We want to create a society that supports everyone to feel healthy, safe, empowered and optimistic about their future.
That means a Canberra with strong, resilient ecosystems, secure employment, a home for everyone, access to cheap, renewable electricity, and a world class public healthcare system.
The ACT Greens know that access to well resourced, easy to navigate, quality secular healthcare is a fundamental human right and a pillar of our liberal democracy. In a society like ours, everyone who needs medical support should be able to access it - no matter what their income or circumstances.
Accessible healthcare for all
Providing accessible, quality healthcare is one of the most important challenges any government faces, and in the ACT, we can do better.
It isn’t right that wealth, gender, race, access to housing and socio-economic factors have a major impact on the healthcare people in Canberra receive.
We’re also continuing to see a rise in preventable chronic diseases and are in the midst of a mental health crisis, all exacerbated by the COVID-19 pandemic - things need to change.
Canberrans deserve a better healthcare system. We know that Canberrans are waiting too long in our Emergency Departments and for elective surgery. We also know that too many people live in chronic pain due to failure of the Federal Government to invest in dental care, meaning the ACT needs to carry this responsibility.
Meanwhile, healthcare practices are changing, requiring investment in new technologies, systems and expertise, while our ageing population is putting increased pressure on our healthcare system.
The Greens have a plan to address our community’s acute healthcare needs now, while also investing heavily in preventative health measures and our mental health system to reduce the future burden on our healthcare systems.
The Greens will improve healthcare for Canberrans - now and for the future, by:
- Improving Emergency Department response
- Scope and introduce seniors streaming in Emergency Departments
- Continue funding for Safe Haven Cafes
- Address Alcohol and Drug and Mental Health Comorbidities
- Expanding and improving walk-in centres
- Commitment to scope and build two more walk-in centres and service evaluation
- Expand Walk-in Centres to include sexual health screening
- Increase Nurse Practitioner capability within walk-in centres
- Increased investment in Preventative Health measures
- Establish an ACT Social Prescribing Framework and Program
- Physical education program targeting obesity in schools
- Increasing exercise equipment and upgrades to encourage physical activity
- Consultation with culturally and linguistically diverse communities on preventative health and translation of preventative health resource
- Expanding Hospital in the Home
- Reducing Elective Surgery Waitlists
- Hydrotherapy Pool
- More end-of-life treatment and care options
- Palliative care ward at the Canberra Hospital
- Enhanced after hours palliative care
- Palliative care respite facility for carers
- Scoping study for a secular hospice
- A health-based response to climate change
- Scoping and Planning for a Northside Hospital
- Disability Health Strategy
- Develop a Mandated Minimum Nurse/Midwife to Patient Ratio Framework
- $1.5 Million to Dental Care for Low Income Families
- Piloting a safe drug consumption site
- Strengthening responses to hoarding
- Health supports for vulnerable people
- Developing a strategic vision for Justice Health in the Alexander Maconochie Centre that detainee health will be improved during their time in prison
1. Improving Emergency Department response
Everyone has the right to timely healthcare, and Emergency Departments (EDs) are the front door to healthcare in critical times of need. The Greens recognise the significant pressure on our EDs, particularly at Canberra Hospital.
The Greens have been focused on improving performance and patient experience at our EDs for many years now, and for that reason we committed to expanding Walk in Centres in 2016 to divert low level ailments from EDs, and introducing PACER to reduce mental health patient presentations.
While these have both had good results on ED waiting times, the Greens have a plan for further improving emergency departments waiting times and patient flow that is innovative, focused on cohorts, and based on new approaches that are proven to achieve results.
a. Scope and introduce seniors streaming in Emergency Departments
The Greens know that about 19% of Emergency Department (ED) presentations are persons 65 years and over. The ACT has recently introduced paediatric streaming into EDs, which has brought about improved ED waiting times and improved patient and carer experience for parents and children. Hospitals around the nation are adjusting their (ED) triage system to allow for ‘geriatric, or seniors, streaming’ and we believe that this would be an improvement for Canberra EDs too.
