The Guardian 6 February, 2008
Hospital league tables
First it was schools that were threatened by the Howard government with proposals for the publication of league tables, and funding dependent on performance. Now, Labor Health Minister Nicola Roxon is proposing public performance tables for hospitals as a condition of federal funding.
Under a deal struck between the federal and state health ministers at a meeting last week, patients will be able to compare the "performance" of public and private hospitals. This will put hospitals under pressure to do whatever is necessary to deliver a good report, and sweep under the table any mistakes or other negative outcomes.
If performance is measured on such criteria as waiting lists, average time spent in hospital for particular treatments, hospitals will be pressured to churn patients, avoid accepting the most serious cases and take other measures that are not based on medical criteria. Infections might go unreported, and whistle-blowing made even more difficult.
The underlying concept of the proposed league tables is to turn the health system into a competitive market, in particular one where the competition is based on cost-cutting rather than on sound medical outcomes and quality of care.
Public hospitals need more government funding, rather than pressure to speed up treatment and cut costs. Government spending on private hospitals has grown at triple the rate of that on public hospitals in the past decade. Billions of dollars every year are being thrown at the private hospital system, through such mechanisms as the private health insurance rebate of 30-40 percent and Medicare rebates.
If this money were redirected to the public hospital system, waiting lists could be slashed, more hospital beds opened, more nurses and doctors employed and patient care and treatment improved over night.
The private hospital system is profit-driven, and the parasitic private health insurance companies that feed off it bleed the public system of much needed funding and undermine patient care.
Review after review has proven the public system to be more cost effective and to offer greater medical services where it is given the necessary resources and staff. The money is there, more than enough to solve the many problems facing public hospitals. It is a question of redirecting those funds from the private to public system where they can be put to better use.