Showing posts with label hospitals. Show all posts
Showing posts with label hospitals. Show all posts

Thursday, 10 August 2017

If you're not feeling well but think things can't get any worse - you forgot to factor in the Australian Minister for Health's cost cutting ways


The Age, 4 August 2017:

State and territory health ministers say hospital treatments and services will suffer under a Commonwealth proposal to withhold budgeted funds and reduce spending.

Federal Health Minister Greg Hunt has drafted a directive to the Independent Hospital Pricing Authority to review its public hospital funding method.

It would result in retrospective funds not being paid and reduced services in future, Queensland Health Minister Cameron Dick said in a joint statement issued after the COAG Health Council meeting in Brisbane on Friday.

Mr Hunt drew condemnation from Queensland, Victoria, Western Australia, South Australia, the Northern Territory and the ACT when he confirmed he would uphold the direction.

"States and Territories have already funded services and boosted frontline staffing taking into consideration Commonwealth funding," the statement said.


Independent Hospital Pricing Authority (IHPA), media release, 17 July 2017:
IHPA releases Consultation Paper on Pricing Framework for Australian Public Hospital Services 2018-19
The Independent Hospital Pricing Authority (IHPA) today released its Consultation Paper on the Pricing Framework for Australian Public Hospital Services 2018-19. The consultation is open to the public until Thursday 17 August 2017.
The Pricing Framework for Australian Public Hospital Services 2018-19 outlines the major policy decisions which will underpin the National Efficient Price and National Efficient Cost Determinations for 2018-19.
This year IHPA will seek feedback regarding work that has been progressed on pricing and funding for safety and quality as well as canvassing options to enable new and innovative approaches to value based or preventative health care models.
The Chair of the Pricing Authority, Shane Solomon said, “IHPA has continued to work closely with the jurisdictions, clinicians and other stakeholders to make significant progress on the implementation of national reforms to incorporate safety and quality into the pricing and funding of public hospitals in Australia.
“A range of factors must now be considered including risk adjustment and how the approach can be embedded as part of broader system change.
“The success of a safety and quality pricing and funding mechanism is dependent on national, state, and local health systems working together to support the implementation of a model and ensure that it is working to improve safety and quality across all services,” he said.
“The Consultation Paper is an important opportunity for stakeholders to engage with IHPA on the approach to pricing and funding for safety and quality as well as the emergence of new innovative pricing models to help improve public hospital services across Australia. We strongly encourage all interested parties to provide feedback as part of this process,” concluded Mr Solomon.
The Consultation Paper on the Pricing Framework for Australian Public Hospital Services 2018-19 is available on the IHPA website.
Submissions should be emailed as an accessible Word document to submissions.ihpa@ihpa.gov.au or mailed to PO Box 483, Darlinghurst NSW 1300 by 5pm on Thursday 17 August 2017.
– ENDS –

Independent Hospital Pricing Authority (IHPA), Ministerial Direction, 16 February 2017:
Ministerial Direction
On 16 February 2017 IHPA received a Ministerial Direction from the Hon. Greg Hunt under section 226(1) of the National Health Reform Act 2011.
The Direction requires that IHPA undertake implementation of agreed recommendations of the COAG Health Council on pricing for safety and quality to give effect to:
  1. nil funding for a public hospital episode including a sentinel event which occurs on or after 1 July 2017, applying to all relevant episodes of care (being admitted and other episodes) in hospitals where the services are funded on an activity basis and hospitals where services are block funded; and
  2. an appropriate reduced funding level for all hospital acquired complications, in accordance with Option 3 of the draft Pricing Framework for Australian Public Hospital Services 2017-18, as existing on 30 November 2016, to reflect the additional cost of a hospital admission with a hospital acquired complication, to be applied across all public hospitals; and
  3. undertake further public consultation to inform a future pricing and funding approach in relation to avoidable hospital readmissions, based on a set of definitions to be developed by the Australian Commission on Safety and Quality in Health Care.
IHPA will incorporate the requirements under this Direction into the final Pricing Framework for Australian Public Hospitals 2017-18 due to be published on the IHPA website in early March 2017.
IHPA will undertake further consultation as part of its annual consultation process on the draft Pricing Framework for Australian Public Hospitals 2018-19 due for publication in June 2017 and provide a report back to the COAG Health Council by 30 November 2017.
Note: This follows on from a Direction received on 29 August 2016 which required IHPA to provide advice to the COAG Health Council on options for pricing for safety and quality.
More information
For any questions, please contact enquiries.ihpa@ihpa.gov.au
Links

