You know it’s called fundamental reform for a reason … it’s not try before you buy

Not the least of the problems we have in the system has been duplication. Beyonf A&E and some of the other basic services, some outpatient care and so forth why does each district have to supply everything one could want in health? Some rationalisation of specialist services would seem to make sense.

“Oh we are very sorry about your Granny, but the officials in Canberra have decided that continued treatment would not be cost-effective.

Euthanasia will proceed in 5 minutes.”

The scheme could be started as long as there is one state willing to forgo GST money in return for accepting the new system. If it works well in one state, state governments will be under heavy pressure to join up.

Surely that cannot be correct: piecemeal health reform? It would have to be a ‘one-in-all-in’ scenario otherwise what is the point of the reform agenda?!

But my problem is with the proposed new management model which replaces a small number of experienced managers with a larger number of inexperienced ones, each with a strong local bias. An illustration: shortly before the last fed election, Tasmania made the hard but correct call to take away some services from the Mersey hospital since they were replicated 50 km up the road. Can you envisage a community based management group making such a call, or being motivated by anything other than the need to protect its ‘patch’?

Of course it’s theoretically possible to put in place performance standards to overcome the self interest of community managers, but that’s a recipe for rorting and unintended adverse consequences. An example: national standard waiting times for elective surgery vary according to the urgency classification of the procedure. But that urgency classification is highly subjective, varies widely between states and consequently invalidates cross jurisdictional comparisons of waiting times. I see a time coming when procedures to correct life threatening heart conditions are classified as ‘3’ to make the stats look better and attract more funding. Of course, that can happen now, and to a small extent does, but it’s a lot easier to keep your eye on seven state or territory administrations than on hundreds of hospitals.

P.S. thanks for your support, Robert. I don’t think I’m a troll either. I get wearied by the growing tendency towards factless debate. E.g., the media treats Garrett as guilty but never does get around to explaining precisely what he did wrong. E.g., the media treats the hospital system as being in crisis but never does get around to providing a statistics-based argument (instead it will tell you that somebody in NSW had a baby in a toilet – which proves nothing). I understand that it isn’t practical for the MSM to do a full review of each issue before publication, but at the same time I find the ‘group think’ certainty infuriating, particularly because so many people seem to unquestioningly take the fish and chip wrap as gospel.

It appears that you think I am against reform of the health system. That is not true. I understand the problems. It is however reasonable to point out flaws in the proposl from the Krudd government.

I am actually all for getting rid of the States, Local government in its’ current form and the Senate and having a Federal Government and Regional Governments. Health is a universal right with equal standards for all Australians and funded and administered Federally. The current barney between SA and the NT over dialysis is evidence of the stupidity of the current arrangements.

She won’t wear stilettoes.