Fixation on having four hospitals costs a fortune — and lives

Let’s hope Canberra agrees to an urgent inquiry into our health system, says

THE diagnosis is clear. Tasmania’s health system is fundamentally broken.

The new Health Minister has not resolved the health crisis, and nor is she likely to, given the chronic systemic and cultural problems she’s inherited, combined with the State Government’s continuing apathy.

Over many years politicians from all sides have demonstrated they’re incapable of providing Tasmanians with the worldclass health system we need.

So it’s time to strip away the politics and parochialism that have paralysed this state and bring in an outsider, an independent honest broker to find out why Tasmania’s hospitals are the worstperforming in the country.

The Productivity Commission, whose work has helped spawn groundbreaking reforms such as the National Disability Insurance Scheme, is best placed to do the job. I’m meeting with the Federal Treasurer next week to make the case for him to direct the Commission to urgently hold a public inquiry into Tasmania’s failing health system.

The Commission is an independent advisory body to the Australian Government with the power to investigate all levels of government. Its core function is inquiries into key policy areas bearing on economic performance and community wellbeing. It already looks at public hospital performance, and is well placed to hold an inquiry into why Tasmania’s hospitals are failing, despite the heroic efforts of staff and similar resourcing from Canberra. The Commission is examining mental health now and in the past has studied Tasmania’s shipping and freight. It is perfectly credentialed to look at the big picture.

Albert Einstein is credited with saying: “The definition of insanity is doing the same thing over and over again, but expecting different results”. Tasmania’s health system is a product of this insanity. It suffers a chronic case of parochialism and political paralysis. The Australian College for Emergency Medicine released data showing the Royal Hobart Hospital and Launceston General Hospital are the country’s worst performing when it comes to how long people wait for treatment in emergency. The peak body for emergency medicine said simply throwing more money at hospitals was not the solution. It shows doctors on the frontline know the health system has systemic problems.

Since then we have heard the RHH is lurching around in the dark without a budget, fearful to spend money without an indication from the State Government of its annual budget halfway through the financial year. Last week, 17 people in mental health crises were sitting in its emergency department, some waiting more than three days. Doctors have pointed the finger at middle management and warned of a crisis of culture, not capacity. Now there are fears of a mass walkout of doctors, nurses and paramedics who can no longer face working in the broken system.

There are precedents for the Federal Government getting involved in the

Tasmanian health system beyond the disastrous Mersey hospital takeover and handback. On my election in 2010 the Federal Government committed $340 million for redevelopment of the RHH, and in 2012 I secured the $325 million Tasmanian Health Assistance Package in recognition the population was older and sicker than other states. The Federal Government could show a keener interest in the fact the Hodgman State Government has diverted $1.6 billion of GST money from Tasmania’s health system since 2014. This is an emergency and it’s time for federal intervention, starting with a Productivity Commission review to identify the root cause.

The ills have been well documented in the 2004 Richardson Report, the 2007 Tasmanian Health Plan, the Report of the Commission on Delivery of Health Services in Tasmania, and the One State, One Health System, Better Outcomes reform package. All make the same diagnosis: a rapidly ageing, geographically dispersed population, high rates of chronic disease, rising costs and worsening performance, and an urgent need to stop trying to offer all services at four major hospital campuses.

It’s time for Tasmanians to pause and consider why on earth we are so fixated on maintaining four hospitals in a state of just half a million people. All this is achieving is longer waits, higher costs and worse outcomes, undoubtedly leading to unnecessary deaths.

In a number of domains, maintenance of separate health regions leads to clinical caseload spread too thinly across too many facilities. The duplication is wasteful, generally leading to higher costs. It also has the potential to be unsafe. This assessment has been independently confirmed three times in the past decade and acknowledged by successive governments. Shame on political parties for putting self-interest in Braddon and Bass ahead of public interest and healthcare.

We should be guided by evidence and should not be in the position of defending poor outcomes on the basis of historical or parochial interests. A bipartisan approach is needed here. It’s time to stop playing politics with the health of Tasmanians. People are dying.

Andrew Wilkie is the federal independent member for Clark.