Ideology and experience sems to be overriding logic and experience in the Government’s quest to devolve more responsibility over health to the states.
The Minister for Health, Michael Wooldridge, said several confusing and conflicting things this week about the plan. He said it was not primarily to save money. Overall it would be better for Australia. Duplication would be avoided. Health standards in some states would be lower than in others. Less money would be given in tied grants so the states had a greater choice in how they spent the money. After the Labor Government had handed responsibility for immunisation to the states immunisation levels fell disastrously. The reason for the fall and the concomitant 17-fold rise in measles, German measles and mumps was that Labor had failed to show national leadership in the area and was responsible for 42 childhood measles deaths.
This is a hotch-potch of nonsense and folly. No-one could doubt Dr Wooldridge’s concern over Australia’s falling immunisation rate and the resulting death and suffering caused among innocent children. As a doctor and health minister he knows that it is unacceptable in a nation as wealthy as Australia. So he we have a prime example of a health matter devolved to the states and within 10 years they have made a demonstrable hash of it, resulting in death ahd suffering. So what does the new government propose: handing more responsibilities to the states in health. Will they make a hash of them, too?
He then blame the Federal Labor Government for not taking national leadership on the issue. How does a government take “”national leadership”. Does it just talk, or does it act? If it acts it requires public servants and programs to do the acting … unpalatable as it may seem for the new government.
Surely, the immunisation fiasco should be a lesson to the new government. Devolution to the states can be a false economy and not in the best interests of Australians’ health. The short-term gain of the heads of a few bureaucrats in Canberra is not worth the long-term pain of falling health standards. Sometimes the states need a strong federal hand to prevent them neglecting key responsibilities so they can squander money on populist or special-interest causes. The new Government has not been elected just to run an economy; it has been elected to lead the nation.
Dr Wooldridge as good as admitted that if untied money with no federal supervision is handed to the states, some states will have poorer health standards than others. Those states, no doubt will blame the federal government. They will be able to do so easily because that is the source of the money. The devolution model can only work if the states engage in full revenue raising so they cannot pass the political buck. Even then, it is likely health standards will not be guaranteed. The smaller the level of government, the more incompetent it becomes.
On the day that Dr Wooldridge presented his self-conflicting arguments for devolution of health, there was a further example of how the states seem incapable of responding in the national interest. Despite the horror of Port Arthur, Queensland refuses to commit to a ban semi-automatic weapons and a national gun registration system.
There is room for efficiency in government, and duplication should be weeded out where it is unnecessary, but the new Government should see that in some things it would be better for the state function to yield to the national one. Immunisation and guns were just this week’s examples.