Sydneys Health infrastructure

History of Sydney health
Sydney as a city wasn’t planned
Hospitals started as a charitable organization that received small government grants.
Infectious diseases prior to 1900 was a major source of illness, hospitals such as tb quarantine wards were isolated, manly, waterfall, randwick.
As public donations decreased and government tax donations increased hospitals were thought more as a public utility, this began the divide between public and private health.
Public hospitals act 1929, reformed
WW2 repatriation hospitals

In the 1800’s there were very few facilities for proper sewage disposal, safe water supply, controls over housing, food supply and working conditions.
Infectious diseases were a major problem that had a dramatic impact on life expectancy.
In the Late 1800’s TB cases decreased by 80-90% before practitioners found a medicinal cure due to improvements in living conditions…

Things have improved AUSTRALIANS are now the second-longest-living people on earth with falling death rates for cancer, heart disease, stroke and injury, but the indigenous population continues to die earlier. Australians' life expectancy is bettered only by the Japanese at 82.2 years. 55 59 79 84

Life Expectancy for Indigenous people 79 84 65 59 Death rates among indigenous males and females were at least twice as high, across all age groups, as those for non-indigenous males and females.

However… WHO ranking of worlds health systems

However… WHO ranking of worlds health systems Health expenditure as a share of GDP, OECD countries 2006

OECD Comparison
Despite the level of health expenditure in Australia, there are fewer physicians per capita than in most other OECD countries.
On average there are also fewer beds per capita than other oecd countries.

Australia’s Healthcare System
Spends 8.8% GDP per year on Average
The Australian healthcare system is mixed. Responsibilities for healthcare are divided between the federal and state governments, and both the public and the private sectors play a role.
Government programs underpin the key aspects of healthcare. Medicare , which is funded out of general tax revenue, pays for hospital and medical services. Medicare covers all Australians, pays the entire cost of treatment in a public hospital, and reimburses for visits to doctors.
PBS Scheme, the government subsidizes prescriptions
Government pays about 70% of healthcare costs (approximately 47% from the federal and 23% from state governments); the remainder is paid by non-government sources, e.g., insurance and private pay.
Problems – Waiting periods for elective surgeries at public hospitals, access for rural, health status of indigenous.
The facts

Australia’s Hospitals Public Hospitals NSW 229 VIC 144 QLD 178 WA 93 SA 80 TAS 27 ACT 3 NT 5 Population NSW 6.8 MIL VIC 5.2 MIL QLD 4.18 MIL WA 2.11 MIL SA 1.58 MIL TAS 493, 400 ACT 339, 800 NT 215, 000

Future Threats
Global Warming
CSIRO predicts – an increase of 0.4 – 2.0 ‘C by the year 2070 which will cause a number of climatic impacts…
Warmer average annual temp
50-100% more hot days 35’C
Sydney may average 4 days over 40’C / YR
More frequent heat waves
70% increase in droughts
10-20% increase in the intensity of extreme daily rainfall
To our infrastructure

Heat waves and Bushfires Floods Storm Surges Tsunamis

Impact on Infrastructure
More strain on emergency services during extreme weather events, aging population…
Heat waves cause technology and equipment to overheat, transport breakdown and water shortage.
Flooding can cause electrical and access problems.
Storm surges push water inland where land is low, shifting rock and damaging roadways, leaking roofs, power cuts.
Tsunami in Indonesia lead to the destruction of 1 referral hospital, 4 district hospitals and 41 out of 240 clinics were destroyed.

Impacts on Public Health
Heat waves in Australia are responsible for more deaths than any other natural hazard
Heatwaves are most likely to affect the elderly
Floods are significantly likely to result in degregation of human health, loss of life, financial loss, trauma and associated human misery.
Hurricane katrina, 19 hospitals evacuated, 18 closed, numerous deaths caused by transportation shortage, especially evacuation.
Tsunami in south asia caused 280’000 fatalities, more than the population of NT, it caused massive hygiene problems and spread infectious diseases, a large number of suicides were also recorded from post dramatic stress.

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