Thursday, 1 June 2017

Would believing Australian Health Minister Greg Hunt's denials be the height of foolishness?


Along with making home-owning aged pensioners pay for their Centrelink/Vet Affairs pensions by way of a debt against the value of their houses, it appears as though funding private hospitals at the expense of public hospitals may be on the Liberal-Nationals-Murdoch-IPA Coalition wish list.

A list voters never actually get to see unless the Liberal and National parties are re-elected to government - at which time its contents are usually presented to the electorate as fixed policy.

Basic outline of unsubmitted recommendations of the
Global Access Partners (GAP) Taskforce on Hospital Funding
Via Twitter


Health department bosses have described their radical proposal to remake hospital funding as "future gazing" after the Turnbull government declared it would never adopt the controversial policy.
The private health insurance rebate would be abolished, consumers would be charged more for extras cover and the states would be forced to find more money for public hospitals under the plan.
As revealed by Fairfax Media on Monday, the nation's most senior health bureaucrats – Department of Health Secretary Martin Bowles and his deputy Mark Cormack – are members of a secretive taskforce formed to develop the policy around a "Commonwealth Hospital Benefit" (CHB).

Health Minister Greg Hunt immediately ruled out adopting the policy.

"Not government policy. Won't be government policy. Will never be government policy," Mr Hunt said.

Mr Hunt said the taskforce – funded by the department but run by a private think tank called Global Access Partners – pre-dated his time in the portfolio and he had already told bureaucrats he was not interested: "I've rejected it once. If it ever comes forward, I'll reject it again."

Officials attended a GAP meeting that explored the proposal just four days after Mr Hunt apparently told them not to pursue the idea in March.

And Mr Cormack met with members of GAP as recently as May, two months after they say Mr Hunt ruled out the proposal…..

They insisted there was nothing secret about the taskforce even though it was never announced, never released anything publicly and branded its material – leaked to Fairfax Media – as "confidential".

Mr Bowles insisted the taskforce was fully independent – even though the government paid for it with a $55,000 contract…….

Under the plan, the Commonwealth would "pool" the approximately $20 billion it currently gives to public hospitals each year with the $3 billion it pays to private sector doctors and the $6 billion it spends on the rebate to help people pay their private health insurance premiums. 

It would use the money to pay a standard benefit for services regardless of whether they are performed in a public or private hospital, or whether people choose to be treated as public or private patients.

While the Turnbull government struck a three-year hospital funding deal with the states last year, it has flagged it wants a more long-term, less ad-hoc agreement – and a CHB proposal could fit the bill. COAG is set to revisit the issue of hospital funding next year to set the course for a post-2020 agreement.


News.com.au, 29 May 2017:

He told Senate Estimates yesterday it was his job as head of the department to look at the future of health funding.

He confirmed the department had entered into broad policy work on the proposal.
However, it emerged he did not put the $55,000 contract for the consultancy work to tender.

Mr Bowles said he gave the work to Mr Peter Fritz, the head of GAP, after they met in 2016 and told the Senate it was possible for him to award contracts for work costing less than $80,000 without a tender process.

Senator Watts probed Mr Bowles about connections between GAP and the Australian Health Research Centre which is funded by a number of large health insurers.

Members of the AHRC attended taskforce meetings, he revealed.

However, Private Healthcare Australia which represents insurers has raised major concerns about the plan.

“I’m genuinely stunned,’ Private Healthcare Australia chief Rachel David said when she was told the work had been paid for by taxpayers.

