St Vincent’s Health Australia is now half-way through its 10-year strategy, an important milestone which gives us an opportunity to both reflect on our journey so far – particularly over the past 12 months – and the work still to be done.
The Australian health and aged care environments are certainly very different to the landscapes in which we launched our strategy in 2014.
Firstly, the Royal Commission into Aged Care Quality and Safety has repeatedly exposed the sector’s vulnerabilities and the need for comprehensive reform. Given the scale of the issues uncovered by the Commission, it’s fair to say aged care is likely to undergo significant upheaval in the next five years.
The Australian private health sector is experiencing a prolonged period of uncertainty with the public increasingly questioning the value of health insurance and amplified competition between hospital providers.
The latest figures show the proportion of Australians with private hospital cover has fallen to its lowest level since June 2007. Efforts to incentivise young consumers to take out health insurance are also not working: the number of 20-29 year olds with private cover plummeted by almost 7 per cent in 2018.
The poor performance of the health insurance industry has flowed through to private hospitals in the shape of softening demand and ultimately reduced revenues.
Meanwhile, Australia’s public hospitals are experiencing stress of a different kind, with often overwhelming demand being placed on Emergency Departments, and with growing waiting lists and times for treatment.
As Australia’s largest not-for-profit provider of health and aged care services, St Vincent’s Health has not been immune to these challenges.
Added to this has been our public hospitals experiencing a dramatic growth in the number of vulnerable people seeking our care and with increasingly complex issues – a development that suggests government-funded community and early intervention services have not kept up with demand and that primary health care is also not providing ‘fit for purpose’ support.
However, it’s a testament to the skills and resilience of our people that over the past 12 months we’ve faced these uncertain times with characteristic determination, resourcefulness and innovation, remaining faithful to our mission and values.
In Care Services, one of the outcomes of an aged care sector in flux was the transitioning of five facilities – two in both Queensland and NSW, one from Victoria – from other providers to the auspices of St Vincent’s Health Australia during the year; a welcome development but one which created an enormous logistical challenge.
The sanctioning of one our Queensland aged care sites during the year – the first such result our aged care division has ever received – was a serious wake up call, and one which we responded to with appropriate seriousness.
Since that time, we’ve worked very hard with our residents, their families, our staff, and the Commission to address the issues raised. In March this year, the sanctions on the facility were lifted. An unannounced audit was conducted in early April, with the facility receiving full accreditation. Another unannounced audit was conducted in July against the new Aged Care Quality Standards. This visit included the Commission interviewing 30 residents and around 20 family members about our care, and the response – as reported to us by the Commission – was overwhelmingly positive.
Our Private Hospitals Division has responded to the testing times in their industry by introducing a comprehensive set of reforms with the aim of boosting competitiveness, increasing flexibility, and meeting the changing expectations of both patients and clinicians.
Known as Excellence Always, the initiative aims to eliminate waste and unnecessary and out-of-date processes, and promote network-wide improvements so that all 10 of our private facilities benefit from the changes.
Our Public Hospitals Division’s response to their challenges has been to turn in some of their strongest results in recent times.
St Vincent’s Sydney is now one of best financially performing public hospitals in New South Wales. The hospital’s efforts in terms of dramatically reducing preventable incidents among both patients and staff has been remarkable.
St Vincent’s Melbourne met all its 2018-19 emergency patient access and elective surgery waiting list improvement targets, while also delivering an operating surplus.
While our dramatically changing working environment has been top of mind for our leaders and teams alike, the challenges facing both disadvantaged Australians and our natural environment has been of equal concern.
St Vincent’s Health Australia only exists to bring God’s love to those in need and share the healing ministry of Jesus with people who are poor and vulnerable.
Sadly, Australia is less fair than it was five years ago: homelessness has grown considerably, poverty is on the increase, and Australia has some of the largest gaps between rich and poor in the developed world.
As always, St Vincent’s Health Australia is committed to preferential option for the poor, marginalised and vulnerable and is determined to play its role in addressing inequality.
We are pleased to report that St Vincent’s Health Australia’s contribution to Mission-related activities – services and research that benefit disadvantaged Australians – reached $170.1 million this year, an increase of 11.2% on the previous 12 months.
We are in the process of developing our first national Homeless Health Framework, a policy agenda for addressing the health needs of homeless people in metropolitan cities, given an unmanaged illness is often the factor that tips a person into homelessness or makes it difficult for them to leave it behind.
Throughout the year, we have regularly pursued advocacy on behalf of vulnerable patient groups to governments and policymakers, particularly in the areas of drug and alcohol dependency and addiction and homelessness.
In terms of the environment, St Vincent’s Health Australia strongly believes it has a responsibility to be a good steward of our natural world for the benefit of future generations.
Climate change is real and it stands to impact harshly on the health of Australians – now and in the future – particularly vulnerable people who have the least capacity to prepare and protect themselves from severe weather.
It’s not widely known that health and aged care generally, and hospitals in particular, are extremely energy intensive: up to 4.5 times more energy-intensive, on a metre squared basis, than the equivalent office space.
If our traditional methods use more resources and create more waste, then we have an even greater responsibility to do things differently.
Reducing carbon emissions makes both environmental and business sense: the more we reduce our energy output, the more we help our environment, and with rising electricity and gas costs, the more funds we can direct towards our services.
That’s why St Vincent’s Health Australia has been investing in a National Energy Action Program since 2017, to both reduce our organisation’s environmental footprint while also reducing costs.
The results have been significant and this year we have continued to reduce our total energy use and carbon emissions, despite the addition of new facilities and thousands more staff.
We’ve achieved this by installing tens of thousands of solar panels across our hospitals and aged care facilities; replacing incandescent and fluorescent lighting with LED alternatives; and introducing a ‘plug-smart’ system to improve the energy efficiency of lighting and other electrical equipment.
We’ve now begun a project to control the flow of chilled water through our facilities to dramatically reduce the energy needed to drive the refrigeration units behind our air conditioning.
Individual facilities across SVHA are also branching out with their own environmental initiatives.
St Vincent’s Private Hospital Sydney recently introduced a new laundry system which has delivered a significant reduction in related water consumption and usage costs. The St Vincent’s Clinic has completed a lighting and ceiling tile upgrade which not only reused and recycled the old tiles but resulted in energy savings of 65,854kWh annually. And St Vincent’s Melbourne has appointed an Environmental Sustainability Officer to rollout environmental projects across the facility.
None of these achievements would have been possible without the contributions of our dedicated staff and volunteers. We are grateful for all their efforts – often above and beyond what is asked of them – and particularly the work they do to supporting the most vulnerable.
More than 180 years after five Sisters of Charity arrived in Australia – inspired by the Venerable Mary Aikenhead to bring God’s love and share the healing ministry of Jesus – St Vincent’s Health Australia remains committed to carrying on their work.