Manly Hospital was originally envisioned by the Manly Community, long before it became the property of the NSW State Government. Even under state control, it has continued to attract enormous community interest, support and on-going involvement in its future. As Pauline Curby portrays in her book “Visitors Sixpence – Manly Hospital, The First 100 Years” – “Throughout this history the role of members of the local (Manly) community in supporting and, at times, directing the affairs of the Hospital, is a constant reference point.”. At the prospect of the Manly Hospital site once again becoming available, after all the current Hospital staff vacate the site in 2018, the Manly Community understandably insist upon determining the future vision for the site.
We were fortunate at this time in the history of Manly Hospital to have Mike Baird as our Premier (NSW State Government representative); our long standing patron and supporter of Manly Hospital and our local Manly Community Centre. He made it clear on numerous occasions that it will be the Manly Community who ultimately determines the future of the site, once the Frenches Forest Northern Beaches Hospital (NBH) is complete in 2018 and Manly Hospital closes. With his recent resignation from politics, a new sponsor is sought. Our latest NSW Premier Gladys Berejiklian (born at Manly Hospital) has indicated she plans to continue with the promises made by our previous Premier. She provided assurances to the Nothern Beaches Communities (Manly Daily 18 Feb’17) “a guarantee that Manly Hospital’s grouns will remain a health facility after it is closed”. Various forms of assurances have come also from our recently appointed NSW Health Minister Brad Hazzard and neighbouring NSW representative, together with James Griffin, our new NSW Government Manly representative.
Manly Community Vision for the future Manly Hospital Site
Each time a survey is conducted into what the Manly Community seek from the future Manly Hospital site – Health Care is the one consist response, especially Aged Care. Other additional preferences for the site include:- Youth Palliative Care, Affordable Housing, Rehabilitation, Disability, Medical Research, Education, etc.
The usable land at the site (62,000 sqm) currently has 43% (26,500sqm) occupied by the current buildings, suggesting that it may not be possible to effectively accommodate all of the above community preferences. With good planning and some innovative thinking around the ways in which community health care service gaps can best integrate and residents collaborate, a new style of environment for Health care begins to emerge. A public/private funded environment that takes the pressure off our current Hospital system. No one organisation has the entire solution to our current Health Care predicament. This vision for vertical integration services and synergies in residential capabilities can extends into the Manly Community itself; not just that located on site.
Ask our elderly, “Where would they prefer to be looked after – in hospital or at home?” Over 70% of our elderly would prefer to remain home when receiving age care services. Besides, being in a hospital bed is bad for your health. Hospital accommodation is far from 5 star, the food is very ordinary and most importantly there is little or no opportunity for healthy exercise, causing you to loose condition rather than improve. Home patient self-diagnosis, home visitations, greater volunteer involvement, innovative eHealth systems and other preventive care measures can enable people to remain in their own home, especially undertaking recuperation when they are not critically ill.
The vertical integration of Health Care services (doctors, pharmacists, physiotherapists, volunteers, aged care providers, professional advisers etc.) aided by platforms of cutting edge eHealth systems have been shown to radically reduce health care costs by cutting the number of hospital beds required. The key “disruptor” is destined to be a low cost fully integrated solution across the community, not building more hospitals. This form of community-directed health care could well address the Health Care cost precipice governments are destined to face in 2018. It’s all going to be about money and the most effective mechanisms for delivering community-directed Health Care at the lowest cost. A rapid start-up of these integrated Health care services, soon after the closure of Manly Hospital, can be achieved by re-using several (10) of the existing buildings, once fully renovated and re-architected for generic Health Care residences and services.
Imagine a new Health Care model where our elderly are assisted by our youth living in nearby affordable housing. Imagine our mentally ill in recovery, our unemployed and those in temporary refuge, all volunteering to work around the site, supporting other residents whilst awaiting more sustainable opportunities – as part of their exit strategy from their current care situation. Imagine an aged community being able to stay at home longer with modern medical provisions, community volunteers and professional support services attending to their needs both at their home, in the knowledge that a nearby Health Care facility exist where more concerted Health Care exists when and if it is needed. Imagine aged care, accommodation advice and information readily available from professionals in choices of public/private health care, including legal service. Such a community-directed Health Care model is limited only by our imagination.
As 2013 Senior Australian of the Year, Professor Ian Maddocks puts it:-
“We’re now living in a society where there’s an increasing number of people with chronic diseases and those people live with their disease 24×7. You’ve got to start by saying what can we do to support that person who is living with a chronic disease, and that’s about training them in self-management (with) community support around them and soon. Then you say what do we do about supporting the carers of that person with a chronic disease? And you say what do we do in terms of the primary care system, both the community support system and the GP?”
Community Health Care – Management, Policy and Technology innovations
- Adopt existing eHealth System (My Health)
- Re-engineer the health system by making use of the existing eHealth patient recording system. Signing people up is the first important step towards enabling more integrated and coordinated health care services (involving patients, doctors, hospital nurses, pharmacists, podiatrists, nutritionists, and allied health professionals, physios, etc). This system is already in use in regions such as North Queensland and Western Sydney. Already 4.2 million people are enrolled.
- Health care data management is another opportunity. People need to be better informed on how to embrace eHealth so that they only have to provide their details once. Doctors also need to promote and encourage their patients to sign-up. Education in the long term benefits of eHealth to the patient is still lacking. The problem at the moment is that the data is not being sufficiently used primarily because multiple duplicates of the same information is being maintained in different silos of data (eg. GP health records)
- Research into Prevention Treatments at the optimum time for patients and the community generally. Getting preventive knowledge out to people, ties in with item 3 below – empowering people to be able to help themselves more through the power of available information on preventative strategies. This is about Subject Matter Experts (SMEs) creating well researching up-to-date information and making it available to people in need, in a form that delivers them maximum benefit. As well as getting this same information onto the screens of clinicians and then seeing where it goes next. Given 50% of the cost of health care is consumed by a small percentage of chronically ill patients, identifying who these are would make pro-actively planning possible so that the right health care services are made available in anticipation of patient needs.
- Self-Help Education and Communication. With the right information being made available to the right people, who in turn can improve their own performance.
- Predictive Patient Analysis. With the likes of DNA testing and genome analysis it is now possible to undertake predictive analysis of the style of health care issues a person is most likely to be disposed towards eg. cancer, dementia, etc.
- Vertical Integration of Care Services
Chronic disease management systems (such as Health Care Homes) can identify at risk patients. It involves identifying the best local providers to meet each patient’s needs and co-ordinating their care and strategies for the patient to better manage their own health conditions
- Technology Tools
- Wearable technology (eg. BitFit, etc.)
- Mobile phone apps for self-analysis and sharing of such information with (away) health professionals
- Health Care websites for self-diagnosis for the likes of mental-illness, etc.
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