This Greens commitment will see Calvary Public Hospital and Canberra Hospital scope and introduce seniors streaming in EDs. This will better support more vulnerable age cohorts and more complex and urgent cases will potentially have quicker access to assessment and medical treatment.
b. Safe Haven Cafes
The dynamic of an ED is unlikely to be a therapeutic environment for a person experiencing a mental health crisis, and the Greens want to better manage these presentations to ED.
This is why Minister for Mental Health, Shane Rattenbury committed $350,000 in the COVID-19 Mental Health Support Package to establish two Safe Haven Cafes as an alternative to EDs when a person is in distress and/or at risk of mental health crisis. This has been based on a successful model at the Royal St Vincent's Hospital in Melbourne, and has also been identified as an effective alternative by the Australian College of Emergency Medicine.
The Greens want mental health consumers' experience in the ED to improve, so we will provide a further $600,000 for two years funding for the two Safe Haven Cafes, including an evaluation to be completed by the end of 2022.
c. Addressing Alcohol and Drug and Mental Health Comorbidities
Presentations to EDs that are for co-occurring alcohol and other drug (AOD) and mental health issues can be some of the complex and most time consuming to treat. This is due to a requirement that the patient no longer be substance affected in order to receive the appropriate mental health assessment. The nature of presentations can also be very intimidating for other patients and accompanying persons, and also have detrimental effects on ED staff and function.
It is also recognised that EDs may not be the best place for these presentations, particularly as they can disrupt the therapeutic environment for other people seeking medical attention.
The Greens believe that providing healthcare for these presentations should be done differently to maintain quality and safety for all patients.
To address these issues in EDs, the Greens will provide:
- $800,000 over four years for an Alcohol and Drug and Mental Health Consultation Liaison Service
- $100,000 for a scoping study for a dedicated Psychiatric Alcohol and Non-prescriptions Drugs Assessment (PANDA) Unit
The Greens want to see an improvement in integration and coordination of care in the ED. An AOD and Mental Health Consultation Liaison Service available at Canberra Hospital’s ED will be able to provide expert care for AOD and mental health comorbidities.
The Liaison Service will be able to provide assessment, treatment options, withdrawal management and referral pathways for co-morbidity consumers. It will also be integrated into existing Alcohol and Drug, and Mental Health teams to facilitate assertive follow-up and referrals so those who may not be motivated to address their substance dependence can be encouraged by specialist teams.
The Greens also want Canberra Health Services to do a scoping study for options to have a dedicated Psychiatric Alcohol and Non-prescriptions Drugs Assessment (PANDA) Unit. This model is proven to improve patient flow and better manage some of the more complex presentations in EDs. This model from St Vincent's Hospital Sydney was developed in response to the high number of presentations to EDs that involve co-occurrence of effects from drug use and mental illness. This model means that patients can be medically managed in a safe setting away from general ED until medically fit for mental health review.
2. Expansion and improvement of walk-in centres
The Greens are strong supporters of nurse-led walk-in centres (WIC), and for that reason expanding the WICs from 2 to 5 in the last term, with the construction of centres at Weston, Dickson and Gungahlin, was a high priority for us in the 2016 Parliamentary Agreement. We know nurse-led walk-in centres provide an excellent alternative to the emergency department for minor ailments. They provide Canberrans the availability to present for free at extended and more convenient hours, without appointment and be seen within very short timeframes.
a. Commitment to scope and build two more walk-in centres and service evaluation
We understand the importance of being strategic about the implementation of our health services, and plan for future need and population and suburban growth.
Canberra now has 5 WICs and we believe that 2 more WICs are needed to meet growing demand, population and city growth. There is an indication that Inner South Canberra may benefit from a WIC, and an additional WIC in Northern Canberra - likely around West Belconnen, but this will need to be confirmed through a geographic needs analysis.
b. Expand Walk-in Centres to include sexual health screening
Currently sexually active people need to attend the sexual health clinic at the Canberra Hospital in Woden or their GP for a sexual health screening. The Greens want to increase access to sexual health services by expanding the remit of WICs to provide this service. We believe that a systemic approach can be achieved through increasing access and better coordination of sexual health screening and education.
