Editorial
Hope is not a plan: Public patients shouldn’t be penalised
All of us hope that a diagnosis of cancer will never become part of our life’s story. But we also know that if such a diagnosis does come, early detection and treatment offer a far better chance of survival and recovery.
Since 2006, the National Bowel Cancer Screening Program has aimed to give Australians that better chance – initially for those aged 55 and 65 and today for everyone aged between 45 and 74 – with self-testing kits mailed out to those eligible across Australia every two years.
The National Bowel Cancer Screening Program recommends a colonoscopy within 30 days of any positive test result.Credit: iStock
In Victoria, statistics show that among those who die of cancer, bowel cancer is behind only lung cancer among men and lung and breast cancer among women. So the kits have the potential to save tens of thousands of lives.
But that potential can only be harnessed if a positive test from the kit is followed by a timely examination and diagnosis, beginning with a colonoscopy. On Friday, this masthead’s senior health reporter Henrietta Cook revealed that public hospital patients in Victoria are waiting up to nine months to be seen for the vital procedure.
Given that the screening program recommends a colonoscopy within 30 days of any positive test result, time is being lost that could be the difference in successfully treating a life-threatening condition.
Adjunct Professor Iain Skinner, a colorectal surgeon at Werribee Mercy Hospital, described the increased demand for colonoscopies as “a challenge faced by many Victorian hospitals”.
The Age recently reported that the Victorian Heart Hospital on Monash Health’s Clayton campus is having to cut back on operating theatres and recovery beds only two years after it opened. While the hospital insisted the number of procedures performed would not be affected, cardiologists who agreed to speak to us under condition of anonymity said the cuts had already forced them to warn of delayed treatment. “It’s terrible from a patient perspective,” one said. “The longer they wait, the worse their heart gets.”
Victoria’s growing population is one of the reasons that the state’s government has embarked on a Big Build of transport infrastructure. But the health of those travelling around the state will not wait. Dr Roderick McRae, the state president of doctors’ union the Australian Salaried Medical Officers Federation, argues “there is a massive underinvestment in physical and mental healthcare across Victoria”.
Governments always have to perform balancing acts in budgeting for citizens’ needs, but are we getting the balance right?
A secret recording heard by The Age last year outlined the possibility of cancelling screening for breast cancer, closing special-care cots for sick babies and removing in-demand dialysis services. Every time a service like this is withdrawn at one hospital, the strain on the rest of the public health system increases.
The Allan government has put billions of extra dollars into health with the stated aim of giving hospitals “the certainty to plan for the future”. Premier Jacinta Allan has said she will “always fight for a strong public health system”.
Another crucial element to managing increased demand for public health services is ensuring that some people do not have to go to hospitals at all, by investing in better community health programs. After a debate over cuts to that sector in 2023, some community health organisations warned that preventive health care was not being given sufficient resources, resulting in the whole system becoming unsustainable.
Too often in the past, the state government’s approach has been to rush annual reports of our state’s health services out on a “dump day”, in the hope that no one will notice their cash flow problems or have the capacity to investigate. The Age and our reporters will continue to investigate the pressures on the state’s health services.
On one such day last year, documents showed that more than a quarter of Victoria’s emergency patients were not being treated within recommended time frames and that fewer than half of mental health patients were transferred from an emergency department to a mental health bed within eight hours. For the funding announced this year to be deemed a success, it must move the needle on such statistics.
Behind the debate over money and how services are run are thousands of stories like that of Sherri, who had the courage and foresight to test herself as part of the National Bowel Cancer Screening Program. In October 2024, that test came back positive. Despite being deemed a category 1 patient, requiring treatment within 30 days, she did not undergo a colonoscopy until this week.
Now she waits to know what her health situation is. As she put it: “It could be nothing, but it could be something that needs attention.”
All of us hope for the best, for Sherri and so many others. But when it comes to service provision, hope is not a plan. People like Sherri, who do not have the money to access the private hospital system or to take out private insurance, should not be penalised when it comes to their health.
That is something that needs attention now.
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