Future Vision & Benefits


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Initiative Title: Future Vision & Benefits
Category: Planning Initiatives
Description:

This Planning Initiative outlines the aggregated community vision for the preferences for how the future Manly Hospital site should be used and the expected benefits to flow back into the community from its implementation in accordance with this vision.   Without some well defined end-state or vision it becomes difficult/impossible to develop a credible strategy and master plan for the site’s design and the implementation steps necessary to make the community’s vision a reality.   

This master plan and associated strategy is to get us from the site’s current state (post Manly Hospital site closure) to an agreed holistic architectural representation of the  community vision; staged over periods of 2, 5, 10 and even 20 years out from now.     With the closure of the Manly Hospital site in Oct’18, an incredible opportunity has opened up for the community to define their next “7 hectares of care”.   Being an iconic site, its blessed with magnificent views down Sydney Harbour, next to North Head National Park and flanked by Collins Beach.  The site is unique in the world, arguably looking over the most beautiful harbour in the world and surrounded by a community that has had an affinity of care for the site for over 100 years.  Some of the best people you could ever find.  There is water access, a small rain forest, native animals and birds, beautiful trees, water flows with interesting site configurations, all culminating in making this opportunity a marvellous bookend to our harbour and its city scrape (the Sydney Harbour Bridge, Opera House and Barangaroo mega-towers) at the other end. 

As Pauline Curby portrays in her book “Visitors Sixpence – Manly Hospital, The First 100 Years” –  “Today Manly Hospital (site) and Community Health Services continues to thrive on a special relationship with its people.”   

The key objective of the community vision for the site is to enable our local community to “get ahead of the health care curve” – building more hospitals is not only financially unsustainable, avoiding expensive GP because they won’t bulk-bill and failing to fill the really important Health Care gaps in our community.   This long held community vision should drive the future evolution of the Manly Hospital site, as its becomes fondly called – the “Manly Community-driven Health Care Facility (McHCF)”.   A new sun rise delivering 7 hectares of community health care and well-being across Northern Beaches.    

Background

Manly Hospital was envisioned originally by the local Manly Community as an ideal place for community health care, long before it became the property of the NSW State Government.   Even under state control, it has continued to attract enormous community interest, support, donations and on-going involvement in its future.  As Pauline Curby again put it – “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.”.  

We have been fortunate at this time in the history of Manly Hospital to have had Mike Baird as both our Premier and NSW State Government representative – a long standing patron and supporter of Manly Hospital and our local Manly Community Centre.  Our current Premier Gladys Berejildian was not only born at Manly Hospital but also worked as a manger of her father’s retail shop in our famous Corso.  The NSW Government Health minister (Brad Hazzard) nearby has guaranteed that “Manly Hospital’s grounds will remain a health facility after it is closed” and “handed back to the community”, once the Frenches Forest Northern Beaches Hospital (NBH) is complete in Oct’18 and Manly Hospital closes.  

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:-  Adolescents & Youth Palliative Care, Affordable Rental Housing for Health Care and Emergency Services workers, Addiction Rehabilitation, Mental Health Services, Medical Research, Education, etc.

The usable land at the site (6.2 hectares or 62,000sqm) currently has 43% (26,500sqm) occupied by current buildings, suggesting that it may not be possible to effectively accommodate all of the above community preferences at the site.    With good planning and some innovative thinking around the ways in which community health care service gaps can best be integrated and synergized between residents, a new style of Health Care is possible – like home hospitals, well-being self-help, new employment opportunities, affordable housing, having our younger folk live and work locally, etc.   A public/private funded health care solution that takes the pressure off our current Hospital system and fills the health care gaps so prevalent across our community, must surely be a good thing!  The closing of the Manly Hospital itself has extended this already significant gap in our local health care services.   No one organisation has the entire solution to our current Health Care predicament. This vision for vertical integration services and residential synergies is intended to extend into the broader Manly Community itself; not just those located on site.  

With a local community seeking to fill the many gaps in our health care system:-

  • Aged Care
  • Youth Hospice
  • Affordable Housing for health care workers,, emergency services and disabled 
  • Respite and Recover for our disadvantaged
  • Mental Health care  
  • Addiction Rehabilitation
  • Well-being Retail Outlets and Community Education services

an integrated community of permanent, temporary and retail services is envisaged that extends our into the broader community for the likes of home care, home visitations and innovative digital social media services.   A heath care and well-being facility open to public access. community support and governance.

