If you spend time in our public hospitals as a patient or as someone who works there you are acutely aware of all the concerns about the state of the system and the level of care. 

Peter Dutton waiting for Tony Abbott to stop making out with patients at St Vincents

The people who serve in the public hospital sector are generally committed above and beyond all call, and are constantly frustrated if they feel that cannot provide the correct and best care for a patient because of the limitations of staff, equipment, time and capacity.

Many of us have called for hospital boards and now once again the idea has been floated, this time by Tony Abbott. 

As a patient you want to know that each person you encounter in your care is accountable to you as an individual and in the scheme of things works in a hierarchy and system that supports them and is accountable to the community.

Currently, even though each doctor or nurse or ward staff may want to function that way, they work in a system where the accountability is remote to a health department. There are layers of self perpetuating bureaucracy who are remote from the coal face and have little practical reality as to the impact that their decisions make. They have no understanding of the cost burden they themselves heft on the health system and how it sucks money out of patient care. There are many real examples where beds and wards have been closed in order to open desks for public officers.

Within a Federally funded or State funded structure, (and Federal funding and control means even greater distance from the patient, the servant and the services), the best model for accountability and responsiveness in hospital administration is to have hospital boards in place.  Where a geographic or demographic situation demands it, local or regional boards should be created.

This idea is not new. Many States had a hospital board structure in past. These were dismantled because governments and health departments wanted more control. They wanted to destroy “pride” that institutions had in themselves and the “competition” between them for excellence.  The Chairs of Boards could embarrass government if they underfunded or showed lack of compassion.

There was a pointed voice that could target the government specifically and with authority. Government did not like that aspect in particular. The Boards could advocate for the needs of the community, and at the same time ensure that business was conducted at its very best to provide delivery of high quality care in a cost effective manner.

Government preferred to create a lowest common denominator controlled more centrally, rather than allow for development of service delivery based on recommendations from those who are experts in delivery and those who carry responsibility and accountability to the people.

There is merit to a structure where a CEO of a hospital is accountable to a Board and the Board is accountable to the community. In fact the Board is made of significant community members with expertise in business , senior doctors and clinicians, nurses and providers, those with legal expertise, consumers etc. The makeup of the Board will require the diligence that you would place in the selection of people to run such an important institution as a hospital. That Board, our representatives, then holds government accountable.

The CEO is hands on, relating to the staff and the service provision and the patients. He walks the corridors, listens and responds to his providers, manages the budget and day to day operations, and reports to an interested board who is engaged. The security of patient care with excellence and efficiency are goals. These models exist in the private sector, and they would serve the public sector well.

Confidence in the hierarchy that supports your working environment is a start to job satisfaction. When you can see it translated in support for the work you do in looking after patients then there are better outcomes for all concerned. Knowing that you can use your skills to the utmost in caring for people because you have the tools, the time, the efficiencies and the capacity, ( be it bed capacity, staff,  or investigative or discharge to step down or rehab care), then you want to stay in your job. The crucial recruitment and retention of doctors and nurses will become easier as the environment in a Board run hospital changes.

Of course, we have to have sufficient funding to enable the service delivery. That denominator does not change. But there will be improvement in the effective use of that dollar translated into service delivery under hospital Boards.

Central take over’s are not the answer. The buck does not stop with the PM. He is too far away.

Let the buck stop with those who live in the community in which the hospital serves. Let it be held in those who are trained to provide the standard of clinical care we should expect in this country, Let it reside in those who know how to run a complex service provision business like a hospital. Let us bring back pride and a desire to work in our public hospitals.  Let us allow the hospital to integrate with the community needs and be part of the plan for our increasing aging population.

Let’s bring in the public hospital Boards and they will be accountable to the communities they serve and they will bring government into account.

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89 comments

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    • John A Neve says:

      05:14am | 15/02/10

      “Plan for hospital boards is one that can work” and it could, but it won’t. This idea is reminiscent of “back to the future”, it’s been done before. Contrary to what the good doctor states here, by and large the local hospital boards failed. There were good ones, very few, the bulk of them were not up to the task.