“It was a dramatic overhaul of the health system that totally changed the role of private health insurance, eliminated the difference between public and private hospitals and wold have put doctors on salaries,” she said.

“It would have been inflationary, there was no demand management,” she said.

This is what Global Access Partners Pty Ltd (formerly CSD Pty Ltd estab.1969) says of itself:


It appears to have been founded by:
Peter Fritz - who besides being GAP Chair & Group Managing Director of TCG Pty Ltd also chairs a number of influential government and private enterprise boards - and Catherine Fritz-Kalish currently GAP’s Managing Director.

Its offices are at 71 Balfour St, Chippendale NSW 2008 Australia.

GAP sees its participation in health public policy to date thus:

* The Australian National Consultative Committee on Health (formerly known as the Australian National Consultative Committee on e-Health) was established as a result of Global Access Partners’ 2004 Forum on ‘Better Health Care through Electronic Information’.
The ANCCH represents the major ICT industry players and other stakeholder groups. The Committee contributes to the debate around the public and private health agenda in Australia with a view to promote and realise better patient health outcomes through the application of changes to process, and the interaction of technology to improve efficiency, safety and productivity.
The group also provides a forum for public-private partnerships in order to promote improved execution and industry development.
The Committee  raises issues of national importance, influences government policy and supports the interests of its members. Its four broad areas of interest are agency coordination, chronic disease management, connectivity and infrastructure, and change management.
The ANCCH initiatives in the area of health and wellbeing over the last seven years have ranged from discussions of national health policy to the problems of implementing an Australia-wide e-health infrastructure and the potential applications of genetic testing in drug therapy to the management and long term funding of chronic "lifestyle" diseases in an ageing Australian population.

* GAP Taskforce on Government Health Procurement (2015-2016) is a cross-sectoral multidisciplinary group established by Global Access Partners to analyse Australia’s public health procurement and offer practical proposals for reform (see final report). The Taskforce considered the impact of procurement processes on the age and reliability of medical equipment, service levels, innovation and competition. Its final report highlights some of the inefficiencies of current health government purchasing  and calls for a more rational tendering process to reduce costs and waste in the system, while improving the quality and safety of care.

Wednesday, 17 May 2017

How the NSW public hospital system still fails those with mental health issues


“To see a mentally ill person in 2014 at a public hospital in NSW treated in such an appalling manner is really beyond comprehension. The sight of the deceased wandering the corridor naked and covered in excrement while the senior nurse is seen to mop the floor apparently oblivious to her is horrific. While this appears not to be a system failure it is clearly a serious human failure. It is for another place to take such disciplinary proceedings as appear necessary.” [Excerpt from a NSW coronial inquest judgment delivered on 7 September 2016]
ABC News, 12  May 2017:

The daughter of a woman who died after she was left to wander the halls of a New South Wales hospital while naked and covered in faeces says nurses there lied to her about what happened.

Miriam Merten died in 2014 from a brain injury after she fell over more than 20 times at the Mental Health Unit of Lismore Base Hospital, on the state's north coast.

A coronial inquest heard she was locked in a seclusion room for hours, and when the two nurses supervising her unlocked the door they allowed her to wander around naked, covered in faeces.

She continued to fall over outside the seclusion room.

Coroner Jeff Linden found she died from "traumatic brain injury caused by numerous falls and the self-beating of her head on various surfaces, the latter not done with the intention of taking her life".

"The sight of the deceased wandering the corridor naked and covered in excrement while the senior nurse is seen to mop the floor, apparently oblivious to her is horrific," he said.

The state's chief psychiatrist Murray Wright said he was equally shocked.

"I can't speak for what was happening in the minds of those nurses but I think it's an absolutely appalling incident," he said.

Ms Merten's daughter, Corina Leigh Merten, said she only found out exactly how her mother died when a journalist contacted her recently.

She said that at the time of her mother's death, nurses gave her a different version of how her mother died.

"I was in school, in Year 12, my dad came and picked me up and we went straight to the hospital," she said.

"At the time they told me she slipped and fell in the shower."

