A report released yesterday (Wednesday) by independent think tank The Centre for Independent Studies, supports local health activists Save Our Hospital Inc (SOHI) in their call to have real autonomy to run Pambula Hospital.
Report authors David Gadiel and Jeremy Sammut say the private sector should run hospitals, and local health districts given full control of their budgets, to halt a further blow-out of the spiralling NSW health budget.
“Health is the single, largest area of NSW public expenditure,” the report – ‘How the NSW Coalition should govern health: Strategies for Microeconomic reform’ - says.
“Total health expenditure represented almost one third of the NSW budget in 2010-11, amounting to $16.4 billion. Despite high and rapidly growing spending, and despite hospitals consuming nearly 60 per cent of NSW health expenditure in the last decade, waiting times for elective admission to public hospitals have lengthened in NSW compared to other states.”
The report calls for more managerial autonomy at local levels to run hospitals, including the freedom to hire and fire personnel suitable for local needs, and seek out private operators to deliver public sector health outcomes.
“Centralised control of human resources by NSW Health – the centrepiece of the restrictive public model – means that hospital managers currently lack administrative authority over their clinical workforce. Statewide nursing awards and prescribed ratios of nurses to patients, combined with the freedoms visiting medical officers (VMOs) and staff specialists may exercise over their work practices, deny managers the flexibility to secure efficient and effective care.”
The report calls the Coalition’s overhaul of the NSW health administration since it was elected in March 2011 “insufficient” to achieve the reforms needed, and the establishment of Local Health Districts “largely cosmetic”, being “virtually identical” to the Keneally Labor government’s Local Health Networks.
“Under the Coalition’s ‘new’ district model, centralised command-and-control management prevails. Hospitals remain, via LHDs, defacto branch offices of NSW Health. LHD managerial independence is compromised because financial risk continues ultimately to be held by the state.”
Co-author of the report, Jeremy Sammut, said that without full financial control the reforms were “rearranging the deck chairs on the Titanic”.