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“The time for comprehensive healthcare reform is now” – perspectives from lutruwita/Tasmania

Introduction by Croakey: National efforts to reform the scope of practice of health professionals are important for driving much-needed health reforms in lutruwita/Tasmania in the wake of the recent state election, according to Scott Willis, National President of the Australian Physiotherapy Association, who has lived and worked in the state’s north for more than 30 years.

His article below comes as the national Scope of Practice Review this week released its second issues paper (stay tuned for a report coming soon at Croakey), with the aim of supporting health professionals in primary care to work to their full scope of practice.

Many of the issues raised by Willis are also relevant for other states and territories.

Willis is this week participating in events with the American Physical Therapy Association in Washington DC (see tweets below his article).


Scott Willis writes:

The healthcare landscape in Tasmania is at a critical juncture. As the newly formed state government takes the helm, it faces a pivotal moment.

Emergency departments are overwhelmed, GP wait times are extending, and access to essential healthcare services is becoming increasingly constrained, a scenario exacerbated in rural areas where the healthcare disparity is more pronounced. This issue, while acutely felt in Tasmania, mirrors a national challenge demanding significant structural reform.

Tasmania is also home to the country’s oldest population with one of the poorest health literacy rates, and highest rates of prescription opioid consumption and chronic musculoskeletal conditions. This combination of health system pressures means the state is uniquely positioned to lead by example in healthcare innovation.

As APA National President working in a multidisciplinary practice in Burnie/Somerset, I know the potential of physiotherapy to transform healthcare and health outcomes. Publicly funded physiotherapy offers a solution not only for Tasmania but also nationally, providing early intervention and non-operative treatment pathways that prevent unnecessary hospitalisation, reduce readmission rates and prevent chronicity of health conditions.

There are many opportunities for physiotherapists to lead care, including in leveraging advanced practice but we remain under-utilised, particularly in primary care.

Physiotherapy-led interventions in residential aged care can reduce falls, the leading cause of injury for older Australians and a significant contributor to emergency wait times, by 55 percent.

Programs like GLA:D—Good Life with osteoArthritis: Denmark— are another example. Such programs have been proven to significantly reduce pain and analgesic consumption, while also improving joint function and reducing the perceived need for surgery. Our leading private Health insurer StLukes health can see the benefit in this, implementing this for its members. It’s about time the Tasmanian Government seriously help Tasmanians live with arthritis better by having access to the care they need.

Some easy reform fixes could be made now but we remain stuck in a system based on treating poor health outcomes. And the broken hospital system will remain broken if we continue to divert funding to tertiary facilities. We can’t keep funding the same things and expect the outcomes to be better.

Recommendations

The Australian Physiotherapy Association (APA) has outlined a series of recommendations for the new government, that leverages the potential of the physiotherapy profession.

Our aim is to both improve the patient journey and health outcomes for Tasmanians, these measures would further save costs and contribute to the sustainability of healthcare services in the state. The recommendations fall under five key categories.

Better community care: We advocate for increased public funding for physiotherapy services, ensuring that physiotherapy-led early intervention and prevention strategies are integrated into digital health platforms and the WorkCover system.

Physiotherapy in hospitals: By supporting physiotherapists to work at the top of their scope, we can improve patient flow and outcomes, particularly for those facing musculoskeletal issues and chronic conditions.

Strengthening rural physiotherapy: Investment in physiotherapy services in rural health settings is crucial. We propose state-level partnerships and funding models that facilitate integrated care and enhance access for rural communities.

Workforce reforms: Addressing the shortage of physiotherapists and ensuring an optimal balance of skill mix is essential. We call for nationally directed interventions to resolve the current supply crisis in the physiotherapy workforce.

Physiotherapy in Urgent Care Clinics: Integrating physiotherapy into Urgent Care Clinics will provide faster access to care for musculoskeletal conditions, combining better health outcomes with cost reductions and system efficiencies.

In Tasmania, almost one in every two hospital emergency department presentations are failing to be seen within the clinically recommended wait times.

By integrating funded First Contact Physiotherapy (FFCP) services into primary care and as part of the Urgent Care Clinics trials, we can facilitate more efficient, appropriate care for the large cohort of patients that present with musculoskeletal conditions.

The rising tide of chronic disease and the pressures on our public hospital system demand a proactive and strategic response.

The APA’s vision for healthcare reform in Tasmania is grounded in evidence-based, patient-centered care. By building the capacity of the physiotherapy profession in the state and supporting practitioners in working to their full scope of practice, we can drive system-level change that advances health, improves care, and increases value.

Investing in the physiotherapy workforce is also paramount to realising the Commonwealth Government’s vision of strengthening Medicare and improving healthcare accessibility.

The Scope of Practice Review is key to driving the deeper structural reform required in primary care. I see this review as an important step forward in a reform process that can bring us close to a value-based healthcare system.

As the Government enters its new term and cements its priorities, we urge all parties to consider our recommendations seriously.

The time for comprehensive healthcare reform is now. Together, we can transform the health and well-being of our community, ensuring a sustainable and efficient healthcare system for generations to come.

• Scott Willis is a proud Palawa man from Burnie, who has lived and worked in northern lutruwita/Tasmania for more than 30 years. He is the first Indigenous National President of the Australian Physiotherapy Association and a former Clinical Council Member of Primary Health Tasmania.

From X/Twitter

Recommended reading on the Tasmanian election result: Jacqui Lambie’s imperial ambitions take a tumble, by Martyn Goddard.

“It is insufficient to say an early election was a bad call. It’s a breathtaking case of political self-harm. It doesn’t even help the workload for ministers: the Health Minister is also the Attorney-General, Minister for Justice, Minister for Veterans Affairs and, curiously, Minister for Mental Health and Wellbeing.”


See Croakey’s archive of articles on allied healthcare