Now 20, Corina Merten said she did not know the coronial inquest was on.

"I'm so disappointed that it took a reporter for me to know what actually happened to my mum," she said.

ABC News, 13 April 2017:

The New South Wales Health Care Complaints Commission said it had found that two nurses caring for a patient who later died from a brain injury kept no record of about 20 falls captured on CCTV.

The woman, known as Patient A, was filmed wandering naked and covered in faeces in Lismore's Adult Mental Health Unit in mid-2014.

CCTV footage showed that in the seven hours before she was transferred to intensive care she fell 24 times.

For most of that time she was alone in a locked room, but nursing records of her confinement made no mention of any falls.

During a five-hour period in the seclusion room, no-one entered to check the patient's temperature, pulse, respiration or blood pressure.

Patient A was not offered any food or water and had no access to a toilet.

The woman died from a brain injury the following day.

The HCCC found the two nurses charged with her care guilty of professional misconduct.


See: Civil and Administrative Tribunal New South Wales, Health Care Complaints Commission v Borthistle [2017] NSWCATOD 56 decision concerning “Patient A” and Health Care Complaints Commission v Burton [2017] NSWCATOD 57 decision concerning “Patient A” .

NSW Health Care Complaints Commission (HCCC), Annual Report 2015-16:

Each year complaints relating to mental health make up around 12% of all complaints received by the Commission.
In 2015-16, there were 759 complaints in this category.
This means that over the five years from 2011 to 2015-16 the Commission has received 3,051 complaints concerning mental health….
Over the last five years the Commission received:
807 complaints about medical practitioners;
647 complaints about psychologists;
438 about mental health services in a public hospital and 299 about psychiatric hospitals;
302 about nurses; and,
220 about community health services.
In addition to the 12% of all health complaints being listed as complaints concerning mental health providers, another 5.4% of all health complaints are complaints concerning psychiatry providers.
This annual report also stated that 21% of all mental health complaints between 2011-12 to 2015-16 related to professional conduct and 31.9% related to treatment.

Of the mental health complaints received in 2015-16 there were:

46 referred to professional council;
40 resolved during assessment;
55 referred for local resolution;
23 investigation conducted by the HCCC;
46 referred to the HCCC's Resolution Service;
12 discontinued with comments;
7 referred to another body/person; and
226 discontinued with no reasons stated.

Case study included in HCCC Annual Report 2015-16 at page 58:

The Commission investigated a complaint against a mental health inpatient unit in a regional public hospital. The key facts were that:
* Patient A was scheduled under the Mental Health Act 2007 (NSW) with a dual diagnosis of schizophrenia and alcohol abuse
* The patient was difficult to manage due to lack of insight, non-compliance with medication and high level aggression.
* The decision to co-locate the patient in a double room with Patient B – both unpredictable and potentially violent patients – without any a risk assessment.
* On a night shift, required observations either not carried out at all or were not carried out in the manner required, but staff signed off that all care level checks were completed
* Overnight Patient B was killed by Patient A.
The investigation found that care and treatment of Patient A was inadequate. His care plan was ineffective, rigid and failed to improve his condition. There were lost opportunities in terms of appropriate, alternative ways to manage and treat him. Furthermore, his safety and that of others was put at risk through the decision to co-locate him with patient B and because staff failed to carry out the required observations.
SANE Australia 2013 report:
A Mental Health Council of Australia study (2011) found that people with mental illness reported similar levels of stigma from health professionals as from the general community.
Some of the study’s key findings are that:
* Almost 29% reported that a health professional had ‘shunned’ them. These figures rose to over 50% for people with post-traumatic stress disorder and borderline personality disorder.
* Over 34% had been advised by a health professional to lower their expectations for accomplishment in life.
* Over 44% agreed that health professionals treating them for a physical disorder behaved differently when they discovered their history of a mental illness.

NSW Health Care Complaints Commission decisions recorded in 2016 & 2017 re other nursing staff complaints relating to treatment of patients with a psychiatric illness:

RNs Haridavan Pandya and Sumintra Prasad – Unsatisfactory professional conduct, 2 February 2017, concerning their care of a mental health patient at Bungarribee House mental health unit in Blacktown hospital on 28 February 2014.

