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Our city is growing and so, as you would expect, is our health system. Unprecedented investment is giving Canberrans – and those in the surrounding region who depend on us – access to great facilities, including the Centenary Hospital for Women and Children, the Capital Region Cancer Centre and new walk-in centres in Belconnen and Tuggeranong. More investment is planned with a new hospital and major refurbishments of the Canberra Hospital on the way.
We’ve celebrated our centenary and in a way we’ve come of age as a city. As the city matures so does its health system. A major tertiary referral hospital in a major city relies on its own expert staff. The Canberra Hospital is no different.
Canberrans have always had access to highly-trained medical staff, but as we mature, the mechanism by which those staff are employed has evolved.
When the ACT ran a smaller district type health service most of the doctors were employed as private contractors – or visiting medical officers (VMOs) as they’re known in the healthcare sector. That is, the doctors are employed on a sessional basis for a particular amount of time or activity but are not employees of the ACT Government. This allows VMOs the opportunity to run private rooms but also maintain their skills and experience by working in the major public health service for an amount of time as well.
Now that the system’s capacity has increased there is more scope to employ more specialist doctors directly. Staff specialists, unlike VMOs, are public servants, and while they may do some private work, the majority of their work is in the public health system.
VMOs give the public health system access to specialist skills that might not otherwise be available. There are some specialisations, such as paediatric cardiology, where there is not enough demand in the ACT public system for a full time staff member to maintain the level of specialty required. By employing VMOs, who have expertise through their private practice, the hospital ensures children with heart problems and other patients needing particularly specialised treatment get the best possible care.
In other areas of hospital services in the ACT, such as neurosurgery and intensive care, the bulk of the work – and, importantly, the most complex and challenging work within those specialisations – is in the public system so staff specialists are employed.
In addition, the nature of their employment means staff specialists tend to spend more time in the hospital, providing greater flexibility as they can respond to patients’ needs as they arise, in addition to taking an active role in the life of the hospital.
Historically, the number of VMOs working in the public health system has been greater than staff specialists. As recently as 30 years ago this worked well for the ACT’s health system. It attracted doctors to Canberra at a time when that was desperately needed and the modern public health system owes a lot to those doctors as their work and dedication helped shape Canberra’s hospitals into the role they play today as major metropolitan hospitals offering tertiary and trauma services to a region of 800,000 people.
However, as our system has grown – and with the development of Canberra as a hub of medical training since the opening of the ANU medical school – so has the need to employ staff specialists to help treat patients, run the hospital, mentor the next generation of doctors and carry out important health research.
Contrary to the belief of the VMO union there is no campaign under way to reduce their numbers. Nothing illustrates this more clearly than the number of VMOs employed, which has risen from 155 in 2007 to 198 in 2014. What we are doing is employing more doctors across the board and these doctors are employed either as public servants or as private contractors, whatever suits the needs or circumstance of the hospital or the individual doctor themselves.
For the ACT community the most important focus should always be about how we build the best health system for Canberra. To achieve this we will need to ensure that we are able to employ highly skilled professionals across the health professions including a mix of VMO and staff specialist positions.
Katy Gallagher is Chief Minister of the ACT.