Arthritis is one of the most common, costly, and disabling of all chronic conditions. In its many forms arthritis affects 1 in 4 Tasmanians, including children and young people. By 2030 the number of Tasmanians with the most disabling types of arthritis – osteoarthritis and rheumatoid arthritis – is expected to significantly increase (20.5% to 149,600 and the cost to the Tasmanian economy will increase by $35 million to $197.7 million).
Yet despite its overwhelming prevalence, the painful and debilitating impact of arthritis, and its national health priority status, there is a gaping mismatch between the burden of disease and its prioritisation in policy and resourcing in Tasmania.
Tasmanians with arthritis deserve better.
The time has come to act.
Arthritis & Osteoporosis Tasmania is seeking a commitment from all political parties and candidates to support the following key election priorities:
- Development of a statewide musculoskeletal model of care for Tasmania. Central to this will be the establishment of a musculoskeletal triaging and assessment service providing a single point of entry for public rheumatology referrals, assessment, and treatment pathways.
- Establishment of a specialist rheumatology and persistent pain service (1FTE rheumatologist, with multi-disciplinary support) based in Launceston, to improve access to public specialist services for those living with inflammatory arthritis in the north and north-west regions of Tasmania.
- Establishment of a statewide paediatric rheumatology service to facilitate early diagnosis and rapid access to effective care to prevent permanent disability and avoid current costly and disruptive travel interstate for specialist services.
- Development of purpose-built hydrotherapy pools to provide much needed community access to preventative health and rehabilitative warm water treatment programs.
- Appropriate level of resourcing to Arthritis & Osteoporosis Tasmania – the only dedicated organisation providing information, education and support services to Tasmanians living with arthritis, their carers and health professionals.
Why are these priorities?
A statewide musculoskeletal model of care is desperately needed for Tasmania. Instead, we have an ad hoc array of underfunded and siloed services; inconsistent patient pathways; unacceptably long waiting lists; and multiple and confusing entry points. Without purposeful action, elective surgery and outpatient clinic waiting times will continue to grow, and the public health system will struggle to cope with the growing burden of disease resulting from arthritis. A musculoskeletal model of care will provide a pathway to improved early diagnosis and effective management of arthritis. A single-entry point for all musculoskeletal services (rheumatology, persistent pain, orthopaedic and neurosurgery specialist services) will address current fragmentation and improve patient equity, access, flow, safety, and outcomes.
There are currently NO public rheumatology specialist services available to Tasmanians living in the north or north-west. Services are currently centralised in Hobart and provided through RHH outpatient clinics (which are unable to cope with demand nor are funded to deliver state-wide services). Early diagnosis and access to specialty services is critical to avoid or limit irreversible joint damage, deformity, and disability.
Juvenile Idiopathic Arthritis (JIA) is a painful, auto-immune disease-causing pain, swelling and stiffness in affected joints. 80% of children with JIA experience pain daily and suffer a high burden of permanent disability, lost educational opportunity through time off school, limited participation in social and physical activities, and resultant mental ill health. JIA affects around 1- 2 per 1000 Australian children aged 0-16yrs, has a similar prevalence to childhood diabetes and epilepsy and a prevalence six times higher than cystic fibrosis.
On average in Australia, it currently takes 10 months from the onset of symptoms until diagnosis of JIA and 4 or 5 doctor visits before the diagnosis is made. In some children it can take years thus creating a vital period without treatment that increases the probability of irreversible joint deformities and vision threatening eye disease and it is, sadly not uncommon for some to have permanent disabilities by the time of diagnosis. Establishment of a statewide paediatric rheumatology service will avoid unacceptable delays in diagnosis, valuable time out of school (lost learning) for the child, and disruption and distress to the family.
There is a dire scarcity of hydrotherapy facilities currently available for community use within Tasmania. Greater access to purpose-built hydrotherapy pools will provide much needed access to preventative health and rehabilitative warm water treatment programs. Scientific studies have shown that warm water exercise can improve strength and general fitness in people with various types of arthritis and related musculoskeletal conditions, and other chronic conditions and injury rehabilitation.
Exercising in water is one of the most comfortable and effective ways that a person with arthritis can exercise. The buoyancy of the water takes the strain off weight bearing joints and the warm water assists with relaxing the muscles, dilating the blood vessels, and increasing blood flow to sore and injured areas. It is particularly helpful for people with arthritis in several joints as all joints can be exercised at once; with conditions affecting feet, knees, hips and back; preparing for or recovering from joint replacement surgery; and for those who find it difficult or painful to exercise on land.
Arthritis & Osteoporosis Tasmania delivers a broad range of quality community information, education and healthy lifestyle support programs, but the scope and reach of these activities is constrained by limited resources. Heavily dependent upon volunteers and community donations, and with more pressure than ever on the donor dollar, the organisation is unsustainable in the long term without appropriate government resourcing.
The closure of Arthritis & Osteoporosis Tasmania would leave Tasmanians without a dedicated information and support service for the 1 in 4 Tasmanians with arthritis, osteoporosis, and related musculoskeletal conditions. Callers to the to the national arthritis Infoline would receive no answer or be picked up in another State by someone unfamiliar with local Tasmanian services and referral pathways.
The highly valued Smoother Movers warm water exercise and strength training programs attended by close to 300 people weekly would no longer be available.
These initiatives do not call for significant additional funding and any investment would be offset by savings achieved through reductions in elective surgery waiting lists (due to less inappropriate referrals for surgery) as well as enhanced information, community education and self-management support for people with arthritis.
References:
- Arthritis Australia for the Australian Government Department of Health, 2019. The National Strategic Action Plan for Arthritis.
- Arthritis Australia, 2016. Counting the Cost: Part 1 Healthcare Costs.