Understanding Australia’s healthcare crisis

Written by James Jennings for Australian Seniors

Along with being too full to finish a delicious meal or having so much money you don’t know how to spend it all, pressure on Australia’s healthcare systems due to an ageing population is, at its core, a pretty good problem to have – more people growing older is a far better outcome than the alternative. 

As positive as an ageing population is for people who are looking forward to a long life, the strain it’s putting on our healthcare systems can’t be overstated. According to the Australian government’s 2023 Intergenerational Report, Australians aged 65 and older – one in every six people – currently account for about 40% of the nation’s total healthcare expenditure. Australia’s health spending on older people is set to more than double to $270 billion by 2035.

Australia’s ageing population

An urgent problem 

Preparing for a future where there’ll be significantly more older Australians requiring healthcare requires urgent attention – a fact that’s not lost on Professor Alison Kitson, inaugural Vice President and Executive Dean of the College of Nursing and Health Sciences at Flinders University and current chair of the International Learning Collaborative, an organisation promoting fundamental care. She believes the key problem lies with our health systems being around 30 years behind the times. 

“We need to shift the mindset away from older people going into acute hospital settings,” she says. “The more we can invest in home care, the more we can invest in community-based nursing and allied health teams going in to support people in their own homes, the better.” 

Why we need more nurse practitioners

How nurse-led care supports ageing Australians

Government investment in nurse practitioners – expert nurses who work in particular fields like palliative, primary and aged care who work alongside general practitioners – would also assist in keeping older patients out of hospitals. 

“They have more time and more ability to get to know the patients and understand their care needs,” says Professor Kitson. “In terms of things like diabetes and cardiovascular issues, the doctor will treat the clinical conditions, but the nurse practitioner is there to work alongside the patient and their family to say, OK, so having a bad heart means this in terms of your exercise and what you should be eating.”

Remote monitoring of patient’s conditions 

How telehealth and remote care benefits older Aussies

Sydney-based GP Dr Kean-Seng Lim is an advocate for telehealth and remote monitoring as a way to not only effectively manage multiple patients’ conditions, but to also ease the burden placed on hospitals and general practices. 

“Monitoring absolutely takes a bit of pressure off the healthcare systems we have set up in this country,” he says. “There are quite a large number of different things which can be measured and monitored as well, such as mood scores, symptom scores for asthma, for chronic lung disease, for diabetes and so forth. Monitoring remotely allows it to be done in a way which is suitable for many people in many different places.” 

As crucial as it is for patients who have obstacles around time or travel, Dr Lim says this type of monitoring is not widely practised at present for one key reason: it’s not covered by Medicare. 

“We often hear how Medicare is such a good thing because it’s been around for 40 years, and it has served Australia well, but the world has changed a lot in 40 years,” he says. “It doesn’t necessarily meet the needs of today.”

Access to healthcare in rural areas

The challenge of delivering aged care in remote regions

Workforce shortages are another fly in the ointment in regard to the health of our healthcare systems, points out Professor Maria Inacio, an epidemiologist at the University of South Australia and director of the Registry of Senior Australians Research Centre at the South Australian Health and Medical Research Institute. 

“The government has made some funding available, but there is no workforce to actually expand and develop to deliver more in rural areas and smaller areas,” she says. 

“The government has tried a lot of different ways to throw money at this, but there are structural issues that come into play. They simply don’t have the workforce in some of these areas to care for people. And once you get to the point that you need specialised care, eventually you have to go where the services are.”

Positive reforms 

How new reforms aim to future-proof healthcare

More positively, there are some promising developments on the horizon. “In Australia, there’s a major national reform happening that affects the care of older people in the aged care and the primary care sector, plus there’s the strengthening of Medicare reforms,” says Professor Inacio.

“We need to share accountability for individuals instead of working in silos, like Medicare is going to do this, aged care is going to do this, the hospitals are going to do this. Then we’re all doing different things better, but not together, even though the responsibility of that person and their experiences are on us all. If we did that better, I think we would be better prepared for these future demands.”