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health: pressure points or system failure? « Previous | |Next »
October 20, 2005

Well you can see the pressure points in the health care system. Here and here. Public hospitals and mental health.

The Queensland health system is widely seen as "unsustainable" without dramatic changes, and that would cost an estimated $1.5 billion a year to fix. Even though Canberra has reduced health funding to the states for years, Queensland have been under funding their mismanaged public hospital system for years.


Premier Beattie was on Radio National Breakfast this morning, and in the media throughout the day, doing his usual spin covering up the lack of inverstment in health; why patients will now make a contribution for minor elective surgery, adult dental health care, glasses and specialist outpatient services; and why it was no big deal to dump the basic principle behind Medicare--universal health care.

It did not occur to him, nor did anyone ask him, why adult dental health care or optical care (glasses) are being dealt with by public hospitals. Isn't that preventative medicine or primary health care that is treated in clinics outside public hospitals? Isn't Queensland meant to be the smart state?

The report into mental health Not For Service, was prepared by the Mental Health Council of Australia, the Mind and Brain Institute and the Human Rights and Equal Opportunity Commission, and it is based on data collected across the country from 2003 to 2005. It is littered with personal stories of loss and despair and describes how system and service failures resulted in worsening illness and, too often, death.

Immediately the states and commonwealth go at one another's throats to shift the blame. I'm with Commonwealth on this one. The drive for national mental health reform in Australia in the early 1990s (de-institutionalization) has hit a brick wall, largely because of the state's dismal record of funding reform (better community services that kept people out of hospital) and placing the emphasis on law and order. For instance, Tthe report dams SA:

Despite repeated inquiries and multiple government commitments, there has been little evidence of substantial mental health reform in South Australia. It remains the State with the greatest emphasis on institutional forms of care. While a great deal of community, media and professional criticism has been expressed about proposed changes to the mix of hospital and community care, there is also a clear desire for real reform. Reform will need to be backed by genuine resource investment as well as real leadership.

However, the Commonwealth's solution ---the Commonwwealth taking over mental health in order to provide enough psychiatric beds in public hospitals --is flawed, as it turns the clock back to institutions and away from the community.

Federalism is not the problem. Does it matter who delivers the mental health services? Couldn't the Commonwealth bypass the states and directly fund ngo's that deliver mental health services if the states don't lift their game. The indication is that they won't given the negative response by NSW Health Minister, John Hatzistergos: the reports methodology was questionable and its recommendations flawed. Yet in NSW, though money is spent on acute mental health facilities within hospitals, this is at the expense of community mental health centres which are being cut back.

| Posted by Gary Sauer-Thompson at 8:13 PM | | Comments (0)