Post by bear on Nov 4, 2021 20:15:31 GMT 7
Shortcomings in the NDIS lead to extended hospitalisations
COVID hasn't overwhelmed Australian hospitals as some people predicted but the fact remains that Australia's public hospitals are always under intense pressure.
States and territories say there are more than a thousand people currently in hospital who don't need to be there, and they're blaming deficiencies in the National Disability Insurance Scheme. Here's chief political correspondent Laura Tingle.
Statement attributable to NDIS Minister Linda Reynolds: The Commonwealth is committed to working with states and territories to improve the coordination and efficiency of hospital discharge as it relates to NDIS participants. The Health Ministers Meeting paper was only circulated today, and the Commonwealth will give this proper consideration before formally responding. The policy solutions are complex and may involve a range of issues outside of the NDIS, such as social housing availability, which can play a role in determining hospital discharge. NDIS participants are entitled to receive critical health care through the state and territory hospital network, and often have more complex health conditions than the general population. Any attempt to portray the NDIS as the major cause of strain on state and territory hospital systems is not supported by the evidence. Some of the policy solutions for hospital discharge reside with state and territory governments, and some with the Commonwealth. State and Territory governments are responsible for providing the majority of social and transitional housing options that these people depend upon need when they leave hospital. Some NDIS participants leaving hospital may need access to a range of state government delivered services, including rehabilitation, housing and homelessness services, transport, mental health, drug and alcohol and justice supports.
Transcript
REPORTER: The sharp decline in the number of surgeries performed as COVID swamped the system
REPORTER: The backlog of patients still in hospital who could be treated and cared for elsewhere.
REPORTER: The states and territories are scared their hospitals won't cope. They're calling on the Federal Government to pay half of public hospital costs for the next few years.
LAURA TINGLE, CHIEF POLITICAL CORRESPONDENT: Hearing states complain about hospital funding is hardly new and the COVID pandemic has put the public health system under unprecedented pressure.
But the states argue it is not just COVID that is the problem.
Ahead of a meeting tomorrow with Federal Health Minister Greg Hunt and Disabilities Minister Linda Reynolds the states and territories have collected data which show the extent to which people with disabilities are occupying public hospital beds.
The data shows that all states and territories have long stay patients who have no medical reason for being in hospital but who are staying there for months or even years and they are blaming shortcomings in the National Disability Insurance Scheme (NDIS).
For example, in Queensland, there were 238 long stay patients at the end of August, with NDIS related delays in access and planning the most reported reason they could not leave.
In Victoria, by the end of June there were 247 patients who were NDIS participants, with NDIS delays again the main reason.
While in NSW, in early September there were 203 NDIS participants more than 10 days past their estimated date of discharge but the state believes the real number could be much higher.
Some of the case studies raised by the states are quite shocking. For example the case of a 25-year-old man with an extensive history of mental health admissions who was in hospital for three years - despite being medically fit to return to the community - due to insufficient funding in his NDIS plan to meet his therapy and behavioural needs.
In another case cited an 18-year-old in Queensland was admitted to hospital in December last year following a breakdown in his accommodation and support arrangements. He did not require medical treatment. Seven months later he was discharged. His hospital stay cost the Queensland health system $2 million.
YVETTE D'ATH, QUEENSLAND HEALTH MINISTER: This is the number one priority.
LAURA TINGLE: Queensland Health Minister, Yvette D'ath is the chair of the State Health Minister's Counsel.
YVETTE D'ATH: What we do know is that there are around 1,000 patients in hospitals around Australia right now who are medically well but need a disability package under the NDIS.
Now, that equates to over $500 million and over 264,000 bed days. This is extraordinary and the number that we have in the health system right now is equal to building a new major hospital in Queensland. That is not good enough.
DR BRONWYN MORKHAM, YOUNG PEOPLE IN NURSING HOMES ALLIANCE: We know younger people decondition very quickly when they are in hospital for extended periods of time and that makes it even harder for them to move back to the community and take up their lives with some independence.
LAURA TINGLE: Bronwyn Morkham represents younger Australians living in aged care and says a lack of suitable care for people with disabilities means many are discharged from hospital only to find themselves in nursing homes.
BRONWYN MORKHAM: This is a real concern to us because the Federal Government also has a younger people in residential aged care strategy underway, and one of the first targets to come online next year is one in which there will be no younger person going into residential aged care from next year.
SAMANTHA CONNOR, PEOPLE WITH DISABILITIES AUSTRALIA: I have a friend who is in hospital nine minutes from here who has been there for 18 months because the type of care that that person needs isn't actually provided in the type of care facility that he needs.
And so, you know this is a very, very long standing issue but it's become a really blown out of proportion during the pandemic.
LAURA TINGLE: Victorian Health Minister Martin Foley says the problem has been getting worse.
