Business as usual not good enough for public hospital funding
Public hospitals continue to face a funding crisis that is rapidly eroding their capacity to provide essential services to the public.
That is the take home message from the AMA’s 2018 Public Hospital Report Card.
AMA President Dr Michael Gannon launched the Report Card in Brisbane on March 9 and called on Governments to get it together when it comes to hospital funding.
“Health is the best investment that Governments can make,” he said.
“Funding for public hospitals is an essential investment in the health of the Australian population, and therefore in the capacity of Australians to participate in the workforce and as members of society.
“In the past, Governments have justified extreme health savings measures, including cuts to public hospital funding, on the basis that Australia’s health spending is unsustainable.
“This falsehood needs to be dismissed, once and for all. There is no evidence to support the contention that Australia has a health spending crisis.”
The Report Card reveals that substandard funding levels are reflected in the performance of Australia’s public hospitals against key measures. Their performance remains frozen at the unsatisfactory levels of previous years.
Bed number ratios for the general population are static. For patients aged over 65, bed ratios continue to fall and are now at their lowest level since 1992-93.
Pressure on emergency departments continues to increase, with waiting times worsening to remain well below the 80 per cent target set in 2012-13 and which has since been abandoned by Governments.
“After three years of no improvement in the percentage of ED patients who leave emergency within four hours, this year’s report highlights a worsening to 72 per cent,” Dr Gannon said.
“It is of concern that the patients least likely to leave an ED within four hours are the sickest.”
Elective surgery performance in 2016-17 is mixed. Nationally the proportion of elective surgery patients treated within clinically indicated treatment timeframes of 90 days improved by five per cent, but performance by jurisdiction varied.
Dr Gannon used the Report Card to call for a change in approach to public hospital funding, saying Governments must promote performance rather than punishment.
It was disappointing, he said, that the 2020 hospital funding agreement tabled at COAG in February this year was business as usual.
“No one wins by playing politics with public hospital funding,” he said.
“The Commonwealth Government had an important opportunity in 2018 to offer an increased level of hospital funding in the 2020 funding agreement.
“While some State Governments share the blame for under-funding their public hospitals, the Commonwealth’s offer to contribute up to 6.5 growth in hospital episodes year on year will not be realised unless State and Territory Governments can find the additional funding to pay the remaining 55 per cent of every additional public hospital episode.
“Jurisdictional jostling to gain the upper hand in funding negotiations is only is only going to let down those who need essential public hospital services.
“If the Commonwealth fails to fund primary care properly, it will pay, along with the States and Territories, in increased costs.
“If the States and Territories fail to put their fair share of funding in public hospitals, then we will experience worse patient outcomes and deteriorating performance which, under current and future funding arrangements, will reduce the year on year growth in Commonwealth funding.”
The Report Card states that the AMA will fiercely resist any approach to use the same methods of the past, which are to simply reduce funding when activity in hospitals doesn’t meet the desires of Governments.
“Public hospitals need adequate, long-term funding to improve their performance,” Dr Gannon said.
“Integrating linkages across sectors to improve patient outcomes, and reduce admissions offers potential.
“But this potential will be difficult to realise unless these new responsibilities are adequately funded and co-designed with those who keep our hospitals working, day in and day out.”
The full 2018 Public Hospital Report Card can be found on the AMA website.
Published: 14 Mar 2018