Action-man Abbott undervalues bureaucracy


Tony AbbottOpposition leader Tony Abbott says the Federal Government's health reform proposals are all about the system, and there's nothing for the long suffering patient. He was right to the extent that health care should be about caring for patients, and not feeding bureaucracy.

However a simplistic and ad hoc approach to rebuilding the nation's health care system would set us back even further. This occurred in 2007 when the Coalition Government tried to improve the lives of Indigenous Australians by riding roughshod over bureaucracy with the Northern Territory Intervention. Last week's action-man images of Abbott riding a quad bike and eating a witchetty grub gives us cause to worry that he could approach health reform in a cavalier manner.

Health bureaucracy is a necessary evil because it protects patients from special interests whose primary motivation is the bottom line of health-related businesses. These include the Australian Pharmacy Guild, drug companies, private health insurance funds, and to some extent the AMA. Lobbyists from these groups dominate debate, as they are better resourced than non-profits such as the Cancer Council, whose only interest is patient health.

After last week's announcement, John Menadue of the Centre for Policy Development said the Rudd Government is moving in the right direction in its determination to get the system right. He suggested that the Government should establish a permanent, independent, professional and community-based statutory health authority similar to the Reserve Bank in the monetary field.

'The Reserve Bank's governance structure has made it almost impervious to lobbying and generally, it has been independent,' said Menadue. 'Such an independent health commission with strong economic capabilities is necessary to facilitate informed public discussion, counter the power of special interests and determine programs and distribute Commonwealth health funds across the country.'

Such a body could establish a world-class health funding system for patients in the future. However those who need proper care now should not be ignored. Again this is where action-man Tony Abbott has a point.

Martin Laverty of Catholic Health Australia has said there are 89,000 patients who have been waiting longer than the clinically appropriate time for their surgery, and that there must be an interim arrangement to ensure they get the treatment they deserve. He suggests using spare capacity in the private hospital system to treat public patients. This surely must be considered as part of a short- and long-term solution for Australia's broken health care system.

Michael MullinsMichael Mullins is editor of Eureka Street.



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Existing comments

Hi Michael. You make a good point about hospital bureaucracies being necessary. Yet surely it's pretty simple. Demand for beds exceeds supply of beds and demand is growing faster than supply!

As a nation we're getting fatter and more prone to associated diseases. So maybe instead of installing McDonalds restaurants into hospitals, perhaps there should be some truly innovative thinking applied? What do you think of sticks and carrots for lifestyle induced disease? Should smokers get the same subsidised health care, whether public or private, as non-smokers?

Jonathan ( Crabtree | 08 March 2010  

This article does not acknowledge the actual size of the bureaucracy. For bureaucracy read one for each state, Federal and multiple organizations such as in NSW mis-named 'area health" bureaucracies. All far removed from the user (you and me).

I also take issue with the wildly optimistic assumption that the Cancer Council has only patient health at interest.

Unfortunately, while most if not all organizations created to serve a greater good, comprise individually well intentioned persons, once melded together in mutual agreement and sometimes self congratulations, the original goals become secondary. This is an inevitable process, which requires some sort of "system rattling" occasionally to re-establish priorities.
Yes, lets go for a Reserve Bank type authority, but only after the Reserve has included just one (yes, 1) small business representative on its Board.

Sandra Blackmore | 08 March 2010  

And haven't you been listening to the WOMEN in the NT? And the statistics on crime reduction in some communities?
Or is the process more important than the outcome?

Sandra Blackmore | 08 March 2010  

Michael---"Last weeks action man images" etc how do you make such wild connections-it seems anything goes to have ashot at Abbott. Hhave you pointed out how Rudd is still fumbling their promise to better HOUSE aborigines--efforts are about as effective as the insulation programme

Brian | 08 March 2010  

Thanks for this, Michael.

You are right, of course, that a certain level of bureaucracy is necessary to ensure equitable, effective, appropriate treatment.

Repetition of such bureaucracy at two tiers of government does not, however, progress this necessity.

I have heard much blathering that each state is different, that each state needs its own health bureaucracy. This, however, is only so much special pleading by denizens of various state capitals.

For those of us outside said state capitals, issues of equitable access are indeed writ large ... and writ uniformly across the land.

People bleat about the lack of hospital beds, and demand new hospitals, even as ongoing bed closures leading to ward closures leading to hospital closures have continued apace.

Here's a suggestion: sufficient bonded scholarships for nursing students/trainees so that this nation can meet its own demand without draining the educated resources of developing nations. Centrelink queues would be simultaneously shortened.

Should we suggest this to someone?

David Arthur | 08 March 2010  

While we're on the issue of health reform, how about some tax reform?

Instead of tobacco excise disappearing into the slushy favour fund known as consolidated, how about it be allocated 100% to chest/respiratory/circulatory/cancer care? And the level of tobacco taxation increased to fully cover these costs?

Equalise alcohol taxes at the same rate per gramme alcohol, be it in beer, wine, spirits, and use this revenue to fund 100% of ambulances and accident/emergency departments.

In other words, tax recreational drugs to effect full cost recovery. With this principle in place, the justification for prohibition of many presently illegal substances are weakened, and they can be brought into the legitimate economy.

David Arthur | 08 March 2010  

Tony Abbott cannot have it both ways. The home insulation scheme failed in large measure because the bureaucratic structure was inadequate to enforce correct practice.

It is high time he stopped vilifying the people who are tasked with putting politicians' ideas into practice and concentrated on ensuring a Public Service resourced and trained for its duties.

Juliet Flesch | 12 March 2010  

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