Modern healthcare is besotted with performance indicators and outcomes. These are easily found in Australia’s Health 2004, the Australian Institute of Health and Welfare’s (AIHW) biennial encyclopaedia on our health and healthcare services.
Each year the AIHW releases about 100 reports on health or healthcare issues. In addition, an avalanche of reports flows from Australia’s nine health departments and the advisory appendages of the Australian Health Ministers’ Conference. This undoubtedly constitutes information overload of mind-numbing proportions.
However, there is one obvious omission — nothing on the “effectiveness, appropriateness, accessibility, responsiveness and capability” of our health bureaucracies, their performance indicators, relevance and value. Australia’s health bureaucracy escapes scrutiny. Indeed, there are only two short sentences on health administration in the 500 or so pages of Australia’s Health 2004. To wit, “Medical administrators work shorter hours than other medical groups . . .” and “Administrators . . . make up a large proportion of the non-clinical workforce (32%) . . .”.
Moreover, the cost to the nation of health administration is mysteriously buried in the appendices. For 2000–2001, it was $1855 million, and growing at 7.3% annually over the past 5 years. Simply put, health administration costs each Australian about 25 cents a day, almost certainly an underestimate.
In recent years we became familiar with the jingle “Your ABC for 8 cents a day”. We all know what we get from the Australian Broadcasting Commission, but what value do Australian taxpayers get for their 25 cents a day spent on health administration?
This question should certainly be on the agenda of the Prime Minister’s Taskforce on Healthcare, or even the next Australian Health Ministers’ Conference.
- Martin B Van Der Weyden1
- The Medical Journal of Australia