Health sector prepares for ageing strain amid push to 100,000

Daily Advertiser 3rd September 2019

Professor Gerard Carroll

AN AGEING population will be a source of constant pressure on health services as Wagga pushes towards 100,000 residents by 2038. Professor Gerard Carroll, of Riverina Cardiology, said the city is a "retirement magnetic," and aged care and health services will feel a higher demand amid the population boom.

The latest census data showed the Murrumbidgee Local Health District is about 15 years ahead of Australia with the number of older residents residing in the area significantly higher than the national average. However, a boost of more than 30,000 residents has been supported by the state government's 20-year economic vision for regional NSW, which identified health and residential care as a primary industry suitable for stimulating growth. An upcoming seminar led by Committee 4 Wagga will address the rise in demand for aged care and health services, which is expected with the population surge. Other critical growth factors will also be addressed at the seminar on September 27, including business, education and government investments in industrial and community infrastructure.

 In the lead up The Daily Advertiser will be exploring these key issues in detail.

 Professor Carroll said the strain caused by an ageing population cannot be ignored because they will require a greater use of in-patient resources. He said illnesses become more complex with age and patients tend to recover much slower. "For example, if a woman of 50 years of age gets a urinary tract infection they will often go to their GP for antibiotics and will be better in a few days," he said. "A woman of 80 with the same problem might have trouble walking, lose balance, becomes a falls risk, becomes confused and there's a greater risk of death. It increases the need for her to be treated more aggressively, so she needs to be hospitalised." While it is in everyone's interest for the elderly to maintain independence, he said there comes a point when they will "progressively become more frail," losing the ability to do everyday tasks. "They become a falls risk and if dementia sets in, those things exacerbate and certainly puts pressure on health resources," he said. "As numbers increase we need community services, support of informal carers in the community and ... progressively increase available residential care, such as nursing homes and hospital-level accommodation."

Senior staff specialist geriatrician Paul Finucane.

Senior staff specialist geriatrician Paul Finucane anticipates that the number of people aged 65 years and older will dramatically increase by 2038.  Although some will reach old age with a clean bill of health, he said there will be "a percentage who have major health problems" and will need assistance from residential care services. He said planning for a population of 100,000 allows the local health district to preempt demand rather than wait for the need to grow. It is "inevitable" that more nursing homes will be needed and the city is in the position to foresee future needs, Professor Finucane said. He said the city will need various levels of residential care for those who can manage with little help to others needing high-level care. "Health services develop because there are perceived gaps in the service, waiting for demand to build up and then try and met up with it," he said. "I think we need to start planning for 2038 and put in place the structures that we need, which goes right back to promoting health and avoiding illness, but also responding to the breakdown of health when it comes to older people." Despite aged care services "always playing catch-up," he said the city was in a better position than other health districts. He said residents could access Wagga's nursing home services within a few short weeks, whereas waiting lists in some other places span months.

 Overall, Professors Finucane and Carroll said Wagga is in the best position - compared to other regional centres - to support the influx of residents. "There will need to be an increase in services, particularly primary care and general practice, and there will be a greater pressure for acute and chronic care, but ... we have a strong backbone in our public and private sectors," Professor Carroll said.

Jay Ross - Calvary Medical Specialist Recruitment Manager

Schools key for growth

Clinical schools will have a fundamental role in recruiting medical specialists who are equipped to manage increasing demands on the health sector. Medical specialist recruitment manager Joy Ross said exposure to a regional environment is a tried-and-tested way of attracting doctors. Those who undertake training at Wagga's two clinical schools typically apply for junior medical positions at the end of their training. But challenges arise when students are not exposed to the regional lifestyle. "We realise that doctors who have not had exposure to a regional city have perceptions, which do not necessarily reflect the reality as we know it," Mrs Ross said. Changing these perceptions will be "one of the biggest challenges," but other means can be used to show a potential candidate that establishing "a vibrant medical practice" and "enjoying a quality lifestyle" is possible.

Looking beyond Wagga's established clinical schools, Professor Gerard Carroll said the next step will be offering a rural medical school, which will "further enhance recruitment and retention". The federal government has supported this concept with a medical school and an end-to-end program to be delivered by 2021. However, the top priority will be to recruit specialists committed to working and living in Wagga. "Visiting specialists provided extraordinarily good and precious services, but ... we've found the more residential specialists we have, the more service provision infrastructure can be developed around them and the greater capacity to satisfy ... the rural patient's [need] to stay in the bush," Professor Carroll said. He said the city has tripled its number of specialists in the past 15 years, which is a strong indicator that the health sector will be able to support the upcoming population growth.