Health

Principles

The Greens NSW believe:

1. The primary goal of the health services is to improve or maintain an optimum standard of health (including physical, intellectual and social wellbeing) across the whole population.

2. Primary health care, health promotion and illness prevention are fundamental components of an effective and sustainable public health system.

3. Because a wide range of government actions affect health outcomes, a whole-of-government approach to health is needed.

4. The oversight of health outcomes should include federal monitoring through the Council of Australian Governments (COAG) and funding collaboration between federal and state authorities aimed at developing high quality health care outcomes in New South Wales.

5. Local government should be funded for and have an active role in health promotion, education and prevention.

6. Access to health services is a basic human right and should be based on health need not on ability to pay.

7. Barriers to health care need to be identified and addressed with specific state campaigns for vulnerable and disadvantaged populations, including children, the elderly, Aboriginal and Torres Strait Islander peoples, residents of rural and regional areas, people with disability, and people with mental illness.

8. An effective and sustainable public health system must be underpinned by evidenced-based research into conventional medicine and complementary treatment modalities.

9. A wide range of conventional and proven complementary therapies should be accessible and affordable under the health system.

10. The unacceptable health status of Australia’s Aboriginal and Torres Strait Islander peoples must be recognised and responded to with levels of funding sufficient to eliminate the mortality gap and create similar health outcomes to the wider Australian community’s as a matter of urgency.

11. Governments must accept responsibility for providing quality public health care services. The NSW government should not be allowed to use devolution of services to shift the blame for funding shortfalls and other policy failures to Local Health Districts.

12. The unacceptable health status of the ‘Forgotten Australians’ (adults who spent time in care as children and their children) must be addressed, focusing on  those with lifelong economic and health disadvantage due to impacts of historic abuse and neglect.

Aims

The Greens NSW will work toward:

13. Providing, at minimum, equitable access to quality health care, ensuring patients’ privacy and the confidentiality of their healthcare information, informing patients and obtaining their consent before employing a medical intervention, and providing a safe clinical environment.

14. Climate change is widely regarded as the biggest threat to health in the 21st Century and will increase demands on our health systems. An immediate and rapid transition to net zero greenhouse gas emissions by 2040 and a reduction of greenhouse gas concentrations in the atmosphere are needed to avoid catastrophic climate change and the worst of these health impacts.

15. Improving primary health care, including:

15.1. Addressing the causes of ill health.

15.2. Prevention.

15.3. Health promotion

15.4. Early intervention.

15.5. Best practice evidence-based treatment programs across the whole population.

16. Ensuring improved access to emergency health services.

17. Ensuring that funding for health addresses pressing health problems such as hospital waiting lists, deficiencies in rural health services and dental health, including the needs of high priority populations groups, such as:

17.1. People with disability.

17.2. People with mental health conditions.

17.3. People with substance abuse issues.

17.4. Aboriginal and Torres Strait Islander peoples with poor health and reduced lifespan.

17.5. Socio-economically disadvantaged people.

18. Funding research to evaluate health interventions and service delivery, and directing resources into long-term improvements in health outcomes.

19. Increasing nurse staffing-to-patient ratios and skills mixes that ensure patient safety, better health outcomes, high recruitment retention, continued professional development, and adequate training of staff.

20.  Providing sufficient funding for the priority areas of midwifery and mental health nursing especially in rural areas.

A. Primary health care, allied and community health services

21. Promoting a model of health care delivery that is based on sustainable Primary Health Care centres (as opposed to GP super clinics) that have a more affordable and accessible staff and skill mix that includes doctors, nurses, occupational therapists, physiotherapists, and health promotion officers.

22. Incentivising continuity of care by promoting the “health care homes” model, and encourage doctors to provide a bulk-billed annual check-up for all who would benefit from it.

23. Increasing the number of and upgrading existing community health centres in areas of need, including regional areas where average life expectancy is 2 to 4.6 years shorter than the average for Sydney.

24. Providing incentives to encourage the co-location of GPs in community health centres and consider alternative funding models that ensure the majority of GPs and specialists in any given area offer bulk-billing for all patients.

25. Increasing the role of nurse practitioners in community health centres and other appropriate settings including outpatient settings, and supporting collaboration with allied health practitioners and GPs, especially in rural areas.

26. Improving accessibility and affordability of a wide range of conventional and proven evidence-based complementary therapies.

27. Improving access, according to need, to community and allied health services such as physiotherapy, osteopathy, chiropractic, podiatry, occupational therapy, counselling, complementary therapies, and midwifery.

28. Improving coordination and integration between health  and community services, including hospitals, post-hospital services, and community providers.

29. Expanding the role of women’s health nurses to include prescribing emergency contraception, and undertaking sexually transmitted infection (STI) testing.

30. Increasing the emphasis on primary health care including, health promotion, illness prevention and early diagnosis.

31. Addressing workforce and demand issues in the primary care sector, including the urgent need for improved conditions and career structures for home-care and personal-care workers.

32. Implementing accreditation standards for complementary practitioners and medicines, and establishing registers, professional conduct standards and complaints mechanisms for all therapeutic practitioners.