RNs Abraham Thomas and Donna Hayden, and Ms Julie Rumble – Unsatisfactory professional conduct, 11 May 2017,concerning the death of a mental health inpatient at Dubbo Mental Health Inpatient Unit on 28 February 2014.

Mr Stephen Woods – disqualified from being registered as an enrolled nurse for a period of 12 months, 16 May 2016, concerning a physical and verbal attack of a patient in the Mental Health Intensive Care Unit at Hornsby Hospital on 9 April 2014.

Mr Neil Mullen (RN) – Unsatisfactory professional conduct – Reprimand and conditions imposed, 18 July 2016, concerning care of care of nine patients in the Shellharbour Hospital mental health unit on 30 and 31 July 2014. 

Mr Mike Siebe Greive - Registered Nurse - Disqualified for 18 months, 30 March 2016, concerning a female mental health patient at the Hornsby Hospital Adult Mental Health Unit between October and December 2013. 

Registered Nurses Wendy Kennedy, Christopher Parker and Jisnu Dowsett cautioned and Stewart Thompson reprimanded by a Nursing and Midwifery Professional Standards Committee, 1 June 2015, concerning care of a patient at Lismore Adult Mental Health Unit’s eight bed High Dependency Unit on 19 and 20 February 2013.  The patient was found deceased in his room on the morning of 20 February 2013.

Mr Ronnie Obusan - finding of unsatisfactory professional conduct – reprimand and conditions, 19 January 2016, concerning the nurse’s interactions with a patient in the mental health unit at Nepean Hospital in 2012. 

I'm sure NSW residents would all like to believe that each and every time they present at a public hospital they will be treated with professional care and respect.

Unfortunately that is not always the case as prejudice, discrimination and racism are rarely acknowleged by government as existing within the state health care system and are therefore tolerated by default.

“Stigma against people who have experienced a mental illness is deeply entrenched in our culture. It finds expression everywhere from the Parliament to the front bar. From courtrooms and pulpits to playgrounds it is possible to hear people who experience mental illness cast in an unfair light.”  [National Survey of Mental Health and Wellbeing Bulletin 6, Carr & Halpirin 2002, Stigma and discrimination]

Friday, 10 June 2016

Lismore Hospital workers not happy with upstairs-downstairs parking arrangements



OUT IN THE STREET FOR TWICE THE PRICE: THE PARKING RAW DEAL FOR LISMORE HOSPITAL WORKERS

Friday 10 June, 2016

Hospital workers who can’t get into the new car park at Lismore Base Hospital will have to pay more than twice as much to park in surrounding streets.

Health Services Union NSW Secretary Gerard Hayes said the new multi-story car park at the hospital will only provide 270 spaces for around 1,600 hospital workers.

“Hospital staff who were able to secure a spot in the new car park will only have to pay $12 a week, but everyone else will be paying more than double that amount to park out in in the street.

“Why should lower-paid hospital workers such as cleaners and security staff be paying $5 a day when lucky doctors and specialists can get parking for just $2.40 a day?

“Talk about a raw deal. The hospital and the Lismore City Council need to work this out and provide a better arrangement so that all staff are treated equitably.”

Hospital workers will today rally outside Lismore Base Hospital to demand action on the parking situation.

Mr Hayes said a system of providing vouchers for hospital staff to access street parking at the same rate as the new multi-storey car park would be a sensible solution.

“Lismore City Council charges $2 to park all day in the CBD, so it looks like there’s an element of price gouging going on around the hospital. The new car park is due to be opened soon, so the Council needs to act in this situation now.”

Tuesday, 7 June 2016

Meanwhile at state level in New South Wales.....


The gloves are off over Tweed Hospital funding…..