Being situated in a popular international tourist location with highly effective ferry services to our CBD, the popularity of the area is putting enormous pressures on the local community seeking to retain our idealistic life style as population numbers grow.   By drawing from other examples, like modern health care arrangements occurring in the Netherlands, we observe how challenges such as these can be achieved through medium density living, proven integration techniques and modern technology, all woven into a community fabric able to deliver innovative health care solutions.  A solution where the well live with the unwell, the young live with the elderly, whilst sharing common goals around integrated health care and well being, the disadvantaged with the advantaged, all caring for one another, themselves and the broader community.   A holistic facility woven into the fabric of the community leveraging its horizontal and vertical integration synergies, rather than standalone silos of institutional health care.

 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 systems (like My Health) and other preventive care measures can enable people to remain in their own home, especially when the appropriate health care services are available and thereby undertaking recuperation when they are chronically ill.

The vertical integration of Health Care services (doctors, pharmacists, physiotherapists, volunteers, aged care providers, professional advisers etc.) aided by platforms of cutting edge health care systems and technology have been shown to radically reduce health care costs by cutting the number of hospital beds required.   The key disruptors are 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 (federal and state) 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, could be achieved by re-using  a few (5) of the existing buildings, once fully renovated, refurbished and re-architected for the generic Health Care residences and services for which they were intended.

Imagine a new Health Care model where our elderly are assisted by our youth living in nearby affordable housing.  Imagine our mentally ill working in a community recovery environment, working with our unemployed, homeless and those in temporary refuge surrounded by community and professional help, banks of volunteers (residents and locally) all willing and able to lend a helping hand; aided by local research into some of the more vexing medical conditions (like dementia and Alzheimer’s disease).      All with a range of integrated health specialists supporting residents and the broader Manly Community awaiting more sustainable opportunities and exit strategies from their current care predicaments.  Imagine an ageing community being able to stay at home longer through the advent of modern medical provisions, community volunteers and professional support services attending to their needs at home; in the knowledge that a nearby Health Care Facility exist where more concerted health care provisions exists when and if needed.   Imagine aged care, accommodation advice and information readily available from professionals in choices of public/private health care, including legal, financial, medical and volunteer services.  Such a community-directed Health Care model is limited only by one’s 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 – Innovation and Technology

  1. Adopt existing MyHealth System 
    1. Re-engineer the health system by making use of the existing MyHealth 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.
    2. Health care data management is another opportunity.  People need to be better informed on how to embrace MyHealth 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 MyHealth 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)
       
  2. 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.
     
  3. Self-Help Education and Communication.  With the right information being made available to the right people, who in turn can improve their own performance.
     
  4. 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. 
     
  5. 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 coordinating their care and strategies for the patient to better manage their own health conditions
       
  6. Technology Tools
    1. Wearable technology (eg. BitFit, etc.)
    2. Mobile phone apps for self-analysis and sharing of such information with (away) health professionals
    3. Health Care websites for self-diagnosis for the likes of mental-illness, etc.

Potential Benefits arising from Community-driven Health Care for Residents

In the PDF below is a more complete outline of the community vision for the future Manly Hospital site and the ensuing health care benefits.   

Future of Manly Hospital pack for MCF 19 Feb’18

This vision is an aggregation of community aspirations and innovative concepts brought together in an iterative programme over the last 10 years; ever since the prospect of the Manly Hospital closing was first mooted.  Having accepted the realities of the inappropriateness of the Manly Hospital site for our new level 4 Hospital, the Manly Community’s attention turned to the site’s usage as a community-driven health care facility. Some of the key elements of this unique health care model include:-

  • care synergies and compatibility across on-site health service provisions
  • a considered mix of permanent and temporary residents – with vertically integrated services and resident capabilities and needs   
  • affordable housing developed for rental by health care workers, emergency services personnel,  inter-mixed with accommodation for our disabled and aged 
  • Employment opportunities for health care workers, volunteers, public and private heath care providers and other ancillary services
  • Retaining our local youth, students and professionals, no longer able to afford live in the community they grew up in 
  • Community “Home Hospitals” being facilitated from on-site professional health care services being extended into the broader community 
  • Professional care services focused upon our most prevalent social challenges (eating & drinking  disorders, obesity, type 2 diabetes, alcoholism, addiction, mental health, domestic violence, palliative care, etc.) delivering well-being, preventative health alternatives, predictive health care, self-help education and related research. 
  • Innovations in health care service delivery both on-site and across the broader community using modern technology (mobile devices, MyHealth) and social media (websites, facebook, twitter)
  • Taking the pressure off our hospital systems’ unsustainable strategy of building  more and more hospitals
  • Consider the re-use of some existing buildings for fast tracking community benefits in filling our more urgent health care gaps. while we await the erection of properly thought through iconic precinct, something the community can be really proud of.
Contact Name: Darryl Dobe
Contact Email Address:
Start Date: 20-Jun-2017
End Date: 21-Dec-2018
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  1. Darryl Dobe   

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