The Greens will work with Sexual Health and Family Planning ACT to explore building this capability in Canberra’s walk-in centres and deliver greater sexual health services to the community.
c. Increase Nurse Practitioner capability within walk-in centres
Nurse practitioners are highly skilled nurses who are trained to deliver a broader range of services, and there is currently enormous potential to increase their use in healthcare delivery capability in WICs. This will allow nurse practitioners in our WICs to offer services like providing referrals, interpret diagnostic tests and prescribe certain medications.
Delivering this extra capability means that more people can rely on walk-in centres for free, primary healthcare, further reducing demands on other parts of our system.
3. Increased investment in Preventative Health measures
The ACT Greens want to build a culture of good health via healthy behaviours and exercise, not a culture of treating disease and ill-health and we understand that preventative healthcare is the most effective way to improve the health and wellbeing of Canberrans, and reduce healthcare costs.
This is why we must increasingly focus on preventative health measures to tackle the root causes of chronic disease and life-limiting illness.
The ACT Greens strongly backed the Healthy Weight Initiative from 2013-2019 and we want to ensure progress in this important health area continues. We know that prevention or minimisation of many chronic health conditions lies in the population maintaining a healthy weight range, positive life-style choices, and daily exercise or activity.
Obesity is linked to many serious chronic diseases and adverse health outcomes. In 2019 63% of Canberrans were classified as overweight or obese. This is the healthy weight initiative target, but the Greens have serious concerns that not setting more ambitious targets is doing Canberrans a disservice and we should be striving for better. If we are serious about tackling the need for acute healthcare services we must embed preventative health measures in daily life.
We want to see increased community awareness of healthy eating and physical exercise as protective factors against chronic disease.
We will do this by:
- creating environments to support healthy and active living
- education and promotion programs for healthy eating and active living support to better enable informed, healthy choices
- providing healthy eating and active living advice as part of routine service delivery
The ACT Government produced the Healthy Canberra ACT Preventative Health Plan 2020 - 2025. We believe this framework will guide the necessary reforms to instill preventative health measures in daily life work and play for all Canberrans.
The Greens want specific and ambitious targets set for each area: active living; increasing healthy living; reducing risky behaviours and promoting healthy ageing.
The Greens will commit $5 million to set targets and support these initiatives as part of the Healthy Canberra ACT Preventative Health Plan.
a. Establishing a ACT Social Prescribing Framework and Program
Social prescribing is a means of primary healthcare delivery that involves engaging people in non-clinical activities that benefit health and health outcomes. This works to address the wider determinants of health and shift from treating symptoms to preventing future health issues through activity based referrals.
The United Kingdom National Health Service (NHS) and NGOs has been piloted, evaluated and embedded social prescribing into healthcare delivery. They have built a catalogue of case studies where people have benefited and resulted in preventing some adverse health outcomes. One consumer from the UK reported being linked with socially prescribed activities that ‘saved their life’.
The Greens want the ACT Health Directorate policy to support delivery of social prescribing into ACT healthcare. This initiative will work with GPs, healthcare providers and NGOs to create a formal referral process for patients to engage in activities like art therapy, walking or reading groups, exercise classes, nature based activities, volunteering as well as support with employment, debt, housing and legal advice.
The Greens will develop an ACT Social Prescribing Framework and Program to start in 2022.
b. physical education program targeting obesity in schools
Children and young people who are obsese are at significant risk of developing serious chronic diseases later in life.
The Greens will expand the existing School Kids Intervention Program (SKIP) from 4 to 12 year olds up to 17 year olds in school. SKIP is a multidisciplinary, family-centred service for children who are overweight or obese. It works with children and their families to improve health and wellbeing through regular access to a paediatric specialist, a paediatric dietitian, an exercise physiologist and a psychologist.
c. Increasing exercise equipment and upgrades to encourage physical activity
To achieve active living and encourage sport and active recreation the Greens will facilitate sports amenities installation and upgrades like small-scale park upgrades, new playground equipment, water fountains and exercise equipment to meet local community needs, so that everyone has access to quality local activity facilities.
The Greens Community Sport and Recreation Package will also help build the active and healthy society we want and need.
d. Consultation with Culturally and Linguistically Diverse communities on preventative health and translation of preventative health resource
Statistically speaking, many people from culturally and linguistically diverse (CALD) backgrounds are at risk of health issues like obesity, and this in turn increases their risk of chronic disease. Nation-wide we need to make sure we are doing better to inform our CALD community on the risks of obesity and chronic disease and also ensure we are communicating healthy behaviours.
