The ACT government has just introduced legislation to compulsorily acquire Calvary public hospital. The current owners and managers since 1971 - the Little Company of Mary (LCM) - will now be replaced by ACT government officials.
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There was no prior warning or discussion with many stakeholders including consumers and staff. It apparently came as a bolt out of the blue for the LCM national board. There is no obvious evidence that the Commonwealth has been consulted and/or involved in this decision, despite it specifically inviting LCM in 1971 to run a hospital on the site.
Why is this happening now? Various reports, including accreditation reports, show that there are no suggestions about adverse quality or costs under the LCM stewardship.
Indeed, the national LCM organisation relies on high quality assets and structures through its significant national, international, and historical Catholic health networks.
It is linked through an Australian network of hospitals to outstanding public health facilities in other jurisdictions including St Vincent's in NSW and Victoria, and the Mater and Mercy group in Queensland and Victoria.
The Calvary national board has had continuing discussions with the ACT government, acting in good faith to continue to develop a world class health service for our community. This is a normal way for a health system to operate as Calvary negotiates, for example, to replace the existing building stock which needs significant upgrade and/or replacement as any 40-year-old hospital would need.
Let's deal with the ideology; although I note that the Health Minister has said this has nothing to do with religion. Is there an elephant in the room? The Catholic church has performed badly over the last decade in some areas. But the failings of one part of the church should not be foisted on a well performing health sector.
Social media has been abuzz on the appropriateness of religious orders running a public hospital given their opposition to termination of pregnancy (TOP) and voluntary assisted dying (VAD). TOP is generally not undertaken in either of Canberra's public hospitals.
Rather, a private provider (MSI - a non-government organisation, too) undertakes TOPs which are free for ACT residents. For medical TOP, general practitioners (also privately owned) can also prescribe the relevant medication.
The purpose of VAD is to enable those choosing that option to die in their homes. It is not the intent that this would occur in hospital, so Calvary's views on the matter are irrelevant. So, what else is going on? This minister said in this masthead that any new hospital "must be owned by Canberrans" and "must be part of the most efficient and effective health system". The contract between Calvary and ACT Health specifies what services are to be provided, including the number and cost, efficiency and effectiveness.
These are public services that are owned by Canberrans as taxpayers - in the same way as services are provided at the Canberra Hospital.
In relation to efficient and effective health systems, any hospital manager and clinician knows that health systems are complicated beasts to manage. That is why people who have studied and worked in health systems tend to run them. For Calvary, it would be difficult to ignore the skills and expertise of its decision makers.
The chair of the board was a previous secretary of the South Australian department of health. He has successfully run hospitals in Adelaide. Another board member was Australia's chief medical officer and previously SA's chief medical officer. The chief executive of Calvary was secretary of the federal health department and has also managed one of Australia's largest health services (Western Sydney Area Health Service).
Calvary has been running public hospitals as part of a single health care system on behalf of governments across Australia for many years - much longer than ACT Health has existed as an entity of the ACT government. Its depth of experience is extraordinary.
The hospital is underpinned by the complementary process of a public and private mix - in much the same way as The Canberra Hospital with the co-located National Capital Private Hospital.
Other areas of ACT's health system are privately run for public patients but not owned by the ACT. For example, primary care via general practitioners, pathology and radiology services all decide how they will conduct their business in treating patients without ACT government ownership.
The public hospitals in the ACT are already grouped into a local hospital network.
The hospitals include Canberra, Calvary, University of Canberra, Clare Holland House and Queen Elizabeth Family Centre. The latter is run under contract (in a similar way to Calvary) by Tresillian.
The minister suggested in her recent opinion piece that system efficiency and sustainability is hampered by having a non-government provider.
It works perfectly well in other jurisdictions and the suggestion diminishes ACT Health and/or the minister in ensuring a good outcome for the residents of the ACT and surrounding districts. Just because things are difficult doesn't mean that we either give up or take a heavy-handed approach such as the one announced.
The thing that is most troubling, though, is that the intent to compulsorily acquire Calvary Hospital (and the fate of the hospice is still unknown) has been done under a cloak of secrecy. Dennis Denuto could have written the legislation given that it seems to reflect the "vibe" of the movie The Castle, rather than sensible processes.
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Calvary has a contract with ACT Health which has many years to run. Other organisations signing contracts with the ACT should worry that they won't be honoured and that new legislation will override them.
The way in which "just terms" are to be calculated is not specified but rather left to be stipulated in a regulation. This lacks transparency. This, together with a yet unspecified time limit for claiming compensation seems somewhat heavy-handed. The legislation requires both parties to act in good faith in relation to the acquisition but it would seem that the ACT is already in breach of its own legislation.
I am hoping the chief minister will take some more advice from those who are well experienced in conducting jurisdictional services with different operators.
Given that the stated objective is to provide improved health services for north Canberra and a smooth transition from LCM to the ACT, the actions of the ACT seem destined to achieve the opposite effect. Who knows? It might be the correct decision but it's certainly the wrong way to go about it.
- Anne Cahill Lambert, AM, is a consumer advocate and previous health services manager. She is also a practising Catholic who expects to hop to hell on a pogo stick when her time comes.
