Is $325 million enough for Tasmania's health care system?

Parliament house flag post

Is $325 million enough for Tasmania's health care system?

Posted 22/06/2012 by Rebecca de Boer



Image source: www.yourhealth.gov.au
 Last week, after much speculation, the Federal Government announced that it would provide an extra $325 million over four years to Tasmania’s health care system. Previously the Tasmanian Government had announced cuts of up to $500 million over four years to the health care system, commencing from 1 July 2011. Many of these cuts were directed to elective surgery, reduced services and the closure of hospital beds. The most recent Tasmanian budget (May 2012) announced a reduction of the savings target by $120 million.

Of the $325 million, only $31.2 million will be directed towards elective surgery with the majority of funding to be spent on better care in the community, improved discharge care and training of medical specialists and more scholarships for nurses and allied health professionals.

Additional health funding for Tasmania (millions)
$31.2 Elective surgery (around 2600 operation with a focus on long wait patients such as orthopaedic and cataract surgery)
Around $22Establishment of walk-in clinics in Hobart and Launceston to provide basic care for minor illnesses and injuries at no cost
$48.7 (over 4 years)Improved care in the community to prevent and manage chronic disease through coordination of care with allied and preventive health services. This will be undertaken by the Tasmanian Medicare Local
$74.5 (over 4 years)Better care for patients when they are discharged and better palliative care in the community
$53.9 (over 4 years)Training for additional medical specialists and the provision of more scholarships for nurses and allied health professionals
$15.4 (over 4 years)To address gaps in mental health services
$36.8 (over 4 years)Roll out of the Personally Controlled Electronic Health Record in Tasmanian hospitals and the enabling of allied health, pathology and diagnostic imaging services to connect to eHealth
$42.0 (over 4 years)To support innovation in clinical services to improve the efficiency and effectiveness of the delivery of care. This includes $1 million towards the establishment of the ‘Virtual Health Sciences Precinct’ which brings together hospitals, universities, research institutes and primary care providers

Whether this will have an impact on the Tasmanian health care system remains to be seen. Many of these initiatives are not readily measurable, for example, improved care in the community to manage chronic disease and better care for patients when they are discharged. Despite this, the Federal Government has required the Tasmanian Government to report monthly on how it spends any of the components of package it delivers, and what services it provides. The Federal Government also sought a guarantee that the Tasmanian Government will not undertake any more cuts to the health care system. A Commission on Tasmanian Government Delivery of Health Services will also be established to examine the effectiveness and efficiency of the delivery of health care by the Tasmanian Government.

The problems facing the Tasmanian health care system are not new. Successive Council of Australian Government (COAG) Reform Council reports have documented the performance of the Tasmanian health care system. Tasmania had the second longest waiting times for elective surgery in 2010-11 (359 days), although this was shorter than the baseline year (369 days). Tasmania was the only jurisdiction not to improve the waiting times in emergency departments for triage category 2 for the period 2007-08 to 2010-11. Tasmania qualified only for 80% of the reward funding under the Elective Surgery Waiting List Reduction Plan as it focussed on low cost, high volume operations (such as cataracts) rather than tackling more complex procedures and reducing the number of people who had been waiting for a long time. Affordability of health care is also a key issue in Tasmania and the number of people who delayed or did not see a GP due to cost increased from around 5% in 2009-10 to 11% in 2010-11.

The election of the Rudd-Gillard government heralded additional Commonwealth funding for health care through an increase of one billion in 2007-08 and various National Partnership Agreements in Health. As part of the negotiations for national health reform, an additional $16.4 billion (across all State and Territories over five years) was secured to account for the growth in public hospital expenditure. The extra money came with accountability and transparency requirements but, as noted by the COAG Reform Council its 2010 report, the current reporting framework does not facilitate this.

Yet additional money, or increased reporting requirements, is not likely to solve the underlying problems of Tasmania’s health care system. As noted by Martyn Goddard, a consumer health advocate in Tasmania, expenditure by the Tasmanian Government on public hospitals rose year on year by an average of 11% from 2002-01 to 2009-10. Other government expenditure rose on average by around 5.7% and total government revenue only increased by 6.1%.

Hospital costs in Tasmania are the highest in the country (see Table 3.15 of Australia’s Hospital Statistics 2010-11), although there are limitations to this data. These costs may be explained by longer stays in hospital (compared to the Australian average), discharge planning processes and organisational culture. On average, Tasmanians have poorer health and health outcomes than most Australians and this may also contribute to increased hospital costs.

What then is the solution? Martyn Goddard has proposed a federal takeover of the Tasmanian health care system with day to day administration of the system at the local level. This has been dismissed by Minister Plibersek. The Tasmanian Greens have proposed a trial of a ‘single funder’ model but it not clear who the single funder will be. The Federal Parliament has recently passed a Bill which will enable greater transparency of public hospital funding but this does not address the underlying structural issues of the Tasmanian health care system or the challenges associated with the Federation. Reform of Commonwealth-State relations is unlikely to ‘fix’ all the problems of the health care system but clarification of the roles and responsibilities is likely to improve accountability. For Tasmania, and the thousands of patients waiting for elective surgery, the money and (potential) improvements to the health care system can’t come quick enough.


Thank you for your comment. If it does not require moderation, it will appear shortly.

Add your comment

[Click to expand]

We welcome your comments, or additional information which is relevant to a post. These can be added by clicking on the ‘Add your comment’ option above. Please note that the Parliamentary Library will moderate comments, and reserves the right not to publish comments that are inconsistent with the objectives of FlagPost. This includes spam, profanity and personal abuse, as well as comments that are factually incorrect or politically partisan. We will close comments after three months.




