Hames_Kim_Dr_Sep08.jpgWA’s new Health Minister Dr Kim Hames seems to be a warmly welcomed replacement for Jim McGinty. Perhaps it is because he is a GP who knows what it is like on medicine’s front line? Or perhaps, as suggested by Medical Hub’s October e-poll, he is making populist decisions such as the retention of Royal Perth Hospital.

51% of polled GPs (November e-poll) were cynical of the Liberals’ populist decision, but Kim hit back by saying, “the reality is that the decision by the party was strongly supported by the community and contributed significantly to our win. So for those doctors to say it was a popular move, they are exactly right. It was popular because it was right.”

Denying that he was ignoring the Reid Report’s recommendation in keeping RPH open, Kim said the Liberal government support almost all of the report’s recommendations – except that one.

“Frankly, I think if Reid were to come back and do it again, in light of exposed access difficulties at Sir Charles Gairdner Hospital and the growing population and increased demand on hospitals, I think he would recognise that our proposal is a good one,” he said.

“Often we find the people who say that Royal Perth should close think, as a result of keeping it open, we are going to downgrade Fiona Stanley Hospital, but that’s just not true. Fiona Stanley will remain as it is. Others are concerned about total numbers of staff. Royal Perth will be reducing from a nearly 700 bed hospital to a 400 bed hospital, so there will be a significant reduction. Fremantle Hospital will be reducing in size as proposed. Labor had planned, instead of reducing Fremantle, to keep it the same size, which is contrary to Reid’s recommendation. We’ll probably be following the recommendations more closely than they were.”

Although only a few months into the job, Kim has been fighting on multiple fronts to improve WA’s hospitals. As the only Liberal in the Labor-dominated roundtable of health ministers, he is already butting heads with federal Minister Nicola Roxon, particularly over the federal government’s tough talk but decreased spending on hospitals (currently at 40.2%, leaving WA to foot the lion’s share of the public health bill).

“I’m strongly opposed to the federal Government taking over our health system. Frankly, I’ve yet to see Canberra do anything better than the states can do themselves,” he told The Australian in October.

He said that if the federal government wanted to expand its role, it should pay states the same Medicare benefits for each broken bone mended and chronic illness treated at public hospitals that it paid to GPs, adding that the federal government was “getting off easy to the tune of almost half a billion dollars” a year.

Emergency Departments, seemingly the AMA’s biggest bugbear, could be in for a major revamp, with Kim recently travelling to the UK to investigate their mandatory four-hour ED turnarounds (from presentation to admission/discharge)

“We keep hearing [the UK system] is working very well, despite our suspicion that they are just hiding patients somewhere else. We are having a detailed look at it to see if we can find patients hidden in closets. But from all reports we have had, particularly from doctors working there, what it does is force enormous efficiencies on every level of the hospital. That’s what we need here.”

With the AMA (WA)’s lobbying power base of hospital doctors and specialists, it was somewhat surprising to learn that Kim is planning to heavily invest in preventative health measures, specifically aimed at more home-based care and easing the Aboriginal health crisis.

“We are going to have two to three specific targets. One of those will be a state-wide pathology assessment system for Aboriginal people of particularly high risk. Also, we’re looking to expand the Silver Chain program and that will have the ability to link in with GPs to try to reduce the need for GPs to send patients to hospitals. We will be trying to link the Hospital in the Home program with the Silver Chain program more strongly together to ensure better coverage for people in the home.”

Elective surgery waiting lists is another area Kim’s administration will be focussing on. According to Kim, transparency, particularly in light of Jim McGinty’s ‘smoke and mirrors’ methods of culling wait lists, will be a hallmark of the Liberal’s health plan.

“I have been very critical of wait lists in the past and I will make sure all those details are clear for everybody to see.”

One of the ways Kim aims to achieve a realistic wait list reduction is to have a doctor and nurse-led advocacy committee, who will bring their clinical experience to bear when assessing individual cases.

“The wait list advocacy committee will oversee the wait list system and make sure that not only does it function well, but they will oversee some of the changes we promised, which is specific funding – $30m over three years to reduce the numbers of patients waiting outside boundaries. There will also be an opportunity for people on the list who have an issue. They may be able to apply to the committee, which will bring them up the list on a case-by-case basis.”

Kim has also confirmed his commitment to honour the previous government’s pledge to co-fund the proposed GP Super Clinics at Midland and Wanneroo.

“We will be putting in $5m for each of those. There are people with reservations about them and I know there are some sensitivities with local doctors where those clinics are going to be established. But we have gone so far down the track that restarting debate on the issue isn’t in the best interest of the people in those communities who are desperately short of doctors.”

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