Page 409 - Week 02 - Wednesday, 13 May 1992
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It is also a question of introducing creativity and flexibility into policy and into the exercise of revenue raising. We are more than willing, on this side of the Assembly, to put forward suggestions and to develop solutions that will help the Government maintain and extend its services in the face of its obvious funding constraints. Let me make one suggestion now: That the Government consider establishing a cardio-thoracic unit as a joint venture with the private sector. The Government, and particularly the Minister for Health, must reform their thinking with regard to the non-government sector. By inviting private sector participation, we would really be establishing an alternative means of raising more total money for our health system. We would be failing to use the total resources available to us if we were to do anything less, and this Government is failing.
Another advantage of inviting private sector involvement, as demonstrated by the joint venture projects in hospitals at Port Macquarie in New South Wales and Mount Gambier in South Australia - - -
Mr Berry: Do they do cardio-thoracic in Port Macquarie?
MRS CARNELL: Yes. Another advantage is that it allows the introduction of workplace contracts which aim to secure definite levels of productivity and improved quality control and include service guarantee agreements which are outcomes oriented. In the Port Macquarie project, 70 per cent of the beds will be public; the remainder will be private, and the cost to government will be substantially less. The people of Port Macquarie will have a hospital with 70 per cent public beds substantially earlier than they would have otherwise.
There are a number of ways that such a project could proceed. If we had just a little imagination and if we were prepared to invite rather than dismiss the non-government sector and the private sector, we could go a long way towards alleviating some of the funding problems faced and provide more service for Canberrans and more hospital beds, both public and private. This would be much better than using Mr Berry's current tactics. His 1991-92 budget cut health spending across the board by 5 per cent in real terms. At the same time, Mr Berry informed the Board of Health that no services were to be cut. This is Mission Impossible.
Any management expert could have told Mr Berry that this style of budgeting merely results in services which are cash-strapped, undercapitalised, and less and less able to provide for community needs. It would have been more sensible to address the question of which services are needed and appropriate for the Government to provide, rather than to cash starve them all.
Mr Berry crows about his wonderful financial management. He seems to believe that the installation of Fiscal, a cash-based accounting system, is the answer to all Health's budgeting problems. Mr Berry's inaction in the implementation of accrual accounting - not just end of year accruals but project-based, management-based accrual accounting - shows his real lack of knowledge and understanding of financial management. I note that last year the Hirth report by Arthur Anderson, an in-depth and wide-ranging inquiry into financial management in the ACT commissioned by Gary Humphries, the then Minister for Health, made numerous recommendations concerning accrual accounting. We have seen very little happen since that time.
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