Page 1657 - Week 06 - Wednesday, 18 May 1994
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outputs to focus on lower level surgery; it looks better if you do 50 minor procedures rather than one major procedure because you have dealt with 50 people and taken 50 people off the waiting list as opposed to taking one person off the waiting list. Casemix is an attempt to fund the hospital to ensure that it equitably deals with the various levels of complexity of cases.
We are doing work on casemix in the ACT, as most other States are. We are cooperating with the Commonwealth Government and we are looking very carefully at what is going on in Victoria; but you would have to say that the story of casemix is not all one way. Some of the claims of the Victorian Government of a miracle cure as a result of casemix techniques are being viewed with great scepticism by impartial public health commentators and with even greater scepticism by the AMA, who Mrs Carnell may quite rightly say are not necessarily impartial on this but, again, are a body whose views I take with a basic level of respect on these issues. They may not always be right, but we always consider them. So casemix is a useful technique that we are looking at using. My understanding is that we are not doing it live at the moment, but that there have been some sorts of paper trials, if you like, on comparing the way we fund procedures under casemix and traditional methods.
Again, the main process that will drive change in the ACT health system, as recommended by Arthur Andersen, will be our financial management committee which, as we said the other day, we have already established and which should be holding its first meeting very shortly. Obviously, our financial advisers there - and we have people from Treasury as well as Arthur Andersen - will be interested in further developing the work we are doing on casemix. I think it is a useful tool, Mrs Carnell, but I do not think it is a magic wand.
MRS CARNELL: I ask a supplementary question, Madam Speaker. In the nine months from 1 July 1993 to 1 April 1994 the number of Victorians waiting for urgent hospital treatment such as heart surgery, Mr Connolly, not minor operations, has decreased from 1,356 to 303. That somewhat negates what you have just said. Also, the Commonwealth has spent $25m over the last five years promoting and developing casemix funding - not a little drop in the ocean and not something that still has to be looked at. If Victoria can go ahead and start reaping the benefits of this $25m worth of Commonwealth money, why cannot the ACT?
MR CONNOLLY: Again, Madam Speaker, Mrs Tehan is very keen to publicise some of these magic wand-like results, but there are very serious questions about where people have been reclassified to get these results. There is no doubt that casemix is a useful tool. We are continuing to work on that, but it is not the magic wand. I have taken, since I have been Health Minister, to reading the Age and the Sydney Morning Herald. It gives me cheer when I read stories of gloom and doom in the health systems in Victoria and New South Wales and realise that in my plight as Health Minister dealing with a carping Opposition I am not alone. There really are very serious arguments being raised about casemix and how it has been applied by the Victorian Government. I am not criticising what they are doing. I am not saying that it is wrong. But to suggest that it is the magic wand is a gross oversimplification and very strongly gilding the lily.
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