      Who will pick these people? Will they be paid positions or voluntary?
      How will we achieve uniformity and consistency across the country?
      Who will monitor these boards?
      There are that many questions to be answered it’s not funny.

      What the good doctor fails to explain, is the AMA’s role in our doctor shortage!! What has been suggested here is just another level of management. It also has the home spun appeal to the masses that politicians love.

      Will it improve our health system, NEVER.

    • 6clegs says:

      11:42am | 15/02/10

      Couldn’t agree more with your comments!


      me thinks the good doctor might be angling to be the next Brendan Nelson ? at the very least the author is trying to deflect the shortage of General Practitioners, and the role the AMA played in that sorry-saga; sorry, but that won’t wash with those of us in (suburban) Tassie struggling to get into a GP that practices within a 15k radius of where one lives.

      Practical vs being able to say ‘I’m a Hospital Board Member’ would do more for the health of Australians, Ms Capolingua.

    • Jack Thomas says:

      01:30pm | 15/02/10

      Why does Tony Abbott need to release a proposal like this, I thought it was all solved by Kevin 07?

      Oh yes, that’s another promise from the election Kevin Rudd has failed to deliver..

      The Weasel words from Rudd about it all being dependant on the States were not evident when he first made the election promise.

      Even Nicola Roxon spouting the latest grab given to her by Labor spinners on this is amazing, she can hardly hold a straight face because she’s waiting for the journo to actually ask about her part in this election fraud.

      Sorry persephine you’re sounding like the Labor spinner again. Get back to writing some more catch phrases for Kevin, I am getting sick of the “our number one priority” and “I’ll tell you one thing..”

    • Martin R says:

      04:55pm | 15/02/10

      In the late 1960’s, we lived in a small western NSW country town whose hospital was run by a Board and it was a brilliant little hospital, an absolute credit to them all.  The care and attention the patients received was second to none.  I am all for it.

    • Tom Holman says:

      06:08am | 15/02/10

      Community accountability is positive provided it is supported and monitored centrally. Consistent measures of the patient experience need to be put in place, as Victoria has done, to help those hospital under-performing and learn from the leading lights.

    • persephone says:

      06:23am | 15/02/10

      If it’s such a brilliant idea, why’s he only proposing it for two states?

      Victoria already has local hospital boards, and has had since the late 1990s.

      I assume that means that, using Abbott’s logic (and yours), there’s nothing wrong with the Victorian health system!

      A good plug for Victoria leading up to the State election.

      I further assume that, as he’s only proposing to have hospital boards in two states, then the others either have them or don’t have any problems.

      And I can’t gell some of your statements with what I do know about hospital boards.

      Firstly, referring to the responsibility for running hospitals, you say ‘let it be held by those who are trained to hold the standard of clinical cae we should expect’ - well, sorry, community run local hospital boards are just that, made up of members of the community.

      There’s usually a couple of health professionals on there (in Victoria, in a non voting capacity) but the bulk of board members are simply those who have put their hands up (it’s an onerous task with no particular kudos and no financial returns), so they’re certainly not experts.

      Which also makes your ‘those who know how to run a complex service provision business’ ignorant as well - there will, by the nature of things, be a couple of business people on the board, but these will mostly be local accountants and small businesspeople, not experts in running large corporations.

      I would have thought, given your former position, you would know that some States have hospital boards. I would have thought that you knew what kind of people were on these boards.

      Obviously not.

    • Nigel says:

      08:56am | 15/02/10

      Sorry persephone, I didn’t understand what your solution to the failing State run hospital service is.  Are you suggesting we should just wait and Kevin07 will fix it like he promised to do at the last election and will no doubt re-state at the forthcoming election?  O perhaps this is one of your usual Liberal=bad, Labor=good posts.

    • persephone says:

      09:22am | 15/02/10

      And yours is, Nigel??

