Growth to change health services

HEALTH services on the Northern Rivers will be focused as much on keeping people out of hospital as they will on caring for those in the wards of Lismore Base as the region grows towards 2036.

North Coast Area Health Service chief executive Chris Crawford said health services would grow to accommodate the extra 70,000 people the State Government predicts will arrive in the region, mostly along the coastal strip, over the next 26 years.

However, that growth would also include a reorientation of services to cater for the much bigger aged population across the region.

NSW Department of Planning forecasts point to massive leaps in the number of people aged 65 or older between 2001 and 2031, both in raw numbers and as a percentage of total population.

As of 2001, across the Lismore, Ballina, Byron, Richmond Valley, Kyogle and Tweed council areas, there were a total 37,110 people aged 65 or older, making up 17.3 per cent of the region’s total population.

By 2031, the department predicts, the same age group will total 91,950 people, more than 30pc of all people living on the Northern Rivers.

That means more focus on rehabilitation services for elderly people recovering from injuries, cardiac services to look after their hearts, cancer services and palliative care. That’s on top of existing health services and, with the rest of the country also aging fast, it likely means doing it in a health system staffed by fewer doctors.

“People are living longer because they are healthier generally, because we better understand the things that make us unwell and because of advances in medicine that mean people will now live who otherwise might have died,” Mr Crawford said.

“People can go on living with a dicky heart or poor lungs for much longer.”

Mr Crawford, with the caveat that it was hard to plan accurately much further than 10 years into the future or to foresee future advances in health technology, said the health service would direct a lot of effort over the coming years to keeping people out of hospital.

“We want to keep them well and intervene earlier so people don’t deteriorate quickly into an acute phase,” Mr Crawford said.

“We will treat people in out-patient clinics and express care clinics as alternatives to emergency departments, or in their own homes.”

Elements of that were already being put in place, such as the area health service’s ‘hospital in the home’ program, which aims to provide varying levels of care to patients, particularly with chronic illness, where they live.

At the same time, the expected decline in the number of doctors working in the health system meant nurses and allied health workers would end up with a greater active role in health service delivery, under the advice of doctors.

However, while the service expected to reduce the proportion of patients ending up in a hospital bed, the sheer number of people coming to the region meant there would still be more people needing to get into the region’s hospitals.

The growth along the coast would be partly catered for by the planned hospital at Ewingsdale, which would be able to treat most medical problems and help take pressure off the major hospitals at Lismore and Tweed.

However, other, smaller, satellite hospitals might end up with a heavy focus on aged care services such as rehabilitation and palliative care. That was a process that was already beginning on parts of the North Coast.

“Wauchope is an example where we’re working with the community to explain that we are giving the Wauchope hospital a new role, specialising in sub-acute, or rehabilitative and palliative services,” he said.

The area health service is not the only one working on keeping pressure off the hospital system.

Community-based groups such as Meals on Wheels worked with the specific goal of helping people stay in their homes (see other story), while councils played an active role in promoting public health and in the general wellbeing of residents.

Lismore Mayor and Northern Rivers Region of Councils president Jenny Dowell said efforts in public health included things such as food inspectors and looking after water quality.

However, the councils also had a role in encouraging community groups that contributed more broadly to residents’ wellbeing. .

Cr Dowell said the psychological and social wellbeing of residents played a big role in maintaining strong physical health and councils contributed to that by encouraging community groups through direct grants, by putting them in touch with similar groups, or by helping with State and Federal grants.

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