The people’s hospital

Australians enjoy a life expectancy that ranks in the top five in the world and a health system that also rates highly, and yet consistent public disquiet about our hospitals persists. Among the root causes for this alarm is the federal–state political divide, which is shackled by the “blame game”, inevitable inefficiencies, duplication of effort, cost shifting, and poorly supervised programs — and all this costs Australians $9 billion to $20 billion a year.

Despite a flurry of reports and proposals that the Commonwealth take over state hospitals, this notion has not gained widespread support or moved beyond threats of intervention. Recently, the Prime Minister lobbed a grenade into the political arena, with a promise that the federal government would take over the Mersey Hospital near Devonport in Tasmania to the tune of $45 million a year. The hospital had been earmarked for downsizing by the Tasmanian Government. Call it political opportunism, savvy electioneering, or policy making on-the-run — in a single swoop Howard had created a people’s hospital.

This development drew a barrage of salvos from Labor state premiers and from health experts. However, others have backed Howard’s proposal, presumably in the hope this small leak in the dam of the federal–state divide might grow into a torrent that will sweep the whole edifice aside. Labor’s recent health proposal for all hospitals offers some hope that this may eventually occur.

It has been claimed that most people in the community are not really interested in who runs their hospitals — “What they’re interested in is the quality of their treatment and being able to walk out of that hospital whole and well in a way that they weren’t when they came in to that hospital”* — surely, another example of belief in the notion of people’s hospitals!

But as long as hospital funding continues to be the spoils in the dogfight that is federal and state politics, hospitals will never be the province of people but will remain the preserve of politicians.