Opinion: If symptoms persist, WA, it’s time to change your health system

             
By CEO, Taryn Harvey

When the head of the Department of Health, Dr Shirley Bowen, said last week that our health system isn’t coping and we need a new model of care, she wasn’t wrong.

But the real question is, why are we still saying this?

Eight years ago, then Health Minister Roger Cook, launched the Sustainable Health Review – a bold plan to transform the way we care for West Australians and create a sustainable health system for the future.

After a two-year review, the final plan was released in 2019, with more than 30 recommendations across health and mental health care. It found that only 16% of someone’s health needs required clinical care, and emphasised the need for more prevention, community-based care, and coordinated services.

Likewise, the ten-year Mental Health, Alcohol and Other Drug Services Plan set similar goals in 2015. It outlined our roadmap for transforming mental health supports and re-structuring the health system. The plan even set clear percentage targets to increase funding for community-based care.

And yet, here we are – recommendations and targets yet to be achieved, hitting new records for ambulance ramping, with a health workforce on its knees and overwhelmed emergency departments.

This time, we’re attributing ramping to a lack of aged care and horror flu season, but these are just the latest symptoms of a now familiar ailment.

Dr Bowen is right that we need a new model of care, but we’ve known that for a long time. And we already know what the new model needs to look like – more community-based supports for those with complex needs, to foster long-term recovery, and keep them out of emergency departments.

This is the best model for both the patient and health system. And nowhere has this fact been seen more clearly and consistently over the years than in mental health. 

Right now, there are close to 50,000 West Australians who have ongoing moderate to severe mental health challenges. This group can’t access support through the NDIS, nor are they being supported adequately through the public health system, where the bulk of mental health treatment currently occurs.

The result? They fall through the cracks. And this group of people is growing, both here in WA and across Australia.

So, at what point do we admit that the sustainable health system we were promised eight years ago hasn’t materialised, and maybe it’s time to stop blaming external factors and start looking inwards?

At what point should we ask why we haven’t made progress on some of the key recommendations of the Sustainable Health Review – funding models that reward outcomes, community-based care for people with complex conditions, and a community-based mental health system that treats people holistically, rather than trapping them in a revolving door.

At what point do we shift our focus from hospital infrastructure projects and tackle the real problem at the scale that’s needed? 

Undoubtedly, the pandemic had an impact on achieving progress in this space. But what we really need is a willingness to act now. Not in another five years, not after another review, and not when the Commonwealth agrees it’s time.

We’re at an important juncture right now, when critical conversations about health and mental health are underway across the country – the National Mental Health and Suicide Prevention Agreement is set to be renegotiated and WA’s next five-year mental health strategy is being drafted as we speak.

We know that this new strategy will once again focus on restructuring the health system to reduce demand on our hospitals. So, why wait for the Commonwealth to tell us what they’re going to do about this issue?

Let’s take the lead on this urgent reform. Let’s tell the Commonwealth we’re ready to finally address the longstanding gap in community-based mental health care, and that we want them to meet us in the middle.

If we don’t seize the strategic opportunity of the current negotiations with Canberra, we’re setting ourselves up for another decade of record ramping, burnt-out staff and more West Australians falling through the cracks. 

This winter, the symptom of our overwhelmed health system is ambulance ramping. But guess what, WA? The cure isn’t solely about fixing aged care. Or just hoping for a milder flu season next year. And the solution certainly isn’t funding an endless supply of hospital beds.

When symptoms persist, we’re taught to go back to the drawing board. Consult the doctor.  Treat the root cause. And at the heart of these symptoms is our need for a new strategic approach to funding and delivering healthcare.

West Australians deserve adequate, affordable, accessible health and mental health care. And that’s what they were promised eight years ago. The time for systemic reform isn’t someday, it’s right now.

This opinion piece originally appeared in The West Australian on 12 August 2025.