      We have a proposal here by Tony Abbott, which Dr Capolingua supports.

      She conveniently ignores, or does not know, that this system is already in place in hospitals in other states of Australia.

      So if it’s the miracle worker she seems to think, then these states must be dramatically outperforming the others.

      Dr Capolingua should know, better than almost anybody, what the situation is with hospitals across the nation.

      Apparently she doesn’t.

      It’s not pro Labor or pro Liberal to point out errors of fact. A fact has no political bias, it just is.

      Secondly, Tony Abbott was the Minister for Health less than three years ago. Have the problems with the Health System only arisen during that time?

      Nigel, you’re welcome to attack me on the basis of facts, using evidence. Of course, it’s easier for you to point out my political allegiances, that’s understood. By doing so, however, without tackling my arguments, simply suggests that what I’m saying is correct and you have no other comeback.

    • Paddy says:

      09:35am | 15/02/10

      You are correct Persephone, Vic does have hospital boards. Unfortunately, rather than being independent, they are essentially hand picked supporters and friendly to the ALP and Brumby / Bracks. Politicised, I believe the term is.
      If you recall in the the four months prior to the last election Bracks removed all waiting lists for essential and non essential surgery and the issued a requirement that all patient had to have an appointment with a specialist to confirm there was still a need to be on the list (I suppose to check they had not died so long was the wait). This resulted in a massive self promotion informing the public of the success in reducing waiting lists.
      These independent boards said nothing while this fraud was being committed. Why?, because it was in their interest and importantly they held their position only by the grace of Brumby and Bracks.
      I support your concern of so called local accountants and small business people on the board, however, remember people running large corporations usually come out of small business and local accountants blend with quality CEO’s to make successful business.
      So, there is nothing wrong with “little"people, may times they focus on the objectives not the politics.

    • alison says:

      10:36am | 15/02/10

      persephone - what no comment on today’s yarn about Senator Conroy needing to sacked for ignoring the workers and slumming it on a skiing holiday at Vail with his fellow comrade Mr Stokes just a few weeks prior to handing him and the other two free to air TV stations a quarter of a billion dollars - i guess even a Labor staffer can’t defend that one ...

      hospital boards will work at a local level - out here in western NSW we have one Board (Greater Western Area Heath Service or GWHS) which covers over half the State, from Lithgow to Broken Hill and up to the Queensland Border. It does not work, locals continually get ignored about what services they need.

      However, it is obvious that not every hospital and town is going to be able to do open heart surgery, which is why the major base hospitals in each region need to be exceptionally well staffed and have the latest health gizmos and gagets, such as MRI’s and hopefully PEP scanners in the not too distant future.

      Having said that, a doctor in town and a hospital which can undertake routine medical proceedures shouldn’t be too much to ask.

    • persephone says:

      12:02pm | 15/02/10

      Alison

      I have a sort of rule that I try not to talk about things I don’t know much about. Conroy’s area is one of these.

      He gets points from me for taking on Telstra and I like the idea of the NBN but I don’t know whether or not skiing with Kerry Stokes is sinful or not.

      I’m all for local hospital boards, what I am criticising here is the writer’s obvious lack of knowledge (i) that these boards already exist; and (ii) of the way they work.

      It’s lovely that she and Abbott see eye to eye on this, and those meetings she must have had with him when he was Health Minister must have been beautiful too.

      But she was head of the AMA so one would have thought she knew something about the way hospitals are run.

      To praise a policy and then show such total ignorance abou the area it covers is a little self defeating.

      And, as I say, it’s yet another admission that the Victorian government is doing a very good job.

      (And, for the record, I yet again state that I am not a labor staffer, or Julia Gillard).

    • Jack Thomas says:

      03:47pm | 16/02/10

      persephone, we’re all still waiting for Kevin 07’s election promise to take over running the hospitals.

      You’re in the ALP offices, surely you have an idea what date that is happening.

      Well? Don’t tell me it’s just another election promise broken?

