Interview - AMA President Dr Bill Glasson, Radio 4BC Breakfast Show with John Miller and Ross Davie - Federal Plans To Control State Hospitals

COMPERE:     Well this has been around for a while, hasn't it, the plan for Canberra to grab hold of our hospitals.  We spoke, I think, to Dr Bill Glasson about two months ago about this when it was first aired.  And it appears to be growing legs.  And the major advantage of it, I guess, is the amount of money that's saved by not duplicating the bureaucracy.

COMPERE 2:  Well it's estimated that there is $2 billion a year in duplication in health administrations.

COMPERE:     That's a lot of money, isn't it?

COMPERE 2:  It's always sort of bemused me that we have a Federal Health Department that really doesn't run any hospitals.

COMPERE:     That's it.

COMPERE 2:  Whereas we have State Health Departments that do.  Now the State Health Minister here, Gordon Nuttall, says Mr Abbott's announcement was an old diversion.  He says that the Federal Budget went over like a lead balloon and they're rolling out older versions.  So let's wait and see what's on the table first, but according to Chris Jones in the Courier Mail this morning, it's on and it has the backing of the Prime Minister who believes that fundamentally we need to reorganise the responsibilities of our Federal and State Governments.

On the line AMA President, Dr Bill Glasson.  Good morning, Dr Bill.

GLASSON:      Good morning, John, how are you?  Morning, Ross.

CHORUS:        Morning, Dr Bill.

COMPERE 2:  Do you think it's just a smokescreen or do you think there's something in this?

GLASSON:      No definitely not, John and Ross.  I think this is - I mean I've spoken with Tony Abbott specifically about this issue because obviously the state of our public hospitals across this country and the realisation that we are probably duplicating nearly one to $2 billion a year in sort of bureaucracy and this issue about cost-shifting and blame-shifting, all this nonsense that goes on.

And it's frustrating that the doctors and nurses are trying to provide the service, and the reality is there's not enough money in the system.  And I suppose we've got to get more efficient.  So I think this is the debate we need and hopefully out of it, it will be a saving for patients in the long term.

COMPERE:     Now Gordon Nuttall would like it to be a diversion of course because, if it all happens, Gordon mightn't be there.  How will it work if it's looked after by the Federal Government?  Who actually then runs the hospitals?

GLASSON:      Yes, Ross, what would happen would - I think the idea is that you'd have a series of regions around this country.  You might break it into, for instance, populations of around about a million people and those regions would deliver the service to those million people.  You'd combine your PBS and MBS money, in other words your drug money and your medical money, all in one bucket.  And you'd say to them, listen you be innovative about how you run the system.  If you want to attract funds by other means, go ahead.  But ultimately you've got the responsibility in your region for delivering that service.

And I think, if the people on the ground who provide that service, ultimately have the responsibility for making sure that service is provided in an appropriate way and get the best bang for the buck, then I think that this is probably a more efficient way forward.

It won't solve all our problems.  This is not some panacea but all I can suggest is that we need this debate.  We need to decide where we need - what we need to have to replace the current system.  The current system is not working and patients out there are absolutely frustrated and certainly the doctors and nurses are similarly frustrated with it.

COMPERE:     Given the possible truth of the old saying that the definition of an elephant is an ant built to Federal Government specifications, don't we run a risk here of creating yet another massive bureaucracy?

GLASSON:      You're right, John.  I think that's where we've got to be very careful.  Ultimately, to me the Commonwealth should still just be the funder.  They should just provide the money to these regions where they like to sort of set them, and ultimately there will be local bureaucracies obviously delivering the service.

But when you think about the duplication that we have at the moment between the seven State Governments with all their Health Departments and then the Commonwealth with its Department on top of that, golly golly, as bureaucrats they have a way of sort of multiplying on floors and floors of hospitals.  And yet the doctors and nurses down the bottom trying to provide the service are getting less and less.

So I think there are huge savings we can make.  And, as I said, I was up in Toowoomba last night talking to the doctors up there, and again we had a long discussion about this issue and about the fact that the system is so unresponsive to the needs of the patient.  And we've got to get back to the system whereby a medical superintendent, a nursing superintendent, administrative superintendent with a secretary more or less sit down and run the system with the clinicians on the ground because they're the ones that ultimately need to make the decisions in the interests of the patient.

COMPERE:     Yes, I mean this was all overturned, was it not, during under the Goss Government here in Queensland where a regional system was brought in and where responsibilities for administration of health in those regions was taken away from medicos.

GLASSON:      Well that's exactly right.  You're absolutely right there.  But I think what's happened in Queensland is that the authority still rests largely in central office and there's not too much authority down at the grass roots.  And as you perfectly say, John, the doctors and nurses who actually deliver the services have got little control over it.

COMPERE:     Well the argument was that doctors and nurses might be very well qualified to look after sick people but lousy administrators.

GLASSON:      Well I think you need the administrators with it.  Don't get me wrong.  But they have to work as a team on the ground.  In other words, those administrators need to be coming down, sitting beside the doctors and nurses with the patients and saying, listen, how can we make this service better.  Not sitting up in some flash air-conditioned office a thousand miles away trying to make a decision on what best happens....

COMPERE:     Integrated into the system?

GLASSON:      Exactly, exactly.

COMPERE 2:  Now there's nothing formal for this has been tabled yet.  Mr Howard's calling for research into this.  Could it happen fast enough for it to become an election platform, a policy?

GLASSON:      I don't think so, Ross.  I think this is probably just put out here for the moment for the debate.  I think it's a debate we need to have.  And I think, given the fact that our public hospitals are in such a mess, we need to be talking about it.  And we need to talk about ultimately how, if you're going to bring this in, how it would happen.  If it's under the Constitution, I'm not quite sure what we need to do.

But the reality is, if you take health away from the States, that only leaves them with education and not much else.  So you're probably saying that we're becoming or the role of the States will become less and less I think with time.  And there are certain people who argue that, you know, we've got one tier of government too many, so what the long-term consequence of that is I'm not sure.

CHORUS:        All right, Dr Bill.

COMPERE:     Dr Bill Glasson, AMA President, thank you for talking to us this morning.

GLASSON:      Thank you, John; thank you, Ross.

COMPERE:     Stay tuned because we'll be talking to Mark Latham about this very matter in about 10 minutes time or so.

GLASSON:      Oh good.

COMPERE:      Okay.  Thank you.

Ends