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"...public opinion deserves to be respected as well as despised" G.W.F. Hegel, 'Philosophy of Right'

public hospitals in crisis « Previous | |Next »
October 20, 2007

The Sydney Morning Herald reports another adverse event at Sydney's Royal North Shore Hospital---a patient with a serious spinal injury could not be operated on for five days due to a lack of staff and no available intensive care bed.

Alan Moir

Associate Professor Bill Sears said that it was a frequent occurrence that patients needing vital surgery were put at risk because they were made to wait due to a lack of intensive care beds. "It's a crisis. The hospital is a basket case"

Sears added that:

People just don't understand how seriously run-down Royal North Shore is. It's terrible. I've worked there for 20 years and it's been heartbreaking to see it decline as it has. It's just the complete lack of resources. There's just no intensive care beds.. ...It's just tragic how the hospital has changed over this time and everybody has been … getting pressure to try and keep the operating theatres closed. I guess it's money. I can't think of any other reason....They shut wards all over the hospital and put offices in there. The hospital has become fuller and fuller of administration management and fewer beds.Obviously they're not getting enough money but they're employing more and more management to decide what they're going to do with the little money they're given, and it's not going through to the patients."

There's the effects of neo-liberalism strategy of starving the public health system of funds. The shortage of beds causes access blockage in the emergency department. Overcrowded ands overstretched emergency departments suggest that some people are turning up at causality departments because they cannot afford or access care provided by GPs.

So governments are crisis managing--putting out spot fires.

| Posted by Gary Sauer-Thompson at 12:59 AM | | Comments (5)


Am surprised there hase been such a quiet response to such a serious thread.
Yep, gorgeous example of neoliberalism in full toxic bloom.
Applies everywhere from Media (ABC, SBS) to police and courts, to education. And my gut hunch is that a chunk of Labor actually subscribes to the underlying self-obsessed "aspirational" theology, which bodes badlyas to the near- seamless take over by the new men; the likes of Iemma, Swan and Brumby etc, from the foundatonal Howards and Costellos.
Seem to recall being told I was born at Royal North Shore or Mater Misericordia, unless they are both the same. Sorry, starting to ramble...

especially when it is not just NSW---crisis management is also happening in Victoria's hospitals with the work bans in place by the nurses. The bitter industrial stand-off has entered its seventh day — with at least 800 beds closed and 450 operations cancelled across the system —and the Brumby Government striking a pose of 'tough on unions.'

What this disputes highlights is that it is unlikely the medical and nursing workforce would be enhanced significantly in the next five years; 35 per cent of emergency department patients had still not been admitted to a hospital bed within eight hours of active treatment starting; there is "a lack of critical mass" in a range of services offered at many acute facilities such as intensive care, emergency services and maternity.

So pouring more money into the hospital system is like filling a bucket full of holes: it's an endless and pointless process. Reform is what is needed.

I see that Malcolm Colless in The Australian argues that what is:

urgently needed [is]to attack the bureaucratic monster created by the state Labor governments which is sucking the life out of our public hospital system.It is a sad fact that only about one in six people employed in the public health system is engaged in face-to-face patient care. The bulk of the remainder are involved in what are essentially administrative areas.Hospital funding needs to be directed away from the back office staff and towards the areas where it is needed most - direct patient care.

He adds that Howard's move to restore the traditional system of individual hospital boards is a sound start to dealing with waste and mismanagement which has flowed from the over-bureaucratised structure of hospital administration established under the Labor state governments.

The structure of hospital administration does need improving. Paul Stanton in The Age observes that:

Despite increased funding going into public health care, it is still a system under pressure. Hospital managers are largely governed by financial imperatives, creating a culture of cost-saving by managers that leads to actions such as slow replacement of staff. Such actions become irritants in the system, further undermining trust and leading staff to turn to their unions for support.

He says that if the Brumby Government forces a detrimental settlement through the courts, it will end up with a workforce that is demoralised and likely to vote with its feet in an already tight labour market.

What is needed is a different and better approach to managing health sector workers. Stanton says:

The British Government has chosen to improve the health sector through better management of staff. Hospital trusts have annual health checks that include human resource indicators such as recognising staff contribution through personal development plans and staff involvement in decision-making. Hospitals are encouraged to measure HR indicators such as sickness and absenteeism rates and staff satisfaction and engagement.

In Victoria, while many hospitals are beginning to implement similar approaches, they are often islands of innovation in a sea of indifference.

The ANF is saying that they had been negotiating for eight months without any bans. But the Government wasn't interested in coming to the table before the industrial action (work bans) started, even though Victorian nurses were among the lowest-paid in Australia.

The other issue is the nurses desire to protect fixed nurse-patient ratios, let alone improve them. The Brumby Government, it seems, wants to do away with nurse-patient ratios.

Instead of negotiating hundreds of nurses have reported that hospital managers had penalised them for closing beds —with some losing more than half their pay.It's , a href="">confrontation.