33. Initially for patients who are terminally ill, legalising the palliative use of crude cannabis and other cannabis products for those for whom other drug choices have been exhausted, have intolerable side effects, or are too expensive.

34. Authorising compassionate trials of cannabis and cannabis-related substances for the treatment of life-threatening diseases for which other drugs have proved to be ineffective, exhibited unacceptable side effects, or are too expensive, and for which there is some clinical or medical anecdotal evidence of likely effectiveness.

35. Regulating and prescribing for medicinal purposes cannabis-derived pharmaceutical drugs based on their therapeutic and palliative effects, and improving their affordability and accessibility.

36. Ensuring universal access to public hospitals is needs-based rather than dependent upon health insurance status.

37. Improving emergency department and outpatient waiting flow by funding adequate staffing, equipment and bed availability.

38. Developing new programs to address the needs of patients with complex psycho-social needs who currently use emergency systems heavily as centres of last resort.

39. Developing alternative benchmark measures to the arbitrary and damaging 4-hour- turn-around rule for emergency departments, including bulk-billed out-of-hospital care for those who could be better treated by GPs or other health providers.

40. Improving linkages and collaboration between hospitals and community-based services to ensure smooth and effective transfer of care, admissions where necessary, and timely relevant follow-up.

41. Increasing the number of outpatient services offered through public hospitals, especially in rural areas.

42. Retaining all current and future public hospital developments and land in public ownership.

43. Ensuring the protection of public hospital land for public hospital services and the provision of sufficient bed numbers for current and projected population growth.

44. Opposing Public Private Partnerships in provision of public hospital services, and restoring public ownership where possible.

45. Ensuring that public hospital services are delivered as close as possible to the communities they serve.

46. Strengthening the public primary-care sector so that it can more effectively provide care and support to people in their homes.

47. Improving the working conditions, training, supervision and career structures for nurses, medical and allied health professionals, including those in the acute, primary- and community-care sectors, aged-care hospitals, associated homes and communities by:

47.1. Improving postgraduate education including interdisciplinary simulation and communication.

47.2. Improving staff wellbeing to prevent burnout.

47.3. Ensuring sufficient numbers of medical internships are made available every year.

47.4. Support specialist colleges to develop adequate training.

48. Increasing the number of registered nurses so that the average staff-to-patient ratio is at least 1 to 4, in line with the NSW Nurses and Midwifery Association’s ‘Safety in Numbers’ campaign.

49. Opposing the development of Urgent Care Centres as replacements for emergency departments.

50. Opposing replacement of doctors with videolink facilities in rural and regional emergency departments where community and local medical staff are opposed to such a move.

B. Dental Care

51. Funding federal/state dental services to ensure everyone has access to comprehensive public dental care and to ensure that per capita funding for public dental-health services in New South Wales sets a benchmark for all other states, and providing an additional $100 million in funding over the next three years.

52. For at-risk populations funding prevention and awareness programs targeting initiatives to increase access to dental services for those who are at a higher risk of poor dental health as well as targeted initiatives for those most in need, including older people, people with intellectual disabilities, refugees, Aboriginal peoples, ‘Forgotten Australians,’ and people in rural and remote communities.

53. Ensuring increased funding for public emergency dental services and preventive dental-health programs.

54. Investing in comprehensive public oral-health workforce development initiatives, including the development of a workforce strategy, including increasing the number of TAFE places for dental health professionals.

55. Lobbying the federal government to:

55.1 Increase the number of university training places for dentists.

55.2 Provide Medicare rebates for dental care.

55.3 Support the development of programs to increase accessibility to quality dental care.

56. Significantly increasing funding for public mental-health services, including public hospital inpatient services, psychologists, community-based outpatient and outreach services, and case managers, especially for patients with acute and pervasive mental-health conditions

C. Mental health

57. Significantly increasing funding for public mental-health services, including public hospital inpatient services, community-based outpatient and outreach services, and case managers, especially for patients with acute and pervasive mental-health conditions, including distinctive separate pathways for mental health patients to access emergency care where possible.

58. Improving hospital and community-based mental health services and continuity of care.

59. Addressing the high rate of homelessness among mentally ill people by establishing supported government-endorsed accommodation for people with mental illness, including crisis, medium-term and long-term accommodation with rehabilitation programs.

60. Increasing support and respite services for carers/families that care for people with mental illness.

61. Providing appropriate treatment in public health facilities and in prisons and other correctional facilities for prisoners with mental health problems.

62. Increasing resources for community based public services providing early-intervention programs for mental health issues.

63. Funding additional public services, including specialist psychiatric services, to assist people who present with symptoms of mental illness at hospital emergency services.

64. Improving funding for services and research to address the complex needs of people with both mental health and drug and alcohol issues.

65. Ensuring that people who are drug and alcohol dependent are primarily regarded as clients of the health system rather than the criminal justice system.

66. Supporting the development of innovative and targeted public mental-health interventions.

67. Recognising and addressing the special needs of refugees and asylum seekers, including those in detention, and other displaced persons.

68. Making additional funding available to allow the provision of public mental-health services within schools and other educational institutions.

