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Legislative Assembly for the ACT: 1995 Week 7 Hansard (19 October) . . Page.. 1867 ..

MR MOORE (continuing):

Mr Powell - maybe Dr Powell; I am not sure - concluded by saying:

If anyone in Australia is considering following the New Zealand model then my advice is forget it. Failure is too kind a description. Basing a public health service on commercial competition is like splitting a fish and chip shop into two so that one sells fish and the other hot dogs, and then expecting them to compete against each other. All you get is a greasy mess which is exactly what New Zealand has.

Mrs Carnell, do you understand what has happened in New Zealand, and what are you doing to avoid the same problems?

MRS CARNELL: As Mr Moore and the rest of the Assembly would be aware, I went to New Zealand recently - at my own expense, obviously - to have a look at exactly what was happening in New Zealand. We are also having a look at what is happening in all other States in Australia and wherever health reform is going on, which is everywhere in the world at the moment, and taking on the good bits of all those approaches. Certainly, there have been some problems in New Zealand, and I think they have taken the purchaser-provider model too far, particularly into such areas as public health. I do not believe that there is naturally a purchaser and naturally a provider in areas such as public health, but there are other areas where the whole approach has been very successful.

This is particularly so in the area of contracts with particular hospitals - in other words, setting out exactly what the government or the provider expects that hospital to produce over a 12-month period - unlike the ACT, which up to date has had some very loose contracts with both of our hospitals. Those loose contracts have said such things as that we expect a certain level of operations or procedures to be done over a 12-month period. We do more or less the same with Calvary.

Mr Berry: And the overflow goes the other way.

MRS CARNELL: We have contracts with both hospitals, Mr Berry, to a certain level of activity; but what we have not done in the past is what they have done in New Zealand, which I think has worked very well, and that is to spell out exactly what the Government expects for its taxpayer dollar, to spell out the sorts of operations we expect, so that hospitals cannot just do lots and lots of day surgery and no major or minor operations. To some extent, that is what we have seen in our hospitals in the ACT over the last couple of years. We have seen a dramatic reduction in the amount of major and minor surgery that has been done and a huge increase in the amount of day surgery.

The only way we can overcome those sorts of problems is to have very specific contracts with our hospital system which say, "We need this amount of orthopaedics, this amount of urology, this amount of general surgery", so that we will not end up with a situation we have seen in the past where for things such as orthopaedic surgery the list was getting longer and longer.

Mr Connolly: In the last six months, 23 per cent.

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