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October 2, 2007
The politics of health continue. Health Minister Tony Abbott has foreshadowed a solution to a dogs breakfast health "system". The next five-year commonwealth-state health agreement would require each hospital to have a chief executive accountable to a local board. The measures would follow the model established by the Federal Government when it intervened to prop up the Mersey hospital in northern Tasmania, which will be funded by the Commonwealth but managed locally.
Clements
The justification? Apparently the ALP is engaged in a federal takeover of hospitals so the Coalition is going local. The ALP is actually talking about a single funding for hospitals, not actually running state public hospitals from Canberra.
This shift to placing power in the hands of local communities by the Coalition effectively cuts out the states, and it is at odds with the plans of some States (eg., SA) to do away with local hospital boards as they modernize their health system so that work in terms of a co-ordinated clusters of hospitals, primary care clinics and aged care facilities in a particular region.
It is also ignores the workforce shortages and the lack of resources at the heart of the health systems that necessitates the shift to clusters and co-ordinated and the transformation of some regional hospitals to aged care and rehabilitation facilities.
Update: I October
The crisis in the hospital "system" surfaces most dramatically in the adverse events in cash-strapped public hospitals and with patient complaints. The Age has an editorial on the topic. It says:
Both parties in this hospital war — or is it just a phoney war, a blame game being waged by political adversaries with no definite, clearly articulated policies to fix the system? — need to focus on issues that get to the heart of the problems in health-care delivery, not tactical manoeuvres that just meddle at the fringes without committing themselves to a real and necessary increase in resources that would go a long way to tackling the system's failures. The Australian public has little interest in the minutiae of hospital funding but knows that more is needed, given that the Government's private health initiatives, and a concomitant decline in realistically indexed federal funding over the past 10 years, have clearly done little to ease pressure on public hospitals. Also, it is more than aware that with growing pressure on hospital beds, the imperative for an early, and sometimes premature, discharge has increased.
The Age's editorial says that rather than pointing the finger at the states and threatening federal takeovers, the Government, or should it win office the Labor Party, needs to deal with the implications of an ageing population — for example, by boosting the number of nursing home places, which will free hospital beds for those who are ill, not just old. More beds means more doctors and nurses to attend them, and the next Government must ensure there are enough university places available to train them.
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Gary,
And so we have the hospital wars.
Tony Abbott argued that the difficulties in the public hospital system stemmed from poor management rather than sparse funding. Large area health services were inefficient, with the majority of decisions getting stuck in state government bureaucrats' offices.
Isn't giving clinicians and community representatives a say in how a budget is spent a good idea? Eg the subsidarity principle. As you have previously pointed out the states have a poor record of governing public hospitals. Something has to shift.