Public hospitals under attack

by Rohan Gowland

Public hospitals around the country are becoming embroiled in disputes 
sparked by State and Federal Government funding cuts. The funding squeeze 
on hospitals has intensified in recent years and now thousands of needy 
patients are turned away on a daily basis. This situation is being 
manipulated to promote the private health system, to the further detriment 
of the public system.

On Monday, around 1,000 health professionals in Victoria voted unanimously 
to go on strike for 24 hours in protest against "the worse funded, the 
worse managed Health system in Australia".

The Victorian Trades Hall Council said, "The State Government needs to 
prioritise a well staffed, safe and reliable health system instead of 
running it down as part of the agenda to further privatise public health."

The latest round of health cuts in NSW, arising from the State Budget, was 
the last straw as far as hospital staff in NSW were concerned. Staff have 
spoken out about the increasing numbers of patients being turned away, 
blaming budget cuts and the reduction of beds for the inability to cope 
with demand.

The claims of hospital staff were confirmed by ambulance officers, who said 
that 20 per cent of the emergency departments at Sydney hospitals were 
effectively closed every day. Ambulance response times have increased due 
to delays in ferrying patients to other hospitals or in trying to admit 
them to overcrowded hospitals.

Patients are having to wait up to 30 minutes for an ambulance to respond to 
an emergency call and then wait up to five hours before receiving treatment 
at a hospital.

Ambulance officers in southern Sydney are finding the situation so 
impossible to cope with that they are planning to put a motion to ban all 
non-urgent transfers between hospitals between 6pm and 8am.

The South Australian public hospital system was put under similar pressure 
when the May Budget delivered cuts of $46 million to health.

"Cuts of $46 million to health services cannot lead to anything other than 
service cuts and bed closures", said Gail Gago, State Secretary of the 
Australian Nursing Federation. "These cuts will add to a health system 
already reeling from previous government slashing", she said.

Ms Gago said the SA State Government had cut around $150 million from the 
health budget since they first won office.

The latest Budget cuts to health were very extreme. Ms Gago said, "Hidden 
away in the Budget papers are tables that show that 181,300 treatments or 
services will be cut from the health service".

Ms Gago said even emergency services were supposed to reduce their services 
by nearly 29,000. "How on earth hospitals are supposed to reduce even their 
emergency services by nearly 29,000 is beyond me. That will mean that 
nearly 80 people every day in the metropolitan area are turned away from a 
hospital emergency service", said Ms Gago.

In recent years the squeeze on resources has seen hospitals trying to 
reduce the need for patients to use beds, thus hiding the real demand on 
beds and allowing hospitals to further cut bed numbers.

More and more, patients have been treated as outpatients — receiving 
surgery and being discharged on the same day without an overnight stay.

In Victoria, it has been dubbed "casemix" and hospital funding was directly 
linked to "increasing throughput" of patients — patients are rushed 
through hospital and sent home sooner. "Quicker and sicker", as health 
workers call it.

Now, outpatient numbers are also being cut. In SA, the Budget cuts have 
reduced the numbers of outpatients by 102,800 in the metropolitan area. 
That is 2,000 people a day that have been completely shut out from 
treatment in a public hospital.

The real agenda

When governments have called for reform of the public health system they 
have bandied about terms like "improving efficiency" and "managing 
resources"; what has followed has always been the same: cuts, cuts, cuts, 
cuts.

These cuts have created the present situation which they are using to argue 
for a re-doubling of support of the private health sector.

The objective is not to improve the operation of the public system or even 
to make it cope as best it could with limited resources.

The objective is the dismantling of the universal and free (at the point of 
service) public health system and its eventual replacement by a system made 
up of private sector profit-driven, user-pays businesses where health care 
is just another product for sale.

Why else does the Federal Government persist with its policy of propping up 
private health insurance funds?

Around $1.5 billion dollars of public money, which should have been spent 
where it is needed, on public hospitals, is being poured into the private 
funds every year, even though the continued decline in membership has 
clearly demonstrated that people prefer the Medicare system.

The privately insured, discovering they were better off in the public 
system, are leaving the health funds in droves.

The Government continues to throw money at the private funds, still 
pursuing its real objective of destroying the public health system. Every 
dollar it gives the private funds is another dollar stolen from the public 
hospitals where it is needed.

The Government, the Australian Medical Association (AMA — representing the 
interests of private specialists) and others pushing private health know 
that the only way the private system will become supreme is if the public 
system is first dismantled. And that is what they intend to see happen, if 
they can.

The Doctors' Reform Society points out that this month's copy of the AMA's 
magazine, Australian Medicine, plainly states: "that the only 
successful strategy to rescue the private health funds is by getting the 
public to lose confidence in the Public Hospitals".

The AMA and others are deliberately promoting the "crisis" in public 
hospitals and manipulating the situation to make people believe, firstly, 
that the public system doesn't work, and secondly, that the private system 
needs to be expanded in order to "relieve the pressure" on the public 
system.

NSW Premier Bob Carr has reportedly joined the other Premiers in calling 
for a fundamental review of public hospital financing, citing the problem 
of "soaring patient demands on the public system".

WA Premier Richard Court said that the decline in membership of health 
funds was placing an "unsustainable strain" on Medicare.

Mr Court, other Liberal Premiers and the AMA last week raised the idea of 
means testing patients at public hospitals and charging for services.

Mr Court is to raise these and other ideas, which promote the privatisation 
of health care, at a State and Territory leaders' forum in Sydney on 
Friday.