ExpertTalk

aims related to the COVID-19 pandemic. Particular attention should be paid to cases, immunisation rates, morbidity, and mortality in this endeavour.

Significant economic impact raises the stakes for the healthcare system, especially when it comes to costs incurred by consumers and corporations. In order to address all of these issues, strong structural and economic recommendations should remove financial barriers to Covid-19 tests, personal protection equipment, medical treatment, and patient care. They should also have a well-defined strategy for how ideas may be quickly expanded and supported.

5. What has been the recent trajectory and current state of healthcare in Australia, and what is the role of drug suppliers?

So besides the traditional issues like an ageing population and increasing demand on health services. Increasing rates of chronic disease. Costs of medical research and innovations the Australian health landscape has been immensely affected by covid-19 pandemic since early 2020. Although Australian health system is considered one of the best in the world, the covid pandemic has exposed number of deficiencies and gaps in the system and just confirmed that even with the best planning, vulnerabilities are very hard to foresee, especially when you are dealing with a very novel and invisible enemy.

In terms of medication and pharma supply issues, Australia imports approximately 90% of its medicines from China and India, while the locally produced medications and their producers have traditionally had to compete with offshore companies on costs and logistics, raising recent concerns that Australia is ‘dangerously dependent’ on global supply chains. NPS Medicine Wise has estimated more than nine million Australians are being prescribed daily medications, which means that medical providers need to more closely and frequently follow up patients’ health conditions considering the current shortage of medications on our market.

The TGA (Therapeutic Goods Administration) stipulates that many disruptions can’t be avoided, admitting that the issue of drug supply shortages is not unique to Australia. Further factors contributing to short supplies include manufacturing problems, difficulties in procurement, overseas political instability, global market crises, the current pandemic, and natural disasters in other regions. It’s just unfortunate that the current situation leaves patients with no alternative but to pay additional costs for essential medication or adjust their dose until they can be provided with their correct medications, with shortages at local pharmacies being a daily struggle. That means marked-up prices on generic brand medications, and pharmaceutical companies ringing overseas suppliers to outsource critical medications. Luckily these issues and concerns have been already dealt with in Australia and the local supply chains have been increasingly popping up and covering the existing gaps in manufacturing domains.

We can only see the global surge on local supply and manufacturing capabilities in the next decade, that’s where significant investments are being diverted.

6. What are the teams' strengths and weaknesses in your area?

Many of us through the Covid pandemic have admitted that we all have recognized and unrecognized weaknesses, but resilience and adaptability emerged as one of our main strengths. With recognized weaknesses, it’s much easier to deal with and plan, or do risk management modelling. While the main burning issues might be different elsewhere, I see and recommend to other healthcare systems and providers to try and recognize what potential team weaknesses might be in their setting and environment. Running regular assessment modellings for a specific health provider or area is one of the tools available. We certainly think that further improvements in essential medical infrastructure and resource checks can be very challenging but are necessary. As we have experienced that despite the fact that the healthcare system in normal conditions, providing general medical services, and lacking Covid trained staff and appropriate PPE equipment, including doctors, nurses, and other emergency staff, but with proper plan and management and the use of enthusiastic young and skilled healthcare workers, was able to maintain treatment management indicators, such as doctor and nurse-to patient ratios, and more importantly ventilator-to-population ratio, almost close to our standards. With appropriate use of hospital capacities space, additional number of beds, and necessary equipment were also created in the main Covid wards.

Additional capacities to treat Covid patients were also created in other healthcare settings and emergency departments. With good communication and team building strategies like regular meetings, motivation team huddles, and peer support of the healthcare management teams in the fight against Covid19 we have been able to address and deal with our weaknesses, becoming stronger, and more resilient and ultimately improving our response to the pandemic. For the leadership teams the importance of regular weekly meetings, brainstorming of ideas to improve the response, further discussing operational plans in various areas of health were usually held with the presence of hospital administrators, public health officers and other decision-makers to evaluate the implementation of newly developed protocols and strategies.

7. Where is Monash Health looking to make investments? Do you have a distinct vision for the direction the business will take?

Primary directions for Monash will be governed by our mid and long term plan which has that flexibility in the case of need. As we see the very turbulent economic crisis at the moment, war in Ukraine and lots of challenges managing covid-19, I think that future investments will be in local manufacturing of essential medical consumables, strategic stockpiling, relying on local energy resources and transitioning to self sufficient health systems which will be able to survive longer periods of time on their own resources. Further transition to health digitalisation and patient communication platforms, digital public health systems and teaming up with start-ups in relevant domains. Vaccine production facilities like the current collaboration between Monash Health, Moderna and Victrian Department of Health to support the production facility in Melbourne. So I see a lot of new changes in a very short future, further collaborations between the healthcare providers globally will be of huge financial benefits.

8. How did you deal with the many deferred surgeries and procedures in the early years?

That was very tough as most health providers in Australia had to completely cancel or reschedule even life-saving surgeries and procedures. We obviously had to adapt quickly and develop strategies with the collaborative approach with our inter state and federal colleagues and health providers. So re assessing all our lists on regular basis and involving the primary health care providers who played an amazing role as well. Between the initial restrictions and free periods we increased the number of procedures to compensate for the periods lost, emergency and high priority patients were never cancelled and we always found the solutions necessary to get the things done. The resilience played a great role and the general population was very understanding a tolerable considering the situation, lots of going into the communities and talking to them.

9. What are your short- and long-term priorities?

We learned on the job what our short and longterm priorities are through the initial support and recommendations of The Australian Commonwealth government postulated healthrelated actions during the primary response to the Covid-19 pandemic: provides national leadership in managing external borders and protecting residents of aged care facilities and approves, procures, and rolls out multiple vaccine options.

The initial short-term priorities were very effective and could be always readily re-implemented again. Our state governments were responsible for determining what public health measures are appropriate, adopting emergency response legislations and implementing them promptly— with managing the border quarantine arrangements and the required Covid