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Legislative Assembly for the ACT: 1996 Week 8 Hansard (27 June) . . Page.. 2350 ..

Mr Berry: I did. I made it clear. Change the government.

MRS CARNELL: Changing the government last time did not work, Mr Berry, because Health did not work under you either. I am sure that I could run through the usual list of waiting lists blowing out by 150 per cent, 200 fewer beds, and all the rest of it. I do not think anybody, except possibly Mr Berry, actually believes that we have got it right in Health since self-government. I refer to situations where budgets have continued to be under pressure and where the Commonwealth Grants Commission, the Institute of Health and Welfare, and all the other bodies that have had an independent look at ACT Health continue to come up with statistics which show that we are simply spending too much for the service that we are getting.

The question that needs to be addressed by whatever government is in power - certainly it is the question that we are addressing - is simply: Why are we spending 30 per cent more in the ACT to treat the same patient at the same level for the same outcomes? That is the fundamental question that any government in this place simply has to answer. One of the first things we did was to implement the Booz Allen inquiry to try to get under the system and have a look at what the problems were. You could look at a number of other inquiries that have occurred in the ACT since self-government and, in fact, before self-government. I think the Kearney report was in 1988, which was before self-government. One of the startling things is that the findings of those inquiries have quite a number of things in common. One is that it costs us too much to run a health system; another one is that we should have a board. In fact, they have virtually all suggested that the structure we have is not as good as it could be.

The structure has changed over the years. Under the Labor Government, certainly with our support, there was a change in structure at Woden Valley Hospital to set up SMTs, which is a vertical management structure in our hospital systems. But, in other hospitals that have SMT structures, what do they also have? They also have a board - something that we do not have. That brings me to the critical point - the reason why we should have a board. Our system is not performing as well as other hospital and health systems around Australia are, particularly in financial terms. What do other hospital systems and other health systems around Australia almost always have? They have boards of management. So, to suggest somehow, as Mr Berry did, that a board was going to be counterproductive simply does not stack up at all. Other speakers suggested that it will not make any difference. I certainly hope that it does make some difference, Mr Speaker, because we desperately need a difference to be made.

I believe that separating the central core departmental structure from the service delivery part of Health will make a significant difference. One of the things that have been very evident to me since coming to this job is how often we get a fuzziness between policy development and what we are actually doing in our health service. It is very difficult for a lot of our service providers to know the difference. A lot of them are involved in both development of policy for their particular service and the business of actually delivering service. So, you can get a situation where the goalposts simply move all the time. In the approach that we are putting on the table now, that simply cannot happen.

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