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hospital reform « Previous | |Next »
February 7, 2008

John Dwyer, in his op-ed in the Sydney Morning Herald--- Hospitals' health depends on reform - and dollars ---argues that the the inadequacies, and solutions, of NSW hospital system are obvious. On the problem side he says that though the vast majority of patients seeking help from our public hospitals receive a high standard of care, the incidence of misadventure, and the inequity that results when hospital services are rationed, are unacceptable.

These nationwide problems are a product of a work force crisis, (we have trained too few clinicians), increasing demand for hospital services from ever sicker patients (public hospital admissions increase by 2 per cent a year) and episodes where the clinical needs of a patient are not met by skilled staff....Each evening many hospitals have staff phoning medical agencies frantically competing for doctors who might help them out during the coming night. It is a lottery in which the doctor you "win" may or may not have the experience needed for the tasks required.

And the solution?

An individual hospital should be an invaluable asset for a "networked" hospital system with the services it offers and, equally important, does not offer, based on its ability to guarantee quality and safety. Role delineation is essential.Not all emergency departments are equal. Some should be rebadged as acute care centres and their capabilities explained to the public. Small hospitals near each other should act as "one hospital" on two sites offering excellence at both, but not duplication of services.
He says that nurses, allied health staff and doctors are devoted to the system but feel disenfranchised. So upfront bonuses may attract nurses back to public hospitals. But unless more flexible working conditions, support and mentoring replace bullying and excessive work loads, retention will remain a major issue.


We must follow international trends and focus on disease prevention, the maintenance of wellness, and the earlier diagnosis and treatment of potentially chronic diseases.The states must introduce new models of primary and community care. The most important reform is to build integrated clinical teams around general practitioners so doctors can care for those now being sent to hospital.

| Posted by Gary Sauer-Thompson at 8:22 AM | | Comments (3)


I attended John Dwyer's first reform meeting at old parliament house, a few years back. The then coalition government ignored the outcome as they did on so many issues and have paid the price.The Rudd Government so far looks as though it will pick up the views of people like John Dwyer and John Menadue and the work of the Rural Doctors,the Rural Health Alliance and other vocal professional groups. But every one will have to keep the pressure on both the Federal Government and the States to achieve the outcome Australia needs

what was being suggested at John Dwyer's first reform meeting at old Parliament house, a few years back? Can you give us some of that history? I don't know it. It looks as if that history will be important now that Rudd + Roxon have signed up to reform and the Commonwealth is taking a leadership role through CoAG. It now looks as if Howard + Abbott blocked things.

I would not presume to give a historical background to the Australian Healthcare Reform Alliance but only because there is a very good summary on the net. Just Google the name and it will come up. You will also get updated material about recent meetings. There was a lot of material coming from the first meeting in 2003 with 300 participants. One of the critical papers was about health reform in Canada.I think the reform commission used in Canada is the model now being pursued by the Government and was an outcome from the Alliance meeting in Canberra in 2003.
That meeting was ignored by the Coalition but the Report was received by all the other parties.
You will also get other background material by using Health reform and John Dwyer in the search engine. Happy hunting.