Page 1040 - Week 04 - Wednesday, 16 March 2005
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problem is with that is that it is just a failing to acknowledge what is occurring on the ground.
Mr Speaker, our hospitals will provide more than 400,000 services this year across inpatient, outpatient and emergency department services. The mix of the way these services are delivered will continue to change. So you can no longer look at the provision of health services by focusing on a single type of service response. Mr Smyth cannot look at what is happening in inpatient services without looking at what is happening equally in outpatient services. And he fails continually to do that. The transfer of services from inpatient to outpatient setting is almost directly responsible for the decrease in the estimated inpatient throughput. It does not mean they are not happening. What it does mean is that they are being delivered differently. I would like to provide some figures for members to look at in this context. The outpatient target for 2004-05 is 235,000 occasions of service. In 2003-04, the target was 225,000 occasions of service, and the outcome in 2003-04 was 242,000 occasions of service.
Two things have occurred to change where we are at with inpatient services. The first is a direct shift of activity in gastroenterology from inpatient to outpatient services. That shift has resulted in all of those occasional services now being recognised as outpatient activity. What has also occurred is that medical oncology services are now only being counted as outpatient occasions of service, whereas previously—and it has been the case ever since we have had a medical oncology service—medical oncology services were being counted twice, as both outpatient and inpatient occasions of service. They are now only being recorded once, as they should have been from the beginning. And that has resulted in a relatively static level of outpatient activity, whilst still seeing a decrease in the level of inpatient activity. It does not mean the services are not being provided. It does not mean that people are not getting these things on the ground. It does not mean that we are spending more and getting less. It just means that the way they are being measured and recorded has been changed.
But if Mr Smyth is so concerned about outpatient occasions of service to back up his argument that my assertion that the decline in inpatient is because of the shift to outpatient, let me put this to him: for the first six months of this financial year, we are over target in the delivery of outpatient services; we are 3 per cent over target. And I am advised that, by the end of this financial year, we will certainly exceed our target for this financial year.
Mr Speaker, who is right? Mr Smyth’s assertion that outpatients are down but inpatients are also down? Or do the facts and the activity on the ground actually speak for themselves? I think it is the latter. If we are 3 per cent ahead of target in outpatient occasions of service six months into the financial year, surely that would demonstrate that there is more activity happening in outpatients because of a shift from inpatient to outpatient. Mr Smyth, though, is not interested in hearing some of that argument.
Notwithstanding all of this, it is important to note that, at the end of January 2005, both hospitals report activity at 4 per cent above their targets for the first seven months of 2004-05 for inpatient activity also. So we are ahead of target. This is the bottom line: we are ahead of target for outpatient occasions of service. We are ahead of target for inpatient occasions of service. So how can Mr Smyth claim that we are spending more and getting less? How can he claim that, when we are ahead of target for both inpatient
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