Tuesday, January 29, 2008

'Quicky" Inquiry for NSW Health

NSW Health Minister, Reba Meagher (pictured below), has announced the terms of reference for the Special Commission of Inquiry into the delivery of patient care in the NSW Health System. The Inquiry will be run by Peter Garling, SC. He has assisted at other inquiries and led the Inquiry into the accident on the old Pacific Highway near Gosford, where two people were swept to their deaths when a section of the highway was washed away. A media release from the Minister can be found here.

The Inquiry will be able to summon witnesses and if necessary, compel them to answer or provide documents.

The Inquiry must report by 31 July 2008, and must identify "any systemic or institutional issues" in the delivery of health care by the NSW Health and to recommend any changes to models of patient care. This is a short time-frame for any Inquiry, but the States are under pressure from the Federal Government to improve services or face a federal takeover.

However, some of the systemic or institutional problems arise from the (former) Federal Government's argumentative and belligerent form of federalism. Under that model, states have been burdened with supplying almost all of the cost increases in health above inflation. Consequentially state health systems and hospitals, and NSW's in particular, have been run by economic managers - the focus has been on Area Health Service budgets, to the detriment of services provided by hospitals and allied health professionals.

There has been insufficient federal funding for new doctors, and restrictions on places for federally-funded university courses for nurses. Further compounding the issue is the rate of payments by Medicare, which have been held artificially low by successive federal governments; a lack of political will to tell people that the Medicare levy should rise above 1.5%; the public has not helped by using hospitals as a source of "cheap" (Medicare-funded) alternative to visiting a GP; and restrictions on funding for, and places for specialist training.

Any reforms that occur just at state level will have marginal impact unless and until Federal & State Governments; Doctor Associations and Colleges; Nurses Associations; Allied Health Professionals and bureaucrats can cooperate. That will require monumental changes in attitudes. I don't know if Federal Health Minster Nicola Roxon and Prime Minister Kevin Rudd can achieve that - time will tell.