The Greens will provide $1.5 million over four years to introduce a program to communicate and engage with CALD communities on preventative health.
We will also provide $200,000 to ensure all educational materials can be translated and available for CALD communities online, in print and through targeted community communications.
4. Expand Hospital in the Home Program
Best practice tells us providing care and treatment outside of a hospital setting is better for patient journey and recovery.
With demand for hospital in-patient care growing, the Greens want to further expand the Hospital in the Home Program to provide support to an additional 500 patients per year. This will require an additional 10 nurses, 1 doctor, and 3 allied health professionals.
The Greens will commit $5.8 million over 4 years to the expansion of this program to reach more Canberrans.
5. Reducing Elective Surgery Waitlists
We understand that our community wants improved waiting times for elective surgery in the ACT. Whilst the ACT Government has been increasing elective surgery rates over recent years, and better triaging means that timeliness for most urgent surgeries is almost 100%, less urgent surgeries still have long waiting lists.
The Greens support 2000 more additional surgeries being delivered over the next four years to reduce elective surgery waitlists, at a cost of $31.4 million.
6. Hydrotherapy Pool
Hydrotherapy can help reduce or prevent many chronic health and pain issues. The Canberra Hospital Hydrotherapy pool has reached its end-of-life and closing it last year caused a significant amount of distress to many Canberrans. There is still significant demand for the rehabilitation and medical treatment that hydrotherapy provides for many on the Southside of Canberra.
The Greens will commit $3 million to the scoping and construction of a hydrotherapy pool on Canberra's Southside.
7. More end-of-life treatment and care options
a. Palliative care ward at Canberra Hospital
For many, ill-health and end-of-life can come suddenly, and the option to access hospice care is limited. It can also be very disruptive to a person's illness and health situation.
The Greens have heard from the community that people who are in in-patient settings and in end-of-life stages would benefit greatly from a dedicated palliative in-patient ward at Canberra Hospital.
Everyone deserves to die with dignity and the Greens will deliver a dedicated palliative care ward at the Canberra Hospital for people who are not able or willing to transfer to Clare Holland House, but deserve a more comfortable end-of-life and reduced stress for the patient and family.
b. Enhanced in-home and after hours palliative care
Research overwhelmingly shows that people prefer to die at home where possible. An expansion of in-home and after hours palliative care will allow more families to be supported on the end of life journey for their loved ones.
The Greens will provide increased palliative care support for patients at home or in residential aged care. After hours care is identified as a specific area for greater resources, particularly as people tend to pass away in the evenings and require pain relief when choosing to die at home.
The Greens will provide an additional $1 million per year to increase palliative outreach and after hours care.
c. Palliative care respite facility for carers
The Greens have long advocated for more end-of-life choices and the ability to die with dignity. Dying with dignity means supporting people who wish to die at home, but it is also important that family and loved ones who are carers are in turn supported. Carer stress and fatigue is identified as being a key barrier to people dying in the home, and that is why the Greens will support establishment of Palliative Care ACT’s proposed respite service ‘The Hub’ .
Through the COVID-19 Innovation Grants announced by Minister Rattenbury, Palliative Care ACT have been able to secure a temporary location for The Hub and are currently developing the business case for the respite service.
The Greens will invest in a 4 bed facility, costing $600,000 per annum for 4 years.
d. Scoping study for a secular hospice
Populations are ageing, internationally, nationally and domestically, and the Greens know that the ACT must start to plan and invest in the future of healthcare and services for ageing demographics.
The Greens commend and appreciate the fantastic service offered at Clare Holland House, however, as it is the only hospice in the ACT, and Catholic-affiliated, it does present a barrier to many people in end-of-life stages.
We understand that the ACT will need to increase hospice care in the near future and rather than increasing capacity at Clare Holland, the Greens believe it’s time to start planning for a new secular palliative care facility.
In step with end-of-life choices and dignity in dying, the Greens know the ACT will need an additional palliative care facility in the near future.
The Greens will commit $100,000 amount to conduct a feasibility study to determine the facility location, and bed capacity.
