Page 4469 - Week 12 - Wednesday, 14 October 2009
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hospital, and there is no satisfactory answer coming out of the government. All the government says is, “This is about an accounting treatment.”
In relation to accounting treatment, I would like to refer to the article that appeared in the Canberra Times in May by Andrew Podger, a former head of the commonwealth department of health and a very much respected health administrator. He talks about how you get a really good hospital system and says that in discussions at the Institute of Public Administration the general agreement was that there needed to be a strong purchaser-provider separation, more sophisticated purchasing, including the use of casemix for hospital services, and a degree of independence for providers, with hospitals having their own expert boards and taking responsibility for quality and safety.
That is one of the reasons that Calvary is seen as being a much better provider of hospital services than elsewhere in the ACT—because of the whole range of things, including the independence of the board and the capacity to really respond. Mr Podger goes on at great length about what is needed for a really responsive hospital system. But he says this about the ACT government’s approach to accounting treatments:
But this is really playing accounting mirrors, because either way the ACT Government (with federal help) will continue to meet the costs of the hospital’s public patient services. Moreover, the underlying liabilities will be lower if the Little Company of Mary uses the assets more effectively than a government owner/manager. It reminds me of the nonsense accounting arguments used a few years ago to support selling government assets even where there was clear evidence of better management by government. The idea that government ownership of Calvary may improve the financial standing of the ACT is particularly obtuse.
And at the end of his article, he asks:
… will the proposed deal improve the quality of public hospital services for patients and their families? If not, then someone please get the accountants to fix the problem that is theirs, not the taxpayers or the hospital users.
I could not say it better. Mr Podger, a respected health bureaucrat, a respected health economist, understands the issues much better than do the ACT government, and this is why we want to see a more thorough probing of the financial implications and the financial reckoning that this government have used. And who better to do it than the person who is accountable to this Assembly to make an assessment? What does the Auditor-General do? She makes recommendations to this place. She does not, as the attorney and the Greens would say, make a decision in this case. What we are asking the Auditor-General to do is to look at these things—and, lo and behold, she might agree with the government and the government will have another arrow in their quiver. But they are scared to find out.
What we want to do is to provide as much information to this Assembly and to this community as possible so that we know that we are getting the best deal—not just an economic deal but a healthcare deal—for the ACT. I commend Mr Hanson for his motion and I commend the motion to the house.
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