THEN



THE NSW Government has promised $48 million in funding for stages one and two of the $211 million Tweed Hospital redevelopment if re-elected next month.
NSW deputy premier Troy Grant, health minister Jillian Skinner and Tweed MP Geoff Provest made the announcement at Tweed Hospital this morning.
The Tweed Hospital has struggled to cope under the pressure of a growing population and a lack of beds with emergency department attendances up by nearly 10 per cent last year alone.
Plans for a redevelopment of the Tweed Hospital were approved in late 2013, however the Northern Rivers Health Board has made the redevelopment of both the Lismore and Byron Hospitals a priority before works start at Tweed.
Mrs Skinner said despite the issues facing the hospital, Tweed redevelopment remained the third priority in the region.
“This $48 million will redevelop the emergency department, increase the ward space and bed capacity as well as a new carpark,” she said.

NOW

Tweed Daily News:


TWEED MP Geoff Provest is calling for greater Tweed representation on the Northern NSW Local Health District Board, saying this area is losing out to its counterparts in Lismore and Byron when it comes to hospital funding.
Mr Provest said "questions needed to be asked" over the NNSWLHD's handling of the Tweed Hospital upgrade, following revelations estimated costs of Stage One of the works had almost doubled from $48 million to $80m.
NSW Health Minister Jillian Skinner declined to comment on the blow-out but her office confirmed estimates for the 2016-2017 Budget would not be increased to meet the shortfall, despite pleas by the Tweed Medical Staff Council to fully fund the actual costings…..

TWEED Hospital surgeons have been backed by the Australian Medical Association as the doctors brace themselves for the reality of another funding campaign.
Dr Stephen White said the Tweed Hospital urgently needed a redevelopment because patients were "pressured" to leave early after procedures for new admissions, a technique known in the industry as 'hot-bedding'.
"It wouldn't be unusual to have three people admitted into the same bed, on the same day, and I think that's extreme," Dr White said.
"People get told the day after surgery they have to go home and the reality is they can't."
Dr White criticised Northern NSW Health District's latest upgrade budgeting blunder, saying up to 30% of surgeons' work "was not recognised" or factored into their forward estimates because the patients were Queenslanders…..


Shadow Health Minister and North Coast MP Walt Secord has challenged Tweed MP Geoff Provest to provide a timeline on the Tweed Hospital upgrade from NSW Health Minister Jillian Skinner.
Only $48 million is due to be released for stage one of the hospital’s upgrade in the June Budget, even through the figure is understood to be closer to $140m.
Mrs Skinner told ABC Radio on May 10 it was unfortunate the Northern Rivers Local Health District board had underestimated the funds required for stage one of the redevelopment but lessons had been learnt.
Mr Secord said the North Coast needed a statement from Mr Provest or Mrs Skinner “stating they are going to fully fund Tweed Hospital, with dates and deadlines”.
“Too often, the community has been tricked by weasel words from the Liberals and Nationals,” he said.
“We need these dates so we can track the progress and ensure that the upgrade is on track.”

FIRST it was a weasel, now it’s a dim sim: a war of words has erupted between Tweed MP Geoff Provest and Shadow Health Minister Walt Secord over funding for the Tweed Hospital.
Mr Provest today quipped back at Mr Secord, also Labor’s MP for the North Coast, over his call for a definitive timeline on the Tweed Hospital upgrade, saying the request was just part of a dirty “smear campaign”.
Yesterday the shadow health minister said Mr Provest had used “weasel words” in dodging a formal commitment to fund the full cost of the hospital’s redevelopment, following a blow out in costs from $48m to an estimated $140m for Stage One of the project.
But Mr Provest retaliated, accusing Mr Secord of mounting a personal attack against him.
“I think he’s the king of smear,” Mr Provest retorted, referring to Mr Secord.
“He has no idea of what is actually happening at the Tweed Hospital.
“I can’t even remember the last time he visited here. He’s not met with the Tweed doctors and not had any communication with them.
“He went to Beijing and fell over on a dim sim, and now he’s back in parliament at Sydney, and just full of the smear that Labor is renowned for.”
But Mr Secord hit back, saying in fact, during the last parliamentary recess, he had been 1600km west of Shanghai in rural China when he tripped and broke his ankle and fibula.
“I am in a wheelchair, but this will not stop me from ensuring Tweed MP Geoff Provest delivers a full upgrade of Tweed Hospital,” he said

Saturday, 9 May 2015

How much can a koala bear before he needs a doctor?