Captcha
Generate a new image
Type characters from the image:

Facebook LinkedIn Twitter Add | Email Print

FlagPost

Flagpost is a blog on current issues of interest to members of the Australian Parliament


Parliamentary Library Logo showing Information Analysis & Advice

Archive

Syndication

Tagcloud

Refugees asylum climate change immigration Australian foreign policy parliament social security welfare policy elections welfare reform school education health financing higher education Australian Defence Force emissions trading indigenous Australians women private health insurance people trafficking illicit drugs gambling health reform federal election 2010 United Nations Employment Asia disability income management Middle East Medicare Australian Bureau of Statistics statistics sport health forced labour federal budget Afghanistan Industrial Relations Carbon Pricing Mechanism politics dental health United States aid child protection environment poker machines Australia in the Asian Century Australian Sports Anti-Doping Agency steroids World Anti-Doping Agency National Disability Insurance Scheme detention aged care 43rd Parliament slavery health system Law Enforcement Australian Federal Police Criminal Law Fair Work Act Australian Public Service governance labour force people smuggling transport debt taxation international relations constitution New Zealand food WADA Australian Crime Commission pharmaceutical benefits scheme pensions public service reform children's health Aviation foreign debt gross debt net debt defence capability parliamentary procedure Senate Senators and Members ALP ASADA Newstart Parenting Payment multiculturalism Youth Allowance sea farers Higher Education Loan Program HECS federal state relations accountability Papua New Guinea youth paid parental leave same sex relationships corruption coal seam gas customs planning federal election 2013 Australian Electoral Commission doping OECD crime health risks International Women's Day Gonski Review of Funding for Schooling sex slavery Special Rapporteur Northern Territory Emergency Response social policy welfare ASIO intelligence community terrorist groups Australian Security Intelligence Organisation carbon tax mining High Court military history electoral reform employer employee renewable energy regional unemployment fishing European Union Federal Court family assistance skilled migration banking United Nations Security Council Australian economy forestry food labelling vocational education and training Drugs UK Parliament welfare systems Indonesia social media children Constitutional reform local government codes of conduct terrorist financing homelessness Parliamentary remuneration money laundering Trafficking in Persons Report energy science social inclusion human rights paternalism Australian Secret Intelligence Service sexual abuse terrorism World Trade Organization Australia public health China housing affordability bulk billing political parties water productivity health policy Governor-General US economy trade unions domestic violence export liquefied natural gas foreign bribery firearms question time speaker superannuation public housing election results by-election expertise public policy climate Intergovernmental Panel on Climate Change leadership voting Department of Agriculture Fisheries and Forestry regulation Pacific Islands reserved seats research and development new psychoactive substances synthetic drugs UNODC carbon markets animal health middle class welfare ADRV Census Indigenous constitutional recognition of local government referendum consumer laws PISA competition policy royal commission US politics violence against women language education baby bonus Leaders of the Opposition citizen engagement policymaking Australia Greens servitude Trafficking Protocol forced marriage Population rural and regional mental health alcohol entitlements ministries Hung Parliament social citizenship maritime Iran transparency ANZUS regional students school chaplains federal budget 2011-12 salary Medicare Locals primary care Building the Education Revolution Scottish referendum early childhood education Middle East; national security; terrorism social services Criminal Code Amendment (Misrepresentation of Age to a Minor) Bill 2013 online grooming sexual assault of minors ACT Assembly national security smoking plain packaging tobacco cigarettes Asia; Japan; international relations Work Health and Safety Migration; asylum seekers; regional processing China; United States; international relations fiscal policy Racial Discrimination Act; social policy; human rights; indigenous Australians Foreign policy Southeast Asia Israel Palestine asylum refugees immigration political finance donations foreign aid disability employment Economics efficiency human rights; Racial Discrimination Act employment law bullying asylum seekers Animal law; food copyright Australian Law Reform Commission industry peace keeping contracts workplace policies same-sex marriage disorderly conduct integrity retirement Parliament House standing orders prime ministers election timetable sitting days First speech defence budget submarines workers financial sector Canada Somalia United Kingdom GDP Tasmania world heritage political engagement leave loading Trade; tariffs; safeguards; Anti-dumping public interest disclosure whistleblowing Productivity Commission limitation period universities Ireland cancer gene patents genetic testing suspension of standing and sessional orders live exports infant mortality honorary citizen railways disciplinary tribunals standard of proof World Health Organisation arts international students skilled graduate visas temporary employment visas apologies roads Italy national heritage NHMRC nutrition anti-dumping Rent Assistance obesity evidence law sacrament of confession US presidential election international days DFAT UN General Assembly deregulation Regulation Impact Statements administrative law small business Breaker Morant regional engagement social determinants of health abortion Members suspension workplace health and safety marine reserves hearing TAFE Victoria astronomy resources sector YMCA youth parliament Korea fuel rebate Australian Greens presidential nomination Racial Discrimination Act political parties preselection solar hot water Financial Action Taskforce Horn of Africa peacekeeping piracy Great Barrier Reef Stronger futures political financing political education Social Inclusion Board early childhood National Quality Framework for Early Childhood Education and Care Murray-Darling Basin sanctions Norway hospitals republic President Barack Obama Presidential visits qantas counselling Korean peninsula Work Choices biosecurity hendra environmental law federalism federation preselection therapeutic goods Therapeutic Goods Administration plebiscites computer games pests suicide nuclear COAG Ministerial Councils floods ADHD stimulant medication advertising electricity extradition standards conscience votes poverty preventative health rural health coastal erosion Parliamentary Budget Office NATO work-life balance

Show all
Show less