8. Health-based response to climate change
Climate change poses a “substantial and mounting threat to public health in Australia”. It impacts health in a variety of ways, such as exposing people to increased temperatures, heatwaves, and smoke from bushfires, and increasing the spread of disease. It is important that the ACT has a strategic, health-based response to climate change, as well as a plan for the health sector to reduce its own contribution to climate change, and reach “zero emissions”.
The Greens will ensure that the ACT Government brings a proposal to the National COAG (or equivalent) for a National Strategy on Climate, Health and Wellbeing for Australia.
The Greens also want an ACT Government climate change preparedness strategy for the ACT health sector, ensuring that the sector recognises and responds to climate change risks to the health of patients, the delivery of care, infrastructure, service provision, the health workforce, and supply chains. This will include a component addressing risks to air quality and smoke.
The Greens will ensure that ACT Health collects and reports on data to monitor progress against resilience indicators, including continuation of the longitudinal survey and climate-related health impacts and costs.
By 2021, the ACT Government will also have developed and adopted a pathway to reach a zero-emissions health sector by 2040. A feature of this strategy will be for any future health facilities to be built as ‘zero emissions’ facilities.
9. Scoping and Planning for a Northside Hospital
The ACT’s population of Canberra and the surrounding region is growing and it is paramount that planning to address the next decade of growth and demand in acute health services is underway now.
The Greens will work to ensure adequate resources are dedicated to continue this work to plan for and complete construction of a Northside Hospital by 2030.
The Greens will commit $2 million over the next two years to conduct planning and feasibility studies for clinical services, master planning, and development of business cases.
10. Disability Health Strategy
The COVID pandemic has highlighted the precarious position of people with a disability and their equitable access to health services. The Greens support the community sector’s calls for a co-designed ACT Government Disability Health Strategy, to improve the health system for people with a disability, and to provide better support to navigate the interface between health and disability service systems.In line with our previously stated approach for the community sector, this strategy should be co-designed with people with relevant lived experience and their advocates.
11. Develop a Mandated Minimum Nurse/Midwife to Patient Ratio Framework
The Greens know that quality healthcare can only be delivered with the right number and skill mix of nurses and midwives.
To better both support nurses and patients, the Greens backed the development of a Nurse Safety Strategy, as a key 2016 Parliamentary Agreement item. The Australian Nursing and Midwifery Federation ACT (ANMF) have since made a compelling case to move the ACT to a more sophisticated, flexible and nurse-led approach to ratios, and we believe that we must do all we can to improve patient outcomes and better support our frontline health workers. The ANMF ACT’s ‘Ratios Saves Lives’ report clearly outlines why nurse/midwife to patient ratios produce better healthcare outcomes across a broad range of health situations, and better protect patients and staff.
The Greens support the development of a Mandated Minimum Ratios Framework. We note that there will not be one single ratio, but varied ratios depending on the clinical setting. We appreciate that this is complex work, requiring the development of a comprehensive framework that can be adapted over time as circumstance change but we stand with our city's nurses, who want to be supported to provide the best possible care to our community.
The Greens believe that everyone will benefit with mandated minimum ratios, and we will commit to mandating minimum ratios and increasing staffing numbers to meet determined ratios over the next term of government.
12. $1.5 Million to Dental Care for Low Income Canberrans
The ACT Greens believe that it is crucial that essential dental care is provided to Canberrans who need it most. There are hundreds of thousands of people across Australia stuck on state/territory waiting lists, with wait times reaching up to years depending on the treatment required. Since 80% of the dental workforce work is undertaken in the private sector, it’s clear that public dental hospitals are only part of the solution. The Australian Greens have a vision to bring dental care into Medicare over time so that everyone can access dental care. While the Federal Government continues to fail to support basic dental care for our community through allowing it to be included in Medicare funding benefits, like all other vital and basic healthcare, the ACT Government needs to pick up the slack.
Many Canberrans struggle to afford dental care and are faced with long waiting times. Failing to get the dental treatment they need and not being able to eat a healthy and well-balanced diet can lead to long-term issues such as heart disease and stroke. Part of having a good preventative health plan means making sure people can access the dental care they need to prevent more serious illness in the future.