      As for Conroy taking on Telstra, I’m not sure where you got that idea from? There’s no evidence of that whatsoever. Just more spin.

    • Tomi says:

      06:51am | 15/02/10

      Wow, what utopianism! Anyone who thinks adding more bureaucracy to the health system will shorten waiting lists needs to stop taking their medication. Let us have failed council politicians, industry representatives with their hands on the coffers, and careerist managers on their way to the next job running our public hospitals. That’ll fix things. Let’s hear what Kiwi doctors now working in Australia have to say about Community Health Boards.

    • Tomi says:

      06:51am | 15/02/10

      Wow, what utopianism! Anyone who thinks adding more bureaucracy to the health system will shorten waiting lists needs to stop taking their medication. Let us have failed council politicians, industry representatives with their hands on the coffers, and careerist managers on their way to the next job running our public hospitals. That’ll fix things. Let’s hear what Kiwi doctors now working in Australia have to say about Community Health Boards.

    • T.Chong says:

      07:20am | 15/02/10

      State Health Depts set out to destroy “pride” ? Utter BS - a claim that reflects more on Doc Capolingas attitude to public health than realities.
      Same as the claim about “competition for excellence” how are such things measured Dr Rosa? Are your fellow drs who work in a large teaching hospital, who take on complex cases “bad ” if the interventions fail, compared to drs who work in hospitals that have less problematic patients to treat?
      Why Doc do you imply that patient “security and excellence of patient care” arent part of the public system?
      In NSW the standards - policies and procedures to deliver care are all encompassing, with the staff doing their best.
      You want people “who know how to run a complex service BUSINESS like a hospital”? Maybe hospitals should not be a BUSINESS. Maybe they should deliver services that a community needs, rather than what a business model / plan indicates.
      Having worked under the old local boards system in rural / regional NSW, under LNP and Labor, I can vouch that localised vested interests are no more enlightened or capable than maligned public servants, if anything, they were more prone to the “nod and a wink” way of doing things that worked well for those in the know.
      A doctor may be great at diagnosing and treating TIAs or a broken finger, but that does not automatically translate to the same person knowing how to run a hospital.
      Local boards are antiquated , with the olde fashioned attitude that “Doctor knows best” last seen in “A Coutry Practice”, and no more believable.

    • Botfly says:

      07:26am | 15/02/10

      It won’t work, I think Rudd is finding this more difficult than he anticipated and just 2 states is not enough. Australians deserve the same benifits right the way around Aus. I don’t like the idea that my fellow Aussies in tassie or South Aus or the Northern territory or Western Aussie are not getting the same benifits as me. I think Kevin Rudd will sort this out , but its going to take time. Better him than me, its a big mess

    • Darren says:

      08:07am | 15/02/10

      wow- good to see the strongest Union in Australia backing community boards - good for me, I live in a nice rich, white area - bad luck for people who don’t!

    • Helena B says:

      08:42am | 15/02/10

      I feel sorry for the woman Tony Abbot is slobbering over in the pic..nothing worse than being stuck in hospital sick ..unable to run and having Tony Abbott slobbering all over you. At least he left the dreaded lycra and budgie smugglers at home or the poor woman would have been blinded as well. The plan won’t work.. we have more than 2 states in Aus

    • The Drover says:

      10:02am | 15/02/10

      Better Abbot slobbering over her than K.Rudd, the thought of that is truely nauseating and would probably leave her hospitalised for far longer.

    • Charles says:

      08:46am | 15/02/10

      The point about an all encompassing bureaucracy suffocating the desire to better things is well made.  I read an article once which stated that only 2 out of every five persons employed by the VIC Helath system was actually employed in primary health delivery (i.e. a doctor and/or nurse).  This meant a significant number of people employed just to watch over those trying to do their job.

      In some respects health has gone the same way as local government, where there are now very few of those employed by councils actually looking after the roads and rubbish, etc and all those things they are supposed to deliver.