This koala appears to have entered accident & emergency department of a public hospital in the Western District Health Service in Victoria:

Thursday, 15 January 2015

Abbott Government health funding cuts will hit home on the NSW North Coast


New South Wales residents can expect the state public hospital system to experience a further strain on service delivery in 2015 courtesy of both federal Abbott Coalition and state Baird Coalition governments' health policies.

On 5 June 2014 The Sydney Morning Herald reported:

The Bureau of Health Information report released on Thursday shows that from January to March more than 600,000 people visited NSW public hospital emergency departments, a 2 per cent jump compared to the same time last year.
About 73 per cent of patients left emergency departments within four hours, up from 66 per cent last year, but still falling far short of the 81 per cent target…..
The new figures show that while about 97 per cent of people are getting surgery on time, some patients are still waiting more than six months.
Median waiting times for ear, nose and throat surgery are now 153 days. Gynaecology, urology and prostate surgery waits increased between seven to 10 per cent.
''NSW still has the longest waiting times for elective surgery in Australia and close to the longest in developed countries,'' said Dr McDonald. ''A 302-day median wait time for a knee replacement is just unacceptable.''

On 11 January 2015The Australian noted:

NSW has abandoned a national target for attending to people who need treatment in hospital emergency departments after the federal government cut reward payments.
Under a national partnership deal struck between the states and the commonwealth in 2011 under the Gillard government, all states were meant to have reached a benchmark of seeing 90 per cent of patients in emergency departments within four hours from January 1 this year.
The agreement included rewards of $50 million a year for reaching this target, but in the federal budget last year the government abolished the payments.
NSW Health Minister Jillian Skinner said, because of that, “there is currently no formal target tied to rewards payments”.
NSW intended to keep to last year’s target of 81 per cent instead of using the new target of 90 per cent, she said.
Although emergency department performance has been improving, it has not met national benchmarks…..

In practice this means that during a year public hospital emergency departments are expected to experience an increase in the number of patients presenting because the Abbott Government has cost-shifted its Medicare rebate cuts onto individuals and families from January 20151, its public hospital funding cuts have also made matters worse for those seeking treatment at hospital accident and emergency departments.

The figure below clearly shows the best that the ill or hurt in NSW could expect in late 2014 – an average wait to receive treatment of between 41 minutes and 2 hours 29 minutes for the majority attending A&E departments.



The 95th percentile represents the time period within which most people received the relevant care or treatment.

On the NSW Far North Coast this averaged out for the majority of patients seeking treatment as a wait of between 29 minutes and 2 hours 11 minutes:


The Australian Medical Association (AMA) is predicting that public hospital emergency department waiting times will now rise not by a factor of minutes but by hours in 2015.

1. Increased GP fees are expected to commence from mid-January 2015 and increase again in July for over 15 million Australians, as Medicare rebates cover less of general practice & specialist doctors standard fees. Many patients will be paying a standard upfront fee of $75 or more for a simple 10 minute visit to their local doctor as fewer medical practices are expected to continue bulk billing. The Medicare rebate formula would have meant that the the federal government met half of that cost for non-concessional patients. However, from 1 July 2015 the medicare rebate on a $75 fee will be reduced to $32.04 leaving the patient $42.95 out-of-pocket.
If a medical practice decides to use the AMA recommended schedule of fees and abandon bulk-billing all together, then concessional patients (such as aged and disability pensioners or children under 16 years) will also have to pay an upfront fee of $75 for a 10 minutes consultation and be $34.95 out-of-pocket.
For non-concessional patients seen by their doctor for between 6 and 10 minutes the rebate reduction will increase their out-of-pocket expense to $20.10 from 19 January rising to $25.10 after 30 June 2015.

UPDATE

A statement that needs to be taken with a grain of salt…….

