilities are languishing – they need upkeep and they need this maintenance program.
“To see the government at least own up to that, and to see the report demonstrate that fairly clearly, is a good thing.
“We’re better off knowing the state of play that we’re at, rather than pretending everything is OK, so we can crack on and get our hospital system up to scratch.”
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Dr Hoath said that adequate investment would be needed for the state government to achieve its maintenance priorities, warning that the $50 million promised would “disappear very quickly”.
“Nothing about this report is good other than we now know what we can focus on and for us it gives us something to hold the government to account.”
Health Infrastructure Minister John Carey said he was determined to take action on the concerns raised by clinicians.
“We recognise the need for maintenance to be delivered effectively – ensuring the best possible care for patients, a safe environment for staff and value for taxpayers,” he said.
“This audit clearly outlines how the state can improve and our government endorses its findings and is working to implement the recommendations.”
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