Who should run our hospitals? Are our standards still comparatively high, or slipping further into embarrassing depths?
Back in 2007 (before winning the poll, interestingly enough) PM Kevin Rudd vowed to fix the Australian health system by mid 2009, or else a move would be made to take control of public hospitals.
In May ’09 we were given an indication of the government’s intention to renege on this issue, when we heard that “the Rudd Government is expected to stop short of a financial takeover of public hospitals and instead seek control of other health areas including outpatient care and community health services.”
According to The Australian, a final decision on a takeover move has now been delayed until early 2010, to “allow for further consultation on the National Health and Hospitals Reform Commission’s final report, released in July.”
Responses to the Government’s Stance
The backlash over this move has made Kevin Rudd an easy target, and probably rightly so.
Family First leader Steve Fielding has recently stated “The health system is still stuffed and the Rudd Government has reneged on its promise to the Australian people.”
Opposition Leader Malcolm Turnbull has responded with “The critical thing is that Mr Rudd be held to account for his promise. Let’s be quite clear about this. In 2007, Mr Rudd said to the Australian people he would fix the public hospital system by 30 June this year or he would take it over. And he has done neither. He hasn’t fixed it. Things have gone backwards and he hasn’t taken it over.”
Are they right? Let’s see what the Australian Medical Association (AMA) has to say on our current standards or health care.
AMA 2009 report: Another year of overall decline
Pressure is now increasing on the Rudd government to make good on their promises as the Australian Medical Association’s 2009 report on public hospitals shows “another year of overall decline in emergency department performance and increasing elective surgery waiting times.”
According to AMA president Dr Andrew Pesce, extra funding by the Rudd government is yet to bring any improvement in Australia’s public hospitals.
“Our report card shows objectively, slowly, things are deteriorating, access in emergency departments is worse, waiting times in emergency departments is worse, on all measures our public hospitals are gradually getting worse,” Dr Pesce told reporters this week.
“Where has that money gone? Why are things still getting worse? The current funding for the public hospital system is dysfunctional to the point that extra funds don’t deliver results.”
Interestingly enough, it appears that the situation might be even worse as the report also stated that hospital data can be “manipulated to cast a better light on achievement of benchmarks for political purposes”.
Mr Rudd responded by stating he would take a ‘very dim view’ of any state-based attempt to be ‘cute’ in reporting what was going on in public hospitals. “I basically agree with them, there is a real problem out there,” Mr Rudd stated to reporters. “And therefore, the Australian government, rather than simply pushing this problem under the carpet, believe it’s time we have a fully fledged national debate about how we fix this system for the long term.”
Changing our Health Care System
The situation is extremely complex. I don’t believe on any level that it’s as simple as throwing more money around in the hope that our waiting times improve, our ambulance ramping problems stop and our hospitals can function more efficiently.
I can tell you with absolute certainty that when wards are full, admitted patients occupy acute ED beds. And this is not a great thing.
On the surface, comments like “build more wards” and “get more staff” would appear to fix the problem. However, “more wards” soon fill up, leaving us with the same problem – emergency beds are filled with admitted patients who are stable, or at least have a provisional diagnosis and plan of care. The incoming patients en-route to hospital, those ramped in corridors and sitting in the waiting room, do not.
So what else do you do to fix the problem? Fast track patients who are likely to go home from emergency rather than being admitted? Put on more emergency doctor’s and nurses, and build more spaces to see people? Implement strategies for early intervention when the capacity to deal with a trauma situation is diminished? Sure, all these things and more.
Ultimately however, I believe there needs to be a complete restructure and change in our health care system. Meaning, high occupancy levels, ridiculously long emergency wait times and corridored patient’s being a daily feature is just not on. Whether or not a government takeover would ultimately improve these key areas remains to be seen.
After all, I would suggest that most Australian’s rank having high standards of health care to be very important, am I right?