For someone who has been intimately involved in healthcare both at the coalface as a registered nurse as well as an academic for over 50 years I am appalled, but not surprised, at the current wave of negativity concerning the Federal Government’s Health Reform Plan.
Not only is the commentary negative, it is also blatantly misinformed in the majority of cases. But more concerning than this is the fact that mainstream debates around the issues at stake have been once again hijacked by the vested interests who have the most to lose by substantial changes to the current system.
Leading this negative commentary is the Leader of the Opposition Tony Abbott, the Minister for Health when money was being siphoned from the health system.
Like so many politicians before him, Abbott’s agenda was influenced by the most powerful interest group in health: the medical profession.
As a result he refused to appoint a Chief Nurse – something vital to the more effective running of a complex system such as health – preferring instead for the Chief Medical Officer to speak on behalf of the nursing profession.
The former Health Minister also ignored requests for nurse practitioners to be fully recognized for their clinical expertise – something that would have also improved the efficiency and effectiveness of health care delivery.
By contrast, Nicola Roxon has delivered on her promise to right these wrongs. We now have a Chief Nurse and Nurse Practitioners will be reimbursed appropriately, as well as being recognized for the key role they play across the health care system.
After years of neglect, at last a federal government is attempting to rebuild a system which has been denuded of funds and which has turned its back on the specific needs of those with chronic and complex conditions and indigenous and rural populations in particular.
States have been allowed to focus their resources on hospitals as if their walls were impervious to other areas of need such as preventive and primary healthcare, including dental and mental health needs.
Why is the focus almost exclusively on waiting lists for surgery when, as Australian of the Year, Professor Patrick McGorry keeps pointing out, someone takes their own life every 4 hours in this country? Why aren’t we agitating for resources to prevent suicides and a lifetime of misery for so many?
As usual, doctors have been given all the airplay and column inches over the last two weeks – doctors who speak authoritatively on the needs of the community, as if they are the chosen spokespeople.
But for those of us in the system who are aware of what agendas lie behind those who claim to speak on behalf of the community, we sense the fear underlying the statements.
The medical profession may claim that its concern is that any change will alter the “sacred relationship between doctor and patient” or increase the waiting lists (a furphy if ever there was one!) But for those of us in the know, it’s hard not to hear their rhetoric as an attempt to capitalize on the fears of the sick and vulnerable while seeking to ensure their status, both financially and socially.
I listen to these debates, as I have for many, many years, with interest and skepticism - ever hopeful to hear a nurse or patient being interviewed. It rarely happens. What the media and the broader community fail to grasp is that nurses have a unique perspective on the issues at stake as their agenda is simple: to be able to provide quality care to each individual patient.
As salaried workers, any change to the system won’t alter their financial status as it might for so many other groups of health professionals, particularly doctors.
Nurses also have a better understanding of what people need and want when they are sick as they provide the majority of one-on-one care to patients. And so they need to be consulted as to the correct structures which will support their ability to deliver appropriate care . Yet where are their voices in the debate ? Why are they rarely interviewed on the media or included in policy discussion?
There are many theories as to why nurses have been largely omitted from public debate or higher level decision making in health. One school of thought was that nursing was marginalized because of it being a predominately female profession in a patriarchal culture – but that doesn’t hold up now that the medical profession has equal numbers of women in its ranks without losing its voice of authority.
Perhaps it’s the fact that, despite requiring a university degree and a high level skill-set, nurses are still seen as ‘handmaidens’ doing the ‘dirty work’ – working with their hands and hearts rather than their heads.
In 2010 however I would have hoped that such outmoded ideas no longer had traction. I call on this Federal Government and the media to include more nurses in decision making and debate – particularly those nurses who work at the interface between the hospital system and the community.
These are the nurses who are forced to confront the messy reality of a complex and dynamic system – to deliver care which is both safe and context appropriate. They have learned to rely on their own resourcefulness rather than standing around waiting and blaming others.
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