Friday, October 05, 2007

Hospitals Can't Heal Themselves

Assertions about Hospital funding, emergency department procedures, ministerial competence, a promised inquiry and changes of minds, and much finger-pointing have been the result of a recent traumatic miscarriage at Royal North Shore (RNS) Hospital in Sydney.

Since 1995-96, the proportion of Federal Government funding towards public hospitals in NSW has fallen from 45% to 41% (2005-06) of the the total funding. The States increased their proportion from 55%-59%. Many will also find unsurprising that the proportion, and dollar amounts, going to private hospitals has increased. Much of that probably comes through the 30% Health Insurance rebate given to taxpayers who then use private hospitals. Still, in NSW 30o people per 1000 people will visit an emergency department - that's a number equivalent to 30% of the population.

Education, transport, universities, TAFE, health. The Federal Government's agenda is to provide more taxpayer support for "private", rather than "public". (The same is true for NSW roads.)

"The time has come", the Walrus said, "to talk of many things ..."
  • We taxpayers might need to pay more tax to fund the public services, such as hospitals, that we want.
  • Or, since State Governments are severely hamstrung in raising revenue by taxes, the Federal Government needs to increase its spending on these.
  • The Federal Government has restricted the number of doctors that can be trained by our universities. It is time they went, with a plan to increase the number of graduating doctors. The plan might also involve lower degree costs for doctors who work in public hospitals after completing their training. Similarly, for nurses.
  • The proposal for local hospital boards is simply about divide, conquer and control by the Federal Government. Let's put that plan to rest.
  • NSW Health Minister Reba Meagher needs to be more productive in her office, and spend more time understanding her portfolio, and less on holidays.
  • Federal Health Minister Tony Abbott must spend less time trying to snipe at, and blame, others (states) and look for ways to work for the people of Australia.
  • NSW Area Health Services need to find failures in all their procedures, staffing levels, staff training, staffing needs (in terms of experience) and infrastructure needs. Then, they can be brutally honest with their departmental and political masters. Only through such a traumatic and cathartic evaluation will a viable 5-10 year plan be possible. We will need that long to fix the systemic and political errors of the last 10 years.
All of these will require a radical change in perspective from all participants.. Economically, we cannot just pump more money in: it needs to be redistributed from elsewhere. As a society we need to set the agenda. We also need politicians and governments who will act in the public interest, not the party interests. Instead of being belligerent, controlling, and blackmailing, governments must actually consider the public good in how they deal with each other.