MARTIN FOLEY, VICTORIAN HEALTH MINISTER: Public hospital beds are being used to poorly accommodate people with disabilities. These are complex issues.
Yes, money is at the heart of it but so is making sure that the National Disability Insurance Scheme achieves its goals - the administrative delays, the lack of training, the lack of housing.
LAURA TINGLE: There are lots of complex reasons why people aren't being discharged from hospital. Sometimes a lack of appropriate housing, care, or rehabilitation services. Sometimes alternative care is available, but the bureaucracy is getting in the way.
ROGER COOK, WA HEALTH MINISTER: The service providers have said to us that there are places for these patients to go to but the funding models that sit behind those particular cases are simply not adequate.
SAMANTHA CONNOR: You need to have enough market providers to actually come in and pick up that load.
LAURA TINGLE: The question is, what to do about it. What is happening in hospitals is but a reflection of broader problems in the NDIS - lack of funding, lack of training, and assessment processes which are not delivering the levels of care needed by participants.
YVETTE D'ATH: So what it is that the health ministers will be asking for from the Commonwealth is what they need to put in place measures that quickly discharge people into the NDIA (National Disability Insurance Agency).
LAURA TINGLE: The state ministers, both Liberal and Labor, will be proposing solutions at tomorrow's meeting to try to ensure the National Disability Insurance Agency is involved in cases that end up in the hospital system a lot earlier.
ROGER COOK: The state-run hospitals are always the service provider of last resort and we are just saying now is not the time to play that game.
We need the Commonwealth to step up, so that we can manage the peaks of the demand that we are currently experiencing.
LAURA TINGLE: But it will ultimately require an acknowledgment by the Federal Government that there is a problem, and it needs to be fixed and they require changes to state government policies in areas like social housing.
7:30 invited both ministers Hunt and Reynolds to be interviewed but they were unavailable. In a statement Minister Reynolds said the health ministers meeting paper was only circulated today and the Commonwealth will give this proper consideration before formally responding.
She said the policy solutions were complex and went well beyond the NDIS itself to issues like social housing. Any attempt to portray the NDIS as the major cause of strain on state and territory hospital systems was not supported by the evidence, she said.
SAMANTHA CONNOR: To be honest, people with disability don't care who pays for it as long as it's paid for. We want them to sit down like grownups and sort it out and make sure people aren't in crisis.
www.abc.net.au/7.30/shortcomings-in-the-ndis-lead-to-extended/13615580
COVID hasn't overwhelmed Australian hospitals as some people predicted but the fact remains that Australia's public hospitals are always under intense pressure.
States and territories say there are more than a thousand people currently in hospital who don't need to be there, and they're blaming deficiencies in the National Disability Insurance Scheme. Here's chief political correspondent Laura Tingle.
Statement attributable to NDIS Minister Linda Reynolds: The Commonwealth is committed to working with states and territories to improve the coordination and efficiency of hospital discharge as it relates to NDIS participants. The Health Ministers Meeting paper was only circulated today, and the Commonwealth will give this proper consideration before formally responding. The policy solutions are complex and may involve a range of issues outside of the NDIS, such as social housing availability, which can play a role in determining hospital discharge. NDIS participants are entitled to receive critical health care through the state and territory hospital network, and often have more complex health conditions than the general population. Any attempt to portray the NDIS as the major cause of strain on state and territory hospital systems is not supported by the evidence. Some of the policy solutions for hospital discharge reside with state and territory governments, and some with the Commonwealth. State and Territory governments are responsible for providing the majority of social and transitional housing options that these people depend upon need when they leave hospital. Some NDIS participants leaving hospital may need access to a range of state government delivered services, including rehabilitation, housing and homelessness services, transport, mental health, drug and alcohol and justice supports.
Transcript
REPORTER: The sharp decline in the number of surgeries performed as COVID swamped the system
REPORTER: The backlog of patients still in hospital who could be treated and cared for elsewhere.
REPORTER: The states and territories are scared their hospitals won't cope. They're calling on the Federal Government to pay half of public hospital costs for the next few years.
LAURA TINGLE, CHIEF POLITICAL CORRESPONDENT: Hearing states complain about hospital funding is hardly new and the COVID pandemic has put the public health system under unprecedented pressure.
But the states argue it is not just COVID that is the problem.
Ahead of a meeting tomorrow with Federal Health Minister Greg Hunt and Disabilities Minister Linda Reynolds the states and territories have collected data which show the extent to which people with disabilities are occupying public hospital beds.
The data shows that all states and territories have long stay patients who have no medical reason for being in hospital but who are staying there for months or even years and they are blaming shortcomings in the National Disability Insurance Scheme (NDIS).
For example, in Queensland, there were 238 long stay patients at the end of August, with NDIS related delays in access and planning the most reported reason they could not leave.