69. Recognising and addressing the special needs of ‘Forgotten Australians’, including their children and their grandchildren, by means such as improved funding for services and research.

70. Developing health services for patients with both physical and intellectual disability.

D. Population health

71. Effectively addressing the diverse individual health needs of all people in New South Wales, prioritising Aboriginal and Torres Strait Islander peoples as well as vulnerable groups such as ‘Forgotten Australians’.

72. Prioritising patient care and direct service delivery.

73. Increasing funding for basic health promotion and disease prevention to better meet essential health needs in the community, including a reduction in unnecessary air pollution such as wood heating pollution estimated to represent an $8 billion health problem in NSW that causes 100 premature deaths in Sydney and many more in regional and rural NSW.

74. Reviewing the funding and resourcing of health services.

75. Developing an integrated whole-of-government framework for good health, by identifying and coordinating activities in portfolios that contribute to health, such as urban planning, employment, transport, community services, and environment.

76. Supporting local government planning and policy development that addresses needs at the level of people's daily lives and experiences.

77. Providing a variety of structured physical activity programs based in schools, other educational institutions, workplaces, and in the community.

78. Promoting, through community campaigns and education, the importance of healthy-lifestyle choices to the general population and to specific target groups.

79. Providing increased funding to expand the range of health-promotion activities provided by NSW Health.

80. Developing public health impact assessments for all major industrial and infrastructure developments.

81. Programs to monitor and significantly improve air quality in all areas where there is evidence that national air quality standards are exceeded.

82. Supporting the implementation of municipal public health plans in all local government areas.

83. Extending and enforcing a ban on smoking in all defined and enclosed or partially enclosed public spaces including ‘high roller’ rooms in casinos.

84. Licensing all retail tobacco outlets and banning cigarette vending machines.

85. Establishing and funding the implementation of smoking reduction targets and restoring funding for mass media campaigns.

86. Supporting programs and policy measures that promote healthy food and drink choices.

87. Increasing awareness of the importance of physical activity and diet to health.

88. Ensuring that physical activity and healthy food choices become a recognised part of Occupational Health and Safety policies and workplace health policies.

89. Supporting the development of a better understanding of the effects of work (including exposure to physical, chemical and psycho-social hazards at work) on individual and community health.

90. Requiring public- and private-sector food services, hospitals, and child care centres to offer a variety of healthy food choices consistent with recognised dietary guidelines.

91. Strengthening the regulation of the foods served in school canteens to improve health outcomes.

92. Advocating a ban on advertising unhealthy foods during children’s television viewing times.

93. Banning the sale and manufacture in New South Wales of products containing trans fats.

94. Improving and enforcing mandatory accurate and comprehensive food labelling, including the labelling of salt, saturated fat and energy content of all fast foods

E. Maternal and child health

95. Supporting maternity and birthing services (including preconception care) that are sensitive to the needs of all women, and that give them control, choice, and continuity, and allow them to remain active in the labour and birthing experience.

96. Developing an integrated approach to the needs of children and young families.

97. Increasing funding for primary maternal health care with the aim of reducing interventions in labour such as induction, instrumental and Caesarean deliveries.

98. Providing breastfeeding support programs based on women's needs and experiences, free from the influence of commercial interests.

99. Providing culturally sensitive maternity and early childhood services.

100. Ensuring all women have access to adequate personal income, leave, rest and social support during pregnancy.

101. Ensuring all parents caring for children have access to adequate personal income, leave, rest and social support.

102. Increasing midwife-based birthing services and woman-centred services and improving continuity of care in all public hospitals.

103. Providing a birth centre in each region where these services are not offered in mainstream health services.

104. Expanding maternal and child health and early childhood services.

105. Increasing public post-natal services and, in particular, services for women experiencing post-natal mental health issues.

106. Providing programs in hospitals and the community designed for women at risk for birthing and parenting.

107. Increasing funding for education and programs that promote the benefits of mass immunisation.

F. Community consultation

108. Achieving greater and more effective community participation in health decision making.

109. Resourcing those health organisations that assist people to participate fully in decisions about health care and health resources.

110. Implementing a Charter of Patient Rights, with patients, families and carers encouraged to play a stronger role.

111. Including members of the health workforce (doctors, nurses, midwives, allied health and other health professionals and support workers) in health-service-delivery policy development and planning.

112. Developing a code of practice for the provision of health information.

G. Commonwealth/state responsibilities

113. Advocating through the Council of Australian Governments (COAG) for:

113.1. Medicare, and increased public health funding.

113.2. The redirection of the current subsidy to private health insurance to the state public health system.

114. Rejecting the case-mix funding model as a crude attempt to cut costs at the expense of health-care staff and patient wellbeing.

115. Supporting the inclusion of local clinicians, nurses and allied health workers on the governing councils of local health networks.

116. Supporting the increased presence of patient and community representatives on the governing councils of local health networks.

117. Provide funding for educational and support programs in schools and in the community regarding the prevention of suicide.

118. Addressing the inequity between mental health services in geographical regions, including lower socioeconomic areas as well as regional/rural settings.