AMA Response to Labor's Public Hospital Plan

QUESTION: $2 billion from Labor, though, is that a reasonable amount?

DR CAPOLINGUA: I actually can't see what the $2 billion is going to be spent on, looking at this plan. There are a list of things that they want to see changed, but the money allocation and the change don't seem to be connected in some ways, and that bit we need to really analyse more carefully.

QUESTION: Do you think the plan will work?

DR CAPOLINGUA: At the moment the plan is to suggest that we need benchmarking of the State hospitals, in order to see what they are doing over time, their accountability. And that part of things is something we've been calling for anyway, that in the Australian Health Care Agreements, increased funding, appropriate indexation and benchmarking or measuring of the hospitals to see what they are delivering.

However, the things chosen to benchmark are things like inappropriate presentations to emergency department and inappropriate hospital admissions and we know that that is not an issue. That, in fact, the people that go to EDs need to be there, that it's a very small number that are inappropriate and that the people that are in hospitals, need to be in hospitals: that's what they're for. So that particular benchmark is wrong. The issue there is bed block - there is nothing in this plan that delivers increased beds.

QUESTION: What about a takeover, in an election down the track?

DR CAPOLINGUA: Similarly, both sides have been talking about a Commonwealth takeover of the public hospital systems. Now, you know, the issue is here that States are very different, that the demographics are very different and, in fact, hospitals across States are also quite different in what they need to deliver and that State responsiveness and responsibility is an important thing and I'm not certain that a Commonwealth takeover will serve the people of Australia any better.

QUESTION: They might say uniformity is - would be a good thing. And if it's run from the federal office as it were, there'd be uniform standards throughout the country.

DR CAPOLINGUA: I think that States and their demographics are indeed not uniform. Australia is quite unique and if you would look at WA and compare it to Victoria or Queensland and compare it to New South Wales, Northern Territory, very, very, different in population, in population distribution, in actual geographics and indeed, we need to know, that our State hospitals are responding to the needs of that community. So, up for debate, but I don't know whether it's going to be served any better.

QUESTION: Are you saying the AMA's really got great reservations about that proposal?

DR CAPOLINGUA: The AMA has long discussed this issue about Commonwealth takeover - the pros and the cons and, indeed, we haven't come down very clearly on what we think is best, but we do have grave concerns about a centralised control. If you're remote from the people, and hospitals are about looking after people, then maybe you don't serve them as well. We don't have to have that big bang change to improve what we need to do and that is to make sure we've got more beds and that we've got the doctors and the nurses in the public sector to look after the patients that need that care.

QUESTION: Are you concerned that WA, being quite an isolated State, may not benefit as much as from an east coast State, under this proposal?

DR CAPOLINGUA: There's always that concern about the States that are more peripheral to the core east coast, you know, having been felt to be left out, or to be treated differently. It's certainly not about WA alone - it's about every State being different and it's about the people in Australia having their different needs met properly.

QUESTION: You must be though, you'd welcome moves to reduce duplication and reduce waste, if that's part of the Labor goal?

DR CAPOLINGUA: Again, where is the duplication and the waste? Give me the evidence that that's the case. At the moment all I can see, is that public hospitals aren't able to cope with the demand from sick people in this country. Over time, the population has increased, people are getting older, there is more chronic disease and all we've been doing is trying to reduce the hospital beds, contract the expenditure in the public sector, and it hasn't worked. I believe, certainly we need to be efficient and responsible with the dollars, but you show me real delivery, real patient care and then I'll be happy.

QUESTION: Well it would eliminate the buck passing and you can't deny that goes on?

DR CAPOLINGUA: If you put good benchmarking in and there is measurable accountability at the States, then I think you will eliminate a lot of the buck passing. We have to have that accountability.

QUESTION: So overall you don't support the plan?

DR CAPOLINGUA: I welcome the plan, because it is another focus, another investment on health and it's certainly looking at addressing the public hospitals. There are concepts there that are well meaning indeed, but let's look at the real issues of bed numbers - there's no commitment to increasing beds. Let's look at the real issues of recruitment and retainment, retaining of doctors and nurses in the public health sector and there's nothing in that. And I'm not sure that the promise of a Commonwealth takeover, will serve Australians better.

QUESTION: The Government today has said that this plan merely acknowledges that State Labor have failed to manage an effective health system. What do you think about that?

DR CAPOLINGUA: At the moment the State Governments are, indeed, Labor Governments, and there are issues in public health in all of the States. That accountability is an issue that States have to bear the brunt of, but let's forget about party politics, let's even forget about elections. Let's make sure that we're investing in the public sector to take us through to the future.