In Victoria, by the end of June there were 247 patients who were NDIS participants, with NDIS delays again the main reason.
While in NSW, in early September there were 203 NDIS participants more than 10 days past their estimated date of discharge but the state believes the real number could be much higher.
Some of the case studies raised by the states are quite shocking. For example the case of a 25-year-old man with an extensive history of mental health admissions who was in hospital for three years - despite being medically fit to return to the community - due to insufficient funding in his NDIS plan to meet his therapy and behavioural needs.
In another case cited an 18-year-old in Queensland was admitted to hospital in December last year following a breakdown in his accommodation and support arrangements. He did not require medical treatment. Seven months later he was discharged. His hospital stay cost the Queensland health system $2 million.
YVETTE D'ATH, QUEENSLAND HEALTH MINISTER: This is the number one priority.
LAURA TINGLE: Queensland Health Minister, Yvette D'ath is the chair of the State Health Minister's Counsel.
YVETTE D'ATH: What we do know is that there are around 1,000 patients in hospitals around Australia right now who are medically well but need a disability package under the NDIS.
Now, that equates to over $500 million and over 264,000 bed days. This is extraordinary and the number that we have in the health system right now is equal to building a new major hospital in Queensland. That is not good enough.
DR BRONWYN MORKHAM, YOUNG PEOPLE IN NURSING HOMES ALLIANCE: We know younger people decondition very quickly when they are in hospital for extended periods of time and that makes it even harder for them to move back to the community and take up their lives with some independence.
LAURA TINGLE: Bronwyn Morkham represents younger Australians living in aged care and says a lack of suitable care for people with disabilities means many are discharged from hospital only to find themselves in nursing homes.
BRONWYN MORKHAM: This is a real concern to us because the Federal Government also has a younger people in residential aged care strategy underway, and one of the first targets to come online next year is one in which there will be no younger person going into residential aged care from next year.
SAMANTHA CONNOR, PEOPLE WITH DISABILITIES AUSTRALIA: I have a friend who is in hospital nine minutes from here who has been there for 18 months because the type of care that that person needs isn't actually provided in the type of care facility that he needs.
And so, you know this is a very, very long standing issue but it's become a really blown out of proportion during the pandemic.
LAURA TINGLE: Victorian Health Minister Martin Foley says the problem has been getting worse.
MARTIN FOLEY, VICTORIAN HEALTH MINISTER: Public hospital beds are being used to poorly accommodate people with disabilities. These are complex issues.
Yes, money is at the heart of it but so is making sure that the National Disability Insurance Scheme achieves its goals - the administrative delays, the lack of training, the lack of housing.
LAURA TINGLE: There are lots of complex reasons why people aren't being discharged from hospital. Sometimes a lack of appropriate housing, care, or rehabilitation services. Sometimes alternative care is available, but the bureaucracy is getting in the way.
ROGER COOK, WA HEALTH MINISTER: The service providers have said to us that there are places for these patients to go to but the funding models that sit behind those particular cases are simply not adequate.
SAMANTHA CONNOR: You need to have enough market providers to actually come in and pick up that load.
LAURA TINGLE: The question is, what to do about it. What is happening in hospitals is but a reflection of broader problems in the NDIS - lack of funding, lack of training, and assessment processes which are not delivering the levels of care needed by participants.
YVETTE D'ATH: So what it is that the health ministers will be asking for from the Commonwealth is what they need to put in place measures that quickly discharge people into the NDIA (National Disability Insurance Agency).
LAURA TINGLE: The state ministers, both Liberal and Labor, will be proposing solutions at tomorrow's meeting to try to ensure the National Disability Insurance Agency is involved in cases that end up in the hospital system a lot earlier.
ROGER COOK: The state-run hospitals are always the service provider of last resort and we are just saying now is not the time to play that game.
We need the Commonwealth to step up, so that we can manage the peaks of the demand that we are currently experiencing.
LAURA TINGLE: But it will ultimately require an acknowledgment by the Federal Government that there is a problem, and it needs to be fixed and they require changes to state government policies in areas like social housing.
7:30 invited both ministers Hunt and Reynolds to be interviewed but they were unavailable. In a statement Minister Reynolds said the health ministers meeting paper was only circulated today and the Commonwealth will give this proper consideration before formally responding.
She said the policy solutions were complex and went well beyond the NDIS itself to issues like social housing. Any attempt to portray the NDIS as the major cause of strain on state and territory hospital systems was not supported by the evidence, she said.
SAMANTHA CONNOR: To be honest, people with disability don't care who pays for it as long as it's paid for. We want them to sit down like grownups and sort it out and make sure people aren't in crisis.
www.abc.net.au/7.30/shortcomings-in-the-ndis-lead-to-extended/13615580