It asked for a modest,additional $17.2 million this financial year and a total of $92 million over four years to hire 30 additional staff to bolster the government’s public presence in regional areas. The ERC process was abandoned and the submission shelved after Mr Pallas postponed his budget.
The government has since allocated $101 million to establish six regional and three suburban public health units as part of a $657 million boost to the testing,surveillance,pathology and intelligence capacity of Victoria’s public health system. The suburban public health units,which will each cover a massive patch of between 1 million and 2 million people,are slated to launch on January 10.
The Age has previously revealed the DHHS had only 14contact tracers in March,the month that COVID-19 cases first began to spike,and that Victoria had only six physicians employed in its health protection branch compared to 24 in NSW.
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The DHHS's dire warning about the state of Victoria’s public health capacity was not the only one issued to the Premier.
Australian Medical Association Victorian president Julian Rait said that in late March,as Australia was entering its national lockdown,he raised with the Premier’s office his concerns that the DHHS was not “fit for purpose’’ to manage the pandemic response.
Dr Rait did not blame the current government for Victoria’s inadequate public health capacity heading into the COVID-19 crisis. He said this was a consequence of the devolution of the broaderhealth system overseen by former premier Jeff Kennett.
However,Labor governments have determined public health funding in all but four state budgets this century. Government sources confirmed that successive health ministers for the Andrews government,Jill Hennessy and Ms Mikakos,made repeated,unsuccessful bids for more funding for public health. Mr Andrews served as health minister under the previous Labor government.
Opposition Leader Michael O’Brien said Victoria had Australia’s most underfunded public health team when the pandemic hit. “This sort of investment is insurance and frankly,I think the government let the insurance lapse and we were caught out pretty badly,’’ he said.
In response to questions fromThe Age,a government spokseswoman said:"There was no rule book for this once in a hundred year pandemic. We'll continue to build the health system Victorians want and deserve.''
The ERC submission noted that Victoria’s health protective services were reviewed six times in as many years. This included a 2014 review in response to the Hazelwood mine fire,a 2016 review into the office of the chief health officer and a review following the thunderstorm asthma crisis.
The limited outreach of Victoria’s public health team compared to its interstate counterparts was exposed during a deadly flu outbreak in aged care centres in 2017.
The submission noted that on the Gold Coast,local public health units attended all influenza outbreaks to ensure residents were vaccinated and received anti-viral medication. In Victoria,the public health team only intervened on request and in circumstances where there had been a failure to follow guidelines.
“Health Protection Service provision in Victoria is currently comprised of a single team of front-line professionals working directly from the central office of the DHHS with a small contingent spread across the department’s four operational divisions,’’ the submission read. “From the central office,the team follows up communicable diseases and threats from the environment for the whole of Victoria."
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NSW has 15 public health units including eight in metropolitan Sydney;Queensland has 13 public public health units across the state. This meant that when outbreaks occurred,public health officials were able to work quickly with local government,neighbourhood schools and community groups to respond.
The Victorian government is establishing three local public health units to cover the north-eastern,southern and western regions of greater Melbourne. Public health experts spoken to byThe Age expressed scepticism about whether this would lead to improved public health resources or simply a division of existing services.
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