CANBERRA OBSERVED: by national correspondentNews Weekly
Rudd Government bid to take over hospitals
, August 22, 2009
Old-hand Canberra senior bureaucrats have a one-line response to Kevin Rudd's intimations that he might take over the entire hospital system if he wins the next election.
It is: be careful what you wish for.
Taking responsibility for every mishap and every chronically ill person waiting in a queue for treatment or for a hospital bed brings with it a lot of potential political angst and an almost limitless demand for money.
With seven million presentations to the emergency wards of the nation's 762 hospitals each year, and almost five million public hospital admissions, a lot can and does go wrong, and only the bad usually gets reported.
But what began as a vague promise to end the "blame game" between the state, territory and federal governments, has hardened and gained a certain policy momentum over recent months.
A recent report by the Australian Health and Hospital Reform Commission has recommended partial takeover of the country's health system, as well as publicly-funded dental care.
The commission described the country's health system as unsustainable, fractured and inefficient.
It would not be surprising if the federal hospital takeover becomes the centrepiece of Mr Rudd's bid for a second term, featuring strongly in Labor's election campaign.
Gough Whitlam has often described the centralisation of the nation's hospital system as the last great unfinished business of the Commonwealth.
Successive governments have resisted Mr Whitlam's urgings but are at the same time frustrated at being in the position of funding around 40-50 per cent of the cost of hospitals, but standing helpless as state governments wholly run them.
On the other hand, the High Court's backing of the Commonwealth over industrial relations laws has also made it easier for such a takeover to occur.
Ironically, "conservative" John Howard was in the corner of Australia's centralists, and in the latter days of his government health minister Tony Abbott made the first tentative moves toward Canberra control with his controversial takeover of the Mersey Hospital in northern Tasmania.
The benefits of the removal of duplication and red tape are usually exaggerated, and a federal takeover is likely to see an increase rather than a reduction in overall health spending.
The difference with Mr Abbott's proposal was that, while he wanted to fund and run the Mersey Hospital, he also wanted to give the local 70,000-strong community a say in how it was run.
This follows the unfortunate moves by state governments to dissolve local boards and rely instead on nameless bureaucracies in state capitals to decide what is best for them.
Under the Abbott plan, hospital boards, comprising local businessmen, community leaders and health professionals, would have assumed greater say and responsibility as would the CEO whose job the board would oversee.
The Abbott plan was for the Federal Government to become a highly involved "back-seat driver" demanding more for the billions it gave the states in the five-yearly Health Care Agreements.
However, the Rudd Government clearly wants to get its hands on the wheel.
In the middle of this debate is another story which has largely gone unreported in the mainstream media - the ACT Government's bid to takeover Calvary Hospital in Canberra, which has been run by the Little Company of Mary for around 30 years.
It has been reported in the Canberra Times
that the Stanhope Labor Government wants to spend anything up to $100 million on acquiring the public hospital - a move which is hardly likely to be welcomed by ACT taxpayers.
The reasons for the takeover are unclear, but it is understood the ACT Government is unhappy with a long-term funding agreement which demands that it provide capital as well as current funding to "privately-owned" hospitals.
There are also suggestions that the Stanhope Government wants uniform ethical policy across the ACT hospital system so that there are no impediments to or controls on abortions and other procedures.
The threatened takeover has national implications because Catholic-run hospitals, which comprise around 20 public and 50 private hospitals, comprise around 13 per cent of the entire system.Religious orders
It comes at a time when Catholic religious orders, which have run hospitals for a century or more - namely the LCM, Sisters of Mercy, Sisters of Charity, St John of God religious - are declining rapidly and their remaining members moving away from any active involvement.
In short, the Catholic Church in Australia is facing its own decisions about the future role and responsibilities of its multi-billion dollar health care domain.
The Stanhope takeover will be a litmus test both for governments, state and federal, and their interest in church-run hospitals.
Mr Rudd would be wise to show a high degree of caution when considering any takeover, because he may end up biting off more than the Federal Government can chew.