Melanie Gates: Keeping people out of hospital is key to fixing the health system
First published in The West Australian. Monday, 11 August 2025
Nobody would deny that WA’s health system is under pressure.
The causes are complex and there are no quick fixes. But those of us working in health care also see a big part of the solution right in front of us — keeping West Australians out of hospital in the first place.
Too often, conversations about fixing the health system start at the hospital door. But to build a system that is truly sustainable and better able to meet future demand, we need to start much earlier. We need to keep people healthy.
That means keeping them supported and connected to care long before they end up in an emergency department. It means investment not only in hospital infrastructure, but also in early intervention, wraparound services and community care. We already have a well-established vital network of community and primary care organisations in WA that can and should be a vital part of freeing up hospital beds.
At Diabetes WA, we see the difference that community-based support can make every single day.
When a GP picks up the phone to our Diabetes Connect service and speaks directly with an endocrinologist, that can be one less referral to a hospital outpatient clinic. When someone living with diabetes calls our helpline because they’re confused about their medications or blood glucose levels, we can often prevent a crisis before it starts. Our telehealth services that we proudly deliver on behalf of the WA Country Health Service can reach people in every corner of this vast State and helps people stay on track with their treatment plans and avoid complications.
None of this happens inside a hospital. But it all can make a real difference to the acute pressure being felt in our hospitals. Yes, we need more beds. But we also need fewer people reaching the point where they need them.
Rates of diabetes are rising in WA. About one in 10 West Australians are known to be living with diabetes, although the true number is likely much higher. Diabetes brings a risk of serious, life-changing complications including heart attacks, strokes and amputations. Those risks increase significantly when people living with the condition are not well supported to effectively manage their diabetes.
At Diabetes WA, we say that it takes a village to support every West Australian living with diabetes. This means hospitals, GPs, allied health providers, community services and aged care facilities all need to be working together.
It is encouraging to hear that WA’s health system is being transformed, with plans to scale up programs like Hospital in the Home and invest in digital health. These innovations will be critical to making our system more responsive, more connected and more accessible.
But digital tools alone won’t fix the system. Nor will simply adding more beds. We need a balanced approach that invests in care at all levels, from prevention to acute care to recovery and beyond. That includes valuing and supporting the role of community-based care. The work done every day in community health organisations, and in general practice might not always make headlines, but it often makes the difference between someone staying well at home and someone ending up in hospital.
Strengthening primary care will improve outcomes, respect patient choice and make sure that people are supported close to home. Nobody should end up stuck in hospital wards because there’s nowhere else to go.
If we’re serious about fixing ambulance ramping, if we’re serious about reducing preventable admissions and if we’re serious about ensuring every West Australian can access timely and appropriate care, we need to start where health begins – in the community.
This crisis is an opportunity. Let’s use the attention being paid to our hospitals to drive change across the whole system. With smart investment, genuine collaboration and a commitment to prevention as well as treatment, we can build a health system that works better for every West Australian.
