Daily Telegraph Blog
Posted on Friday, 27 May 2011
Last year, before Julia Gillard deposed him, Kevin Rudd wanted to reform public hospitals. He said that he wanted them to be nationally funded but locally run. The former prime minister was always more talk than action but, on this issue, he was fundamentally right.
The difference between the government and the opposition is that nothing much will change under Labor while the Coalition has an achievable plan for more beds and better services. Public hospitals will get more funding for providing more services and local managers will be given the power to solve problems themselves rather than just to say “no” and blame it on head office.
Australian public hospitals are still among the world’s best but they’re coping thanks to the goodwill of staff rather than the inherent strengths of the system. In most states, hospitals get last year’s funding plus or minus a margin based on how many scandals have made the news. Decisions about staffing levels and significant new spending are made by distant bureaucrats. Doctors and nurses are the meat in the sandwich between frustrated patients and officials whose concern is meeting budget rather than delivering services.
The Coalition will work with the states to establish community hospital boards so that each major hospital is accountable to the people it serves. The board will appoint the hospital CEO and, with the CEO, set the hospital budget. Hospitals will be funded on an “efficient price” basis so that there will be an incentive to provide more services rather than simply to cut costs. The Commonwealth will fund hospitals to the same extent that it currently does – only that would be calculated as a set percentage of the efficient price rather than as a diminishing percentage of bloc funding that’s never enough.
Importantly, if a state is prepared to surrender a percentage of its GST, the Commonwealth would pay 100 per cent of the efficient price thus becoming the sole funder of hospitals’ day-to-day operations. This would be serious hospital reform; the kind that Labor talked about but couldn’t deliver.
27 May 2011