Page 3650 - Week 12 - Wednesday, 21 November 2007
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Problems experienced within our health system go beyond public hospitals. If primary health care does not get sorted out, of course there will be increased demand on our hospitals. We need many more bulk-billing GPs, subsidisation and expansion of dental services, and adequate aged care with adequately paid staff. These are all matters that require cooperation at commonwealth and territory levels.
While noting that health can seem to be a bottomless pit for government funding, needs can be prioritised within the hospitals. We know that we need more acute beds and more staff; we know that our doctors and nurses are stretched to capacity. I wonder whether the Liberals plan on having the public boards responsible for employment; it was hard to tell from the bill.
It has been said—sceptically, I suppose—that Howard has pushed the public boards proposal because this could be a back-door approach to introducing AWAs into hospitals, a practice that I believe many staff would oppose.
Mr Barr: You could be right.
DR FOSKEY: That could be right. As I have previously stated, whichever direction is taken, if the goal is to improve to a fair level the health services provided to consumers, consumers must have input. There are many consumer representatives who are well qualified and trained in advocacy. I know the government has processes by which the consumer organisations can contribute. If these are not happening well enough, those are the processes that should be improved.
Consumer organisations have said that, if public boards are to exist, they must have a place for consumer representatives, and this bill does not provide for that. However, organisations also said that many avenues already exist for consumer representation, and mandatory accreditation criteria feature consultation with such advocates.
The AMA has given its support to public hospital boards, stating that local hospital boards bring management accountability and responsibility right back to the community. Yet the AMA president also said at the same time that the AMA does not—and I quote:
… believe that the people of Australia will be served any better with a Commonwealth takeover of health service delivery. The Commonwealth is very remote to services on the ground. Each state has got different demographics and different issues, and different demands; and we need a local accountability and responsibility in health.
That may have led the AMA to decide that local boards were the way to go, but if what we need is local accountability and responsibility, there are other measures apart from establishing local public boards, which, in the case of the ACT, it has been demonstrated did not work. If the idea of public boards was being pushed by Labor rather than by the Liberal Party, and if it was dissociated from a commonwealth takeover of health, I wonder whether it would receive greater acceptance amongst health advocates.
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