The ACT Greens will commit $1.5 million over 4 years to further support low income Canberrans who simply can’t afford to pay for the dentist, and shouldn’t need to wait for a year for a basic appointment.
13. Piloting a safe drug consumption site
Medically Supervised Injecting Centres (MSICs) are places where people inject or take drugs, such as heroin or methamphetamine (ice), under the supervision of medical staff and health professionals. MSICs are also referred to as drug consumption rooms. But these facilities provide more than overdose prevention. The safe and supportive environment also sees social workers and drug and alcohol counsellors provide health and rehabilitation advice and options to drug users in a way that enables changed behaviours in the longer term - similar to the benefits of pill testing.
The ACT Greens propose establishing a pilot site in Canberra, modelled on the effective Medically Supervised Injecting Centres operating in Sydney and Melbourne.
14. Strengthening responses to hoarding
Hoarding can be a substantial health issue - both for the person themselves, and sometimes for neighbours and the local community. It is a complex mental health and public health issue, and needs more systemic coordination across a broad range of government agencies to address issues such as fire, contamination, access, waste and spread of disease as the current system does not allow the problems to be well managed holistically across government and the community. The Greens remain concerned about the level of resourcing available to support both hoarders and people impacted by hoarding.
While there is an existing cross agency network, and Woden Community Services have sometimes been funded to support hoarders, the Greens are concerned that movement on particular cases is still exceedingly slow and community funding is sporadic. There is also currently no single legislation or regulation that supports direct government action on hoarding - only on individual aspects at a time.
To address hoarding issues, the Greens will:
- develop coordinated legislation or regulations to better target improved outcomes
- strengthen capacity within and across Government for responding to hoarding, including enforcement capacity
- fund a non-government organisation to deliver the Hoarding Advocacy Support Service with two full-time specialist case workers to assist with managing hoarding behaviours, and
- provide secretariat support funding for the Clean Living Network.
The Greens will commit $1.2 million over four years to address hoarding.
15. Health supports for vulnerable people
People experiencing homelessness typically have poorer health outcomes compared to the rest of the population. Further, they do not focus on their health in the same way that other people do either - just surviving each day is understandably often their priority. The transient nature of many people experiencing homelessness, and the focus of specialist homelessness services on responding to crises, means that health can be overlooked.
The Greens’ housing and homelessness initiative will help improve support for people experiencing homelessness to access health services. It will embed specialist workers within homelessness services, which will help support both the workers in these services as well as clients. These specialists will include experts in fields such as disability, aged care, domestic and family violence, and alcohol and other drug services. Having these expert workers will ensure that better supports are provided to those with complex issues.
As part of the 2016 Parliamentary Agreement, the Greens ensured that the Early Morning Centre was fully funded to operate 5 days per week, from 7.30am to 2.30pm Monday to Friday, over the past 4 years, which has improved health, job and educational outcomes for homeless people in Canberra over this period. The extended opening hours has enabled additional social inclusion services and activities including computing skills, a dental and health clinic, counselling, cooking and nutrition, current affairs discussions, music and arts workshops.
The Greens will now also expand funding for the Early Morning Centre to operate 7 days a week to ensure that people get the support they need every day of the week, and to provide further avenues for health support and referral.
16. A strategic vision for Justice Health in the Alexander Maconochie Centre that detainee health will be improved during their time in prison
The Greens want a clear Government policy position that the health of detainees will be better when they are released than it was when they were first admitted. The health of offenders has clear links to broader community outcomes, and improving their mental and physical health may in part support reduced reoffending.
To achieve this, Justice Health, as a division of Canberra Health Services, needs to be better supported and have extended responsibility for providing health care management for detainees leaving custody, as well as increased specialist care for vulnerable offenders on community based orders and parole.
This would mean, for example, that people with substance use issues would be appropriately treated and clean when they were released, that detainees with mental health issues would have mental health care plans and warm referrals to appropriate mental health services outside, and would have dietary and dental conditions addressed while they were in prison. Improving detainees’ health will give them the best chance of a fresh start on the outside.
We would employ a new team of 6 advanced care nurses with multi-disciplinary backgrounds to: better respond to women offenders' unique health needs; enhance First Nations people’s health services; and engage in developing longer term care plans that would continue from inside to out of the AMC.