For many years Canberrans have been presented with the fact that our health system, particularly Woden Valley Hospital, has been spending more than the national average to deliver services. The dollar amounts have been presented by the Commonwealth Grants Commission. The answer to the question of “”how much” has been well known. The answer to the question “”why so much” has been more elusive.
To its credit the Carnell Government embarked on that process and the result came this week in the report of the Booz, Allen and Hamilton report. The Government did this after promising before the election that it would do something about health. It promised to identify efficiencies, create the savings and plough the money back into health in two major ways … the non-hospital part of health and in reducing waiting lists. In short, it promised to redirect some of the spending under the Budget heading “”Health” from wastage to real health.
The Government has set its own target and will be judged by it. The measure of it will be in the reduction of waiting lists; the number of patients treated in the various specialities; and what new health services are delivered. The achieving it will be in addressing the inefficiencies identified by the consultants’ report. These are not pie-in-the-sky efficiencies based on percentage salami-slicing. Rather they are based on what has been achieved, on average, at other Australian hospitals. There is no need for the inefficiency in other hospitals; there is no need for them at Woden.
There is no need run a staff cafeteria at a $500,000 loss per year. There is no need to have shift overlaps of five hours, or to discharge most patients late in the afternoon, or have complex administration systems that require large clerical staffs and still do not deliver comparable service as other equivalent hospitals.
The tragedy is that the efficiencies identified by the consultants could probably have been achieved years ago and the laxity in past years now means redundancies to fix the problems.
Experience in organisations like Telecom, Australia Post and other corporations giving public service shows that huge efficiencies can be made by running the scythe through middle management and clerical areas. The result invariably is better service as bottle-necks get broken and power bases get run around. It is not alchemy to say that better services can be provided with fewer people; to the contrary the extra people hinder the good working of the core.
It seems unlikely that Woden Valley Hospital will provide the best service while inefficiencies like those identified by Booz-Allen remain. There may well be legitimate arguments about some of the detail. These should be worked through co-operatively. But while ever money is being wasted on the inefficiencies now documented, Canberrans will have the poorer health service for it.
From the voters perspective, the consultants’ report should be welcome as setting the benchmark. The Liberal Party put so much emphasis on health before and after the election that it will be impossible for it to find excuses not to pursue reform or if the reform process does not deliver a better health system. It would be a very lame Government that went to the next election without having delivered.