      Hospital boards worked well in the past, they were removed for political reasons rather than those of efficacy, and therefore as a possible way forward they should be given a chance.

    • John A Neve says:

      09:15am | 15/02/10

      Charles @ 0946hrs,

      Are you suggesting past boards weren’t political?
      I would suggest they were very political as are local councils. In fact many wannabes used both as a stepping stone.

      As to the numbers employed by the health system; don’t cooks, cleaners, porters and maintenance people count?

    • T.Chong says:

      09:20am | 15/02/10

      Charles : 2 out of 5…, Unless you want to go back to early last century, then you need the other 3out of 5.
      Hospitals need cleaners and clerical and kitchen staff.. They need radiographers and pathology staff, they need wardspeople / porters. They need people to look after stores / supplies, they need people to sterilise surgical equipment etc etc etc
      Do you advocate the “good olde days” ? when nurses were expected to deliver patient care, AND prepare meals, clean the bathroom, mop the floor etc
      If you or your loved one was sick would you want the nurse to get back to you, just as soon as they can,after delivering the meals for the ward (after all you wouldnt expect others to miss out on lunch , just because you’re sick, would you?)
      Hospitals are like defence forces. The number of front line nurses and doctors or soldiers is small compared to overall numbers, as both these entities need large back up of resources and infrastructure to do their job properly

    • Darryl Price says:

      09:39am | 15/02/10

      Ha ha love the caption on the photo…

    • Carl Palmer says:

      09:45am | 15/02/10

      The link between the source of funding and service delivery needs to be as short as possible. The more “layers” you have the more inefficient it will be. It is well known that in NSW the various “Heath Services” are extremely bureaucratic, top heavy and very expensive for very questionable returns. They are bureaucrats who report to Govt. and execute Govt demands.

      We need to be able to “point the finger” and get action. There needs to be one organisation / group that is held accountable so that we can get the biggest bang for our buck.

    • persephone says:

      12:04pm | 15/02/10

      Yep, so local boards become the scapegoats for government policy.

      Instead of blaming the government for a poor outcome at the local hospital, the general populace will blame members of the local board (seen it happen; a local hospital board member copped lots of flack for announcing the government’s policy on fluoridation).

    • Evan Findlay says:

      10:22am | 15/02/10

      Tony Abbott and Rosana Capolingua fail to realise that this does not address the problem. In an external report on the state of NSW health and hospitals there were 120 recommendations. Not one of those recommendations advocated the re-introduction of hospital boards. One of the problems with hospitals and the allocation of it’s financial resources is in it’s bureaucracy. Too many in management and too little at the coalface. There are approximately 750 hospitals across Australia, by introducing boards you are simply relegating the problem to another tier of management. Having worked in hospitals and aged care for the past seven years I am acutely aware of the problems and there solutions. More doctors, first and foremost. It was the Howard government and the then head of the AMA, Dr Brendan Nelson, that refused to increase the intake of medical students into universities. Huge mistake; secondly more nurses and better pay. You will never attract enough nursing staff to the industry if you keep paying them peanuts. Thirdly, you need to look at preventative measures to lighten the load on the health system and also for a healthier society. I would hate to have to count the amount of overweight people who come through the hospital doors, but we are probably looking at 50 to 60% of patients. Fourthly, Funding, Funding, Funding! It speaks for itself. When the coalition government was last in they ripped over a billion dollars out of the health system and then expected them to improve their outcomes. It doesn’t work like that. Great if it did, but less funding means less services.

      Once again Tony is on his Headline a Day mission espousing simple and populist ideals to fix detail and complex problems. Creating Hospital boards will do absolutely nothing at improving services, finding more doctors and nurses or lessening the waiting lists. I have no problem with Nicola Roxon and Mr Rudd taking their time in announcing a policy. Let’s just hope it can go some way to fixing the problem. I can guarantee now though it will not be the be all and end all. The health system has been neglected and underfunded for too long and it’s now at the point of meltdown. A recent report stated that some 90 to 100 billion dollars would be needed to fix the problem and I don’t think the taxpayers are ready to part with that sort of money.

    • Phil says:

      10:39am | 15/02/10

      The NSW Coalition has been pushing this idea at the state level for about a decade and it has been rejected at two successive state elections. The only people who are really serious about it are the doctors and the handful of local “worthies” (usually hand picked by the local pollies, especially in rural and provincial areas) who used to populate the boards before they were eventually abolished.

      The reason the doctors, and especially the AMA, are keen on the idea is because it would effectively hand control of the public hospitals back to doctors to be run in doctors’ interests. Only a handful of doctors are actually so self-serving but unfortunately the AMA only ever seems to advocate on behalf of this minority.

      Some of us well remember the AMA under Bruce Shepherd and their attempts to treat the NSW public hospital system as their personal plaything. It should never happen again, but it seems the old Painters and Doctors Union is alive and kicking.

    • Kathryn says:

      11:00am | 15/02/10

      Oh great, just what we need, more Boards filled with fat bureaucrats with their hands in the government coffers—NOT!!!!  This has been tried (and failing) in Victoria.  A whole new level of “Fat Cats” is not the answer.  Do we really need another pompous CEO walking off with millions of dollars after he has failed his job?  How will this be funded?  Increased taxes or, more probably, sharp increase in the “user pays” mentality of the USA.  No thanks!  It seems reasonable to me that health and education should be a NATIONAL issue and controlled at Federal level.  This would ensure uniformity and consistency throughout the country.  Those whingers constantly complaining about our health system should get out more!  In actual fact, our health system is one of the best in the world - compare it to what passes for health care in America and be grateful!

    • marie says:

      11:26am | 15/02/10

      As usual the same politcal aligned people side up with their political parties views. Bottom line is both major political parties DO NOT know how to fix the health system. Thats because the issue is a political football, and no party is really interested in fixing the system properly, WHY ? Because it cost BIG money to fix. Both parties keep looking for cheap fixes. No matter which party is in government, this issue will never go away.

    • Phil says:

      02:10pm | 15/02/10

      Marie Agreed. The only way to fix the system is to have one body looking after it and increase medicare levy to 3%. As unpopular as this is its probably the only way. NSW is a mess area health services are just run by managers. Often hospitals have more in admin than in care what a joke.

    • persephone says:

      02:28pm | 15/02/10

      Well, that’s true to some extent, because Health is a never ending hole when it comes to money - you can keep shovelling it, but you’ll never fill it.

      If you cut waiting times, the call will be for new hospitals; if you build more hospitals, the call will be for more nurses; if you employ more nurses, then the next call will be that they receive higher wages and better working conditions.

      New procedures, new treatments, new equipment, new drugs - all add up to endless ways you can improve the health system and all cost bucketloads. And when you’re up to date on all of that, the next technological advance comes along.

      So we’ll never be able to afford a perfect health system, where all patients get the level of care their individual problem requires in the hospital closest to their home, or every emergency ward can cope with the totally unexpected, one off, emergency situation.

      The trick is determing what’s the best we can achieve and how much we’re prepared to spend to achieve it.

    • exzilerate says:

      11:36am | 15/02/10

      Your comment:Its hard to believe that Abbott did virtually nothing as Health Minister under the Howard Govt. except to rip millions from the Public Health system and now breathtakingly he is being listened to with his “new” Heath plan. What a walking talking hypocrite - not to be trusted by anyone at all.

    • Seen this before says:

      12:03pm | 15/02/10

      We had hospital boards in Qld, along with ambulance boards and fireboards. When Goss came to power they all disappeared.

      And not before time either. The boards were refuges for National Party mates and local celebratories, also in the Nats of course.

      Our hospitals were hopeless backwoods places and no on ever knew who the board was anyway.

      Since then, life and Australia has changed considerably.

      The Abbott ‘solution’ is step 1 in a move to fully privatise hospitals, and reward ‘mates’ with positions to these dodgy boards.

      It’s time people understood that there are more staff and interests in hospitals than just doctors and nurses too, although listening to politicians and media commentators one would think that doctors and nurses ran these places.

    • Andy says:

      12:07pm | 15/02/10

      At least Abbott is prepared to put something on the table as a start. Over 2 years and Rudd is still reading reports with no intention of letting us know what he has in mind (if anything) and also where are the super clinics he and Roxon so proudly trumpeted about?

    • Francis Forbes says:

      12:26pm | 15/02/10

      Might as well try with boards, its pretty obvious that the current structure is failing help

    • Steve says:

      12:28pm | 15/02/10

      Tony’s RE-floated this one, hasn’t he?  Didn’t he float it for some place in Tasmania when he was Health Minister?

    • Darryl Price says:

      03:40pm | 15/02/10

      Umm…no.

    • LuckyLady says:

      01:01pm | 15/02/10

      2 States? I have family living in Western Aus..what about them? We are one country, and we want it that way. What is good for me is good for my family and every other Australian’s family around this vast country of ours . It won’t work its just a rehash of an idea he had before. I to agree I can’t imagine anything worse than being pawed by Tony Abbott when I was sick and in hospital. The lady in the picture deserves a medal.
      I think its a huge challenge to fix something thats been neglected for so long, I believe Labor will try their best to fix the problem but after years of neglect from the Howard Government( The Liberals) it will take some sorting out. Rudd has only been in governemnt for 2 years, The Liberals has 11 years to stuff it up.

    • Luke says:

      01:23pm | 15/02/10

      Yep and the Libs were thrown out because Rudd claimed (promised) he could fix the mess of the health system by june 2009. Maybe the Libs learned a lesson after 2 years in opposition and can now do what Kevin can’t. To blame the opposition for Rudd breaking his promise is a weak excuse and just shifting the bame. I thought Kevin said it stopped with him???? Did you hear that too?

    • Andy7 says:

      01:53pm | 15/02/10

      Maybe he shouldn’t have spent so much time writting kiddies books and essay’s long enough to sink a ship. And you know what? that word “challenge” is ringing hollow.

    • persephone says:

      02:31pm | 15/02/10

      No, Luke, the Libs were thrown out because of WorkChoices.

    • Diane says:

      01:47pm | 15/02/10

      Will they also overhaul the complete lack of privacy which you get in the public health system? Eg having your case discussed in a ward with other patients and visitors present; having receptionists tell the whole waiting room what you suffer from; having pharmacists ask you personal questions in front of everyone; having your pills given to you in front of everyone, with the name of the medication visible on the box, hence telling everyone what you suffer from;  having your chart left at the end of your bed where everyone can read it; having your medical records shared around by dozens of doctors, when you’d rather only one doctor have access to them; having extra-sensitive data recorded in your medical records when you’d prefer certain things be left out; having to wait 7 years before you can ask for your medical records to be destroyed, and even then, it’s only if the doctor agrees to it; having information shared with next of kin; having no privacy after you die (look at what happened to Michael Jackson a few days ago) etc.

      Doctors have no respect for privacy at all, and they’re allowed to get away with it by politicians who just don’t care. They barely get a slap on the wrist if anything when they breach confidentiality.

    • Michael says:

      03:59pm | 15/02/10

      This proposal is a cruel hoax and a distraction from the fundamental question of how a finite amount of resources are allocated throughout a health system. .

      There are three aspects to health administration - access, efficiency and quality. The cynical (or experienced) say you can only have two and there’s something in it.

      Health administration sought economies of scale to avoid duplication on the so-called corporate services. it didn’t make sense, for example, for every hospital to have its own payroll system. I am not arguing in favour of bloated bureaucracies but those that are arguing for a more local admin need to say whether all of this will be unwound. And we haven’t got to the point of economies of scale for purchasing or the ability of large budgets to absorb shocks to manage cost over-runs in individual hospitals.

      There is a popular perception that non-clinical = bad. And that more clinical = good. This is a myth. Non-clinical includes the staff essential to make sure that hospitals operate properly (eg IT systems) and within the law (accreditation, FoI etc)

      The second point is how will this resolve the question of allocation of resources between Hospital A and B? Resources covers both funding and clinical workforce. If two hospitals want to specialise in much the same thing, how will the local boards resolve that? How will the clinical managers make sure that they don’t “cut the baby in two” as each argues, inevitably, in its own interest?

      How does this proposal improve any of the delivery of an equitable health service? Could the proponents of removing what they regard as the dead weight of a centralised bureaucracy explain just how practically this would work? How budgets would be set? How services would be optimised? Who is accountable to whom for what? This question of centralisation was carried entirely by people who wanted more control is, with respect, breathtakingly simplistic. The greater control is because the government of the day wants greater accountability over how taxes were spent. In a scenario where there will be even greater pressure on the health system. Dr Capolngua’s argument needs to explain how funding will be managed and allocated. Resources have to be rationed.

      This proposal cannot be taken seriously until someone explains how it would work. Otherwise any appeal it has is just because it is not what we have now. And that’s illogical - what we have now is bad, so anything different must be good….. Oh I see ..............

      If anyone could explain the practical difference that this would make, please do so.

      This is a really complex matter that will not be solved by a simplistic reorganisation. It might also be reasonable to ask the health administrators what can be done to improve the system

    • Pablo says:

      04:12pm | 15/02/10

      Hey it’s an exelent idea, take one of the most dificult problems for any level of goverment, and throw it to “tha people” to deal with. At the very least it should end the headaches for our poor overworked parlamentarians. Now if if he can come up with way to get all the virgins ooops , sorry ment women, to get back to their ironing, he has my vote

    • Carl Palmer says:

      04:14pm | 15/02/10

      There are big bucks involved here and someone needs to be made responsible.

      Currently there are too many fingers in the pie and as I said, we need to get the biggest bang for our buck. If it is a hospital board or the Federal Govt – don’t care. The current arrangements are not efficient, there is wastage and we can’t continue to fund this black hole.

      I believe it was Abbott who was pushing for the Feds to take control sometime back but Howard said no and the current PM said he would take control. So you have the 2 major Federal parties expressing interest – so give it to them.

      Federal Govt to hospital instead of fed to state to area health service to hospital.

    • Nicki says:

      04:35pm | 15/02/10

      Why he didn’t do it while he was Government Minister, this is empty promise and only fools will buy a ticket from this magician.
      He had his chance for many years,by now we could have a perfect health care if he did his job properly, this is politics not care for Australian people.I don’t trust snake eyes anymore.

    • davo says:

      04:46pm | 15/02/10

      Well regardless of what you think of this idea its interesting to note that not one of the posts so far says the system is working. Everyone agrees that it is not working and clearly there is a problem with State Governments as they have been running the hospitals.

      There is a major structural problem with the health system in this country and it is not going to go away on its own. Keven “the buck stops with me” Dudd has done nothing about the problem.

      Whatever is done with health in this country to solve the problems it will only be acheived by standing up to the States and removing their ability to swamp the health system in administration.

      If anyone remembers bob carr’s promise to halve waiting lists—the spin doctors cured that problem for him—the same spinners are now Canberra based—watch out Australia- dont let KDudd do to the nation what what bob carr did to NSW- if that happens help us all!

    • eeldraw says:

      02:38pm | 16/02/10

      Predicting Abbott’s long term health care revolution if elected:
      Step 1: More bureaucracy
      Step 2: Privatise Medibank Private
      Step 3: Privatise Hospitals
      Step 4: Eliminate Medicare
      Step 5: Claim credit for putting country back into surplus (by selling off these and other assets)
      Step 6: Ignore our falling quality of life because, well… “Gee our surplus looks good, dunnit?”

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      04:01pm | 16/02/10

      In the age of posterboy presidents, if Tony had his ears pinned back I’d vote for him grin

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