The Guardian 4 May, 2005

Patients pay in Victorian health crisis

Bob Briton

Evidence of Victoria’s health care crisis keeps bubbling to the surface. Last week, papers carried reports that staff at the aged care facility at Yarraville were feeding elderly residents two at a time and that the residents were suffering skin tears and bruising because of the rush to get them into lifting and standing machines. The results of declining staffing levels have led to more complaints being made about aged care facilities in Victoria than anywhere else in Australia. The Health Services Union has called on the federal government to implement minimum staffing levels for homes.

It seems that most people have stopped waiting for the Bracks government to step in and alleviate the real suffering being caused by the failures of the health system — and with good cause. In the same daily newspapers relaying the bad news about aged care centres there were details of how hospitals struggling to operate within their budgets will respond to the government’s latest financial diktat.

Seven of the 14 metropolitan hospital groups have been forced to devise ways to meet daunting financial targets. Failure will lead to the Health Minister appointing a board delegate or sacking the board entirely. Eastern Health (which includes the Box Hill, Maroondah and Angliss Hospitals) will have to reduce its 2003-04 deficit of $3.87 million to just $2.5 million this financial year. Bayside Health (which includes The Alfred) will have to break even this year after recording a $9.39 million deficit last year.

The government expects these hospitals to increase the number of patients admitted from emergency within 12 hours and cut elective surgery lists without increasing costs. A number of the "financial recovery plans" (like that for the Royal Children’s and Western Health hospitals) propose not replacing staff as they leave. Virtually all of the hospital groups will be obliged to raise the number of patients with private health insurance. They will also have to reduce the use of their operating theatres.

The agreements reached with the government detail each hospital network’s financial position and performance targets such as patient admissions and "ambulance bypass". As well as shaking more money from patients by (somehow) increasing the proportion of them with private health insurance, hospitals with be increasing a range of fees and charges that mount up during a patient’s stay in hospital:

  • Royal Children’s will increase its parking fees

  • Southern Health will raise the daily rate of phone hire for patients from $4.40 to $5.50.

    The Alfred is set to axe a layer of senior management and the Caufield General Medical Centre will shut down an aged care ward. Northern Hospital will close its operating theatre entirely over Christmas.

    Department of Human Services executive director Shane Solomon says that the aim of the agreements and the "financial recovery plans" is to get hospitals to run more efficiently. "This is about setting expectations. If you’re going well, you don’t see us. If you’re not going well, then we’re going to be talking to you", the tough-talking bureaucrat said.

    Victorian AMA president Sam Lees sees it differently: "The so-called efficiencies that reduce patient care would not be acceptable and certainly going back to larger and larger wards of the Florence Nightingale style is not appropriate". Though hardly representative of a viable alternative for the health system, opposition health spokesman David Davis made the correct observation that the government is shifting the responsibility for the health crisis out to health services.

    As it stands, however, neither the government nor the opposition are willing to adequately fund the public health system or tackle the profiteering by specialist service providers and transnational drug companies which are at the centre of ballooning health care costs. Meanwhile the Commonwealth government continues to fork out around $4 billion per annum to prop up the financially unsustainable private hospital system and allocate billions more to a senseless and life-destroying military budget.

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