I really miss those nightly TV news shots of Dr Rudd and Nurse Roxon tramping through the wards of public hospitals dressed in their fetching baby blue scrubs. What has replaced those earnest looks of the Ruddster, patronisingly patting some poor patient trapped in a hospital bed? They were soap opera quality, I’m sure you will agree.
We would then have a nightly announcement, with the Health and Hospital Reform screen behind the nodding contingent – clearly carted around from hospital to hospital by bitter staff members – dreamt up that day by the Ruddster. Nurse Roxon has now told us that she had no idea what he would utter, what thought bubble would emanate from his lips, on any given day. After all, she was only the Health Minister. That’s the way to make policy!
Having rained on Dr Rudd’s parade, Premier Barnett forced a major rethink that didn’t involve the states handing back GST revenue. But what really has been achieved by the Health and Hospital Reform package?
Certainly, in the case of Victoria, the major current news coming from the public hospitals is the significant cuts to bed numbers and elective surgical procedures as the feds decide that they had given Victorian too much money because the ABS was overestimating population growth – supposedly. This has meant that hospital managers have been forced to trim their budgets within the budget year. I thought all this sort of stuff was supposed to be fixed up by the Ruddster.
The core features as I recall involve:
- Hospital networks (these already existed in Victoria so no gains there);
- Medicare Locals – buggered if I know what these really do apart from being souped up General Divisions of GPs, but with boundaries that are different from the hospital networks;
- More federal funding for hospitals – recurrent and capital – based on agreed shares;
- Lots of targets - eg. the 4 hour maximum wait in ER, cuts to elective surgery lists
- Casemix funding for all larger hospitals (again no gain for Victoria because casemix funding has been in place for years. It probably only achieved a one-off gain in efficiency in any case)
- National pricing authority to set prices for casemix (unhappy resemblance to central planning agency);
- GP Superclinics (AHAHAHAHA – an appalling, politically motivated intervention) Where are we in relation to numbers and service delivery?
- More doctors and nurses (actually more than we need).
So any thoughts, Cats? It all looks like the same old, same old mess. Wasteful expenditure, unmet demand, runaway inefficiencies, crazy resource allocation, failure of central planning.
It would be interesting also to see what has happened to the number of health bureaucrats. Remember Gillard’s pledge that the numbers would not increase with the ‘reforms’. Mmmm – there are more than 6000 public servant in the Commonwealth Department of Health and Ageing and the Commonwealth does not run one hospital. My guess is that the states have not reduced the number of head office health bureaucrats as the hospital networks have been staffed. Any information very welcome.