Jane McCredie: The true meaning of health reforms

HANDS up all those who think 2011 will see an end to the federal/state “blame game” over provision of health services.

Nobody?

I thought so.

There’s no doubt the current system, with the federal government largely (though not entirely) responsible for primary care while the states run the hospitals, allows for some pretty effective dodging of responsibility on both sides.

But will the federal government’s much vaunted health reforms actually fix the problems, or will they simply add an extra layer of bureaucracy and red tape?

And, more to the point, will they even happen in the current tumultuous political climate?

The deal formulated by the Council of Australian Governments that would allow the federal government to claw back a proportion of each state or territory’s GST in return for more federal funding for hospitals was never agreed to by Western Australia and now may not be honoured by incoming conservative governments in the eastern states.

Both Victoria’s new Liberal premier, Ted Baillieu, and the man almost certain to be the next premier of New South Wales, Barry O’Farrell, have signalled they’ll be having another look at the deal struck by their Labor predecessors.

Add to that a federal Labor government that is clinging to power by its fingernails, and at the whim of an odd ragbag of independents, and it would be a brave hospital administrator who’d bet on the partial federal takeover going ahead.

Prime Minister Julia Gillard is certainly continuing in the finest traditions of contemporary Australian politics by avoiding saying anything that might lead to her being held accountable for results or the lack of them.

On the ABC’s The 7.30 Report last week, Gillard was happy to speak of her plans for “transformative reforms” in the sector: “… when I look at health ― nothing [is] more important to Australians when they or their families are under pressure than knowing that they can see a doctor, they can see a nurse, they can get a hospital bed. Well we will be making our health reforms real next year and we’ll be transforming our health system for the decades to come.”

So, what does “making it real” mean in politician speak?

There’s already been more money for elective surgery, Gillard said, and more doctors and nurses are on the way but “making them real” takes time ― true enough, so probably not by the end of 2011 then.

On local hospital networks, the PM said “you’ll be able to see their boundaries” in 2011, which presumably means they won’t actually be up and running.

And on Medicare Locals, “people will be able to see those taking shape”.

It’s hard to know what that might mean.

The Prime Minister has a point when she says a thorough overhaul of the health system can’t be accomplished overnight, but wouldn’t it be refreshing to hear a politician say: “This is what we’re going to do, and how we’re going to do it, and when we’re going to do it by”?

Problem with that, of course, is that people might notice when you didn’t do it.

A happy festive season to you all and let’s hope for some healthy developments in 2011.

Jane McCredie is a Sydney-based science and medicine writer. She has worked for Melbourne’s The Age and contributed to publications including the BMJ, The Australian and the Sydney Morning Herald. She is also a former news and features editor with Australian Doctor. Her book, Making girls and boys, on the science of sex and gender, will be published by UNSW Press early next year.

Posted 13 December 2010