Federal Politics


Our hospitals under pressure

The complexity of administering large hospitals is such that even the best-run facilities experience mishaps from time to time. In this, the ACT's two public hospitals are not immune. In the past month in Canberra, there have been at least two publicised instances of ''access block'' at Canberra Hospital's emergency department and the acute mental health unit, one involving an elderly cancer patient suffering severe breathing difficulties forced to wait 33 hours before being admitted to a ward. A baby narrowly escaped injury after a wooden panel dropped from a wall on to a cot in the new Centenary Hospital for Women and Children, and at the same facility staff missed a call for help to resuscitate a baby in a neonatal intensive care unit. Later, the mother of the child concerned (one of twins) discovered after returning from the ICU that her personal belongings had been taken from her room in readiness for a new arrival, forcing her to sit for two hours in a waiting room before being discharged. None of these episodes resulted in lasting harm. But they are certainly distressing experiences for the individuals concerned and symptomatic of a health system under stress.

The result, not surprisingly, is that the territory's public hospital system is one of the dominant issues of this year's election. With the most to gain from highlighting discontent, the ACT Liberals have alleged Government interference in the operation of the Canberra Hospital emergency room (particularly around admission data), suggesting that facilities like the Centenary Hospital were opened before they were ready in order to gain political kudos, and accused Chief Minister Katy Gallagher of putting a photo opportunities ahead of patient treatment.

Having been in power since 2001, Labor is, of course, highly vulnerable to such allegations. That the case of the elderly cancer patient elicited an expression of regret from Ms Gallagher suggests the Government knows it too. In some voters' minds, however, such admissions only bear out the Liberals' criticism.

The Government has long promised to do whatever it takes to reduce waiting times, increase the availability of beds and boost clinician numbers. Its election promises are geared very much to that end. It has promised $74 million for new beds, doctors and nurses at Canberra Hospital, in addition to providing 70 new beds at Calvary Hospital. Then there is the construction of a new sub-acute hospital on the northside, to which Labor says it is fully committed but to which it has yet to set aside any more than $4 million for planning purposes.

The Liberals confidently predict they can do better, though their promises - a new sub-acute hospital, urgent-care clinics, GP support and extra funding for chronic disease management - do not differ markedly in spirit from that of the Government's. Only on the costings are significant differences apparent, with the Government alleging the Opposition's five-year plan will cut $800 million out of recurrent health spending. Such pledges are always highly contested in electioneering, and given that some future Commonwealth health funding is conditional on certain targets being met by the states and territories, not to be relied upon.

What can be taken as read is that both parties share a common desire to improve those statistics - emergency room waiting times, bulk billing rates, elective surgery waiting times - where the ACT lags behind the other states and territories. Last financial year, the territory also failed to meet the ACT Health Directorate's target of a public health hospital bed occupancy rate of 85 per cent.

Of course there are no quick fixes for these and other systemic ills. Creating more beds will enable Canberra's public hospitals to better cope with surges in presentations at emergency departments, but the territory's growing population means public hospitals will probably continue to struggle to meet demand for their services.

The necessity to fund this expansion of health services with new or expanded taxes - or cuts to other services - are issues none of the parties choose to discuss in great detail at election time. Instead the Opposition scores points by lambasting the Government over its alleged incompetence. And Labor denies or deflects the criticism and points to how much better things are since the Liberals were last in government.

In some cases, there is certainly maladministration, but on the whole Australia's public hospitals, and the health outcomes they achieve, are world-class. No party enjoys a mortgage on effective public hospital management but try telling that to the politicians contesting the October 20 poll.