Saturday, March 29, 2008


Australian healthcare 'still in the 8Os

March 29, 2008 - 8:22AM, smh

Australia has a 1980s healthcare system attempting to deal with 21st century problems - and it could get worse, a Melbourne conference has heard.

According to Professor Anthony Scott of the Melbourne Institute of Applied Economic and Social Research, healthcare in Australia is on a downward spiral.

"We are heading toward the situation that exists in the United States, which has the most ineffective health system in the world," Professor Scott said.

Speaking just days after the Federal Government announced a further $1 billion injection into hospitals, Professor Scott painted a picture of a lopsided, over-governed system that would greatly benefit from centralised funding.

In a presentation to the New Agenda For Prosperity Conference entitled Making Hospitals Work, he said Australia had a hospital system that benefited the rich ahead of the poor and one in which public hospitals provided significantly poorer outcomes than those run privately.

"The rich have greater access to health care, but at the same time it is the poor who tend to need it more," he said.

While Professor Scott advocated schemes that rewarded performance in healthcare he warned of the difficulties of assessing complex medical environments.

"Some degree of performance management is necessary," he said.

"But there can be difficulty defining good performance.

"It can be difficult to use incentives in complex environments.

"They can be good in a factory making widgets, but healthcare can be more complex."

Leading health economist Dr Stephen Duckett told the conference the health system laboured under gross funding inequities.

Dr Duckett, the man given the task of restoring credibility to the Queensland health system after the Dr Death scandal, said the hospital system could not work as it should while public hospitals treat many more patients than private hospitals, but get much less money from the Commonwealth.

Using cataract surgery as an example, Dr Duckett said a procedure that cost $3,800 in a private hospital cost $1,200 less in a public hospital.

"A public hospital pays the surgeon $10 a minute, but (in a private hospital) he charges the patient $100 a minute," Dr Duckett said.

As a result, doctors understandably spent less time treating public patients.

He said commonwealth support was 78 per cent higher in the private than the public system.

"What is needed is more money and more equity and balance in the system," he said.

Federal Health Minister Nicola Roxon told the conference the latest funding represented the largest injection of money into the health system in a decade.

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