Thursday, 4 March 2010

The planned takeover

of our hospitals by the Federal government bothers me a little. There is more, much more, to health care than hospitals.
So, why just take over hospitals? Why not take over the lot and provide a national health care system the way they plan a national curriculum?
I suspect the answer is that taking over the hospitals is the easy bit. All they plan to do is take over the funding of hospitals. The states will give up some of their GST revenue in return for the Federal funding of hospitals. Local boards will continue to run each hospital. In other words, the government is not going to take any responsibility for the actual running of the hospitals, just the funding of them. Funding will depend on the number of patients they treat.
I foresee all sorts of problems ahead, particularly where the aged and those with chronic illnesses are concerned. There will be increased pressure to get people in and out of hospital as rapidly as possible. Hospital staff, while apparently liking the idea in principle, admit that some people will be sent home before they should be discharged. That could end up being a very expensive option indeed - just ask any lawyer.
We will say nothing about the extra layer of bureaucracy required to run the hospitals because no government is going to hand over money without demands about the way in which it can be spent. State governments will still want a say in services.
My other guess is that there will be a cut to other services or that these will be 'outsourced' in ways that requires the state government to pay for them. Out patient services will be greatly reduced. Anything that did not first require, at very least, some sort of day surgery will be farmed out to already overworked GPs or some sort of community clinic. These will need to be funded by the state government - and they will say that the money they have foregone will not allow them to fully fund enough of these services. The user will pay. Some people will not attend. The problem may reach the point where the individual needs more rather than less.
We may avoid all of this if the government gives the hospitals sufficient funds and flexible guidelines. We may avoid it if the states and Canberra can agree on fair funding. Of course that will mean the states voting in governments of the same persuasion as Canberra.
It might all work and something needs to change. I am just not sure that this is the change that will make it work.

No comments: