Tuesday, 2 August 2011

Health reform still in intensive care

Reform deal to lift hospital standards: PM

Gillard health

JULIA Gillard has declared the health "blame game" over as she defended a watered-down hospital funding deal with the states.

The deal stipulates 90 per cent of emergency patients should be treated within four hours, and 100 per cent of elective surgery operations should be performed within clinically recommended times.

But proposed treatment guarantees have been downgraded to targets, while penalties have been weakened for hospitals that don't make the grade.

Ms Gillard said a new level of transparency in the system would provide the necessary encouragement for hospitals to improve their performances.

She said there was no practical difference between the final deal and that proposed by Kevin Rudd before the 2007 election.

“What was promised was at least $16.4 billion of new funding. What's been delivered? Precisely that,” she said in Canberra.

Mr Rudd's push to force the states to surrender a portion of their GST has also been abandoned. Ms Gillard said in her view, the goal was “never going to be agreed”.

The original proposal included a so-called “National Access Guarantee”, which would have forced hospitals to find a bed for patients overdue for elective surgery in public or private hospitals.

It would have required 95 per cent of emergency patients to receive treatment within four hours, with under-performing hospitals missing out on lucrative bonus payments.

Ms Gillard said the lowering of the emergency treatment target to 90 per cent of patients had been done on expert advice, which suggested some emergency patients needed to be monitored for longer then four hours before being released.

The 100 per cent elective surgery target was lifted from a guaranteed 95 per cent in the original plan. Ms Gillard said the reforms would force badly performing hospitals to lift their standards because they would be subject to greater scrutiny.

“People will be able to transparently see who is not meeting targets and demand that it be addressed,” she said.

“So, you know, the force of transparency is it always keeps before decision-makers and the public what's going well and what's going badly and it always informs a will for change.”

Ms Gillard said the reforms would put and end to the notorious “blame game” in which the commonwealth and states squabbled over responsibility for problems in the health system.

“What it means is that the political blues people have got used to seeing every few years between federal governments and state governments are over. They're over because funding is certain into the future. We will be an equal partner in growth,” she said.

Acting Opposition Leader Julie Bishop said the Prime Minister had capitulated to the states.

She said the blame game would continue and that nothing in today’s announcement would secure any long term benefits for Australia’s health system.

"The so-called great negotiator, once again, has given everything away and received nothing in return," Ms Bishop said.

"It reminds me of the Malaysia swap deal."

But the architect of the Medicare system, Dr John Deeble, backed the health agreement as a "sensible, pragmatic solution".

While acknowledging it would not solve all the problems caused by rising demand for health services, Dr Deeble welcomed the extra funding and the move away from the contentious GST clawback."I really think it is a substantial step," he said.

"People said it was watered down. But it was watered down from something that wasn’t going to work anyway.

"I support it. This is as much as you can reasonably expect to do."

Australian Medical Association President Steve Hambleton said doctors would be watching closely to ensure the promised extra funding filtered down to patients.

He welcomed the changes to the emergency and elective surgery targets, saying the government had listened to the AMA's advice.

"It is a positive change, mainly because it’s a target not imposed by Canberra, but imposed as a result of consultation with doctors," Dr Hambleton said.

"I think this is progress. There are some signals here that make the AMA happy."

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