Public Hospitals in Crisis: More Funding, Better Management, and Commonwealth/State Cooperation Needed

AMA President, Dr Rosanna Capolingua, said the conclusions of the Report Card reflect the recent media coverage of system failures and personal tragedies in public hospitals right around the country.

"Our hardworking doctors and nurses are being let down by a lack of proper funding and resources, and poor management," Dr Capolingua said.

"Patients are suffering because of the failures of all governments.

"Commonwealth funding needs to be increased and State management and accountability must be dealt with.

"We have seen the tragic consequences of these failures in hospitals like Royal North Shore Hospital in Sydney. It is just one of many hospitals that have been telling the story."

The AMA Public Hospital Report Card 2007 shows that:

• public hospital capacity has been slashed by nearly 60 per cent over 20 years,
• hospitals have been cut too deeply, and the chances of system failures are too high,
• the system is under constant pressure and is run for too much of the time at unsafe levels of capacity utilisation (above 85 per cent),
• there are particular concerns with the teaching hospitals, where capacity utilisation is more like 95 per cent, on average, with short term peaks well above that,
• less than two-thirds of urgent emergency department patients are seen within clinically appropriate times,
• more than half a million Australians go to an emergency department each year suffering symptoms such as moderately severe blood loss, persistent vomiting, and dehydration, and are not seen within 30 minutes, which is the clinical benchmark,
• inadequate resourcing and insufficient beds are causing access block in emergency departments and the lack of nursing home beds at the other end of the admission is causing exit block,
• there has been a marked deterioration in the proportion of patients being admitted for elective surgery within the medically recommended times, and
• waiting lists have blown out across the country.

"This should not be happening in 21^st century Australia," Dr Capolingua said.

"In times of economic prosperity, with an ageing population and growing health care needs, it is incumbent on all Australian governments to adequately fund and properly manage our public hospitals.

"This is not about any blame game, this is about each government accepting responsibility for the health services it delivers to its people.

"Now is the time to invest — substantially and strategically — in the future health of our nation and our people.

"Public hospitals are at the heart of our health system, and I share the dismay of all Australians that our public hospitals are failing to meet basic standards.

"We need leadership to restore public confidence in our hospitals.

"We need to see both the Government and the Opposition promise in this Federal election campaign to inject an extra $3 billion in the first year of the next Australian Health Care Agreement, with the Commonwealth contribution to be indexed at 8 to 9 per cent a year after that.

"The State and Territory Governments must dramatically improve the management of their public hospitals, including more clinical input to decision making.

"Health care is consistently described in polls as a vote changing issue, yet neither Mr Howard nor Mr Rudd talked about health in the debate on Sunday.

"They know that health is important — why aren't they talking about it?

"Mr Howard and Mr Rudd seem scared to talk about health — is this because their plans won't stand up to scrutiny?

"I challenge Mr Howard and Mr Rudd to tell the Australian people what they are going to do to improve our public hospitals," Dr Capolingua said.

To view the AMA Public Hospital Report Card 2007, follow the link.