The Sydney Morning Herald 15 January 2015 at 12:34pm:

The government has capitulated and scrapped its plans to next week cut the Medicare rebate by $20 for short visits to the doctor after a fierce backlash by doctors and non-government Senators, who vowed to veto the measure.
In her first act as the new Health Minister, Sussan Ley broke her holidays to announce on Thursday that the cuts - quietly introduced by her predecessor Peter Dutton late last year - are now "off the table".
Ms Ley said she was still committed to introducing price signals into Medicare including the revised $5 GP co-payment due to start July 1, but pledged to "pause, listen and consult".....


Friday, 17 October 2014

Why is the NSW Baird Government removing surgical facilities from the new $80 million Byron Central Hospital?


In September 2014 it was reported that the early works contract for the new $80 million Byron Central Hospital had been awarded and, that main works construction on the greenfields site was to begin in 2015.

On 16 October 2014 the Echo Netdaily reported on the possible privatisation of surgical services within this hospital:

The NSW Parliament is today set to debate controversial government plans to privatise the proposed Byron Central Hospital after a move by the Labor opposition yesterday to force the coalition to release all documents related to the development.
It comes as a residents group revealed the Ewingsdale landowner of the surrounding land where plans are being pushed through for almost 200 dwellings, a nursing home and shopping centre is the daughter of one of Australia’s richest beef barons who has been buying up prime farmland nearby.
Byron Shire Council last week narrowly approved pushing the so-called ‘seniors’ development through to its development application (DA) stage, outraging local resident groups who say it should have been deferred for more time to consider the contentious plan which contravened the shire’s new Local Environment Plan (LEP).
But comments by Ballina MP Don Page, following the council decision, that he wanted the private sector to provide surgical services at the hospital has sparked the move in parliament to try and throw light on the hospital plans and the push for privately-run services.
Labor’s shadow health minister Walt Secord says his call for papers, known as a Standing Order 52, in the NSW Legislative Council yesterday will be debated this week.
‘It’s an extraordinary step, but this is about finding out the National Party plans for Byron Central Hospital’, Mr Secord told Echonetdaily.
He said Mr Page’s comments to the ABC in favour of a privately-run service followed an announcement by state health minister Jillian Skinner last month that the central hospital’s project team was ‘undertaking a market sounding process to determine whether there is interest from private providers to deliver surgical services at the facility’.

Read the rest of the article here.

The aforementioned debate did take place and Greens MLC Jan Barham from the Northern Rivers spoke up for the people of Byron Bay Shire and revealed what government members were obfuscating that day -  that surgical facilities had been entirely removed from the architectural plans for this hospital.

NSW Legislative Council Hansard [Proof Copy] 16 October 2014:

Ms JAN BARHAM [10.55 a.m.]: I support the motion moved by the Hon. Walt Secord. I urge members to have a history lesson on this matter because both sides have misrepresented the situation. As to Byron Central Hospital, I spent 10 years attending meetings and dealing with the processes conducted under the former Government for its delivery, only to be thwarted time and time again. For example, a Central Coast hospital was proposed and it was suggested that Byron would lose its two hospitals and get one large hospital in Ballina. I apologise to the Minister for Ageing, who outlined the Government's position, but he is incorrect. The previous process was always followed carefully and stringently, with wide consultation on delivery of the supply plan for the new Byron Central Hospital.

Until February 2014, architectural plans that were shown to community members—who had served for more than 20 years on committees discussing the delivery of a new hospital—included surgery services. The services plan that was completed in 2002 and put out for public consultation included surgery.
The idea of removing surgery services from the hospital, as proposed in the current planning process, is abhorrent to the local community. People feel that promises have been broken and they deserve answers. Members may note that I have put questions on the Notice Paper about these issues. I recently attended a forum at which design plans for the hospital were released, and committee members were shocked to see that the previous architectural plans had been changed to remove surgery services. It was the first they had heard of it. There has been a lack of consultation and notification about this process. People who have the community's interests at heart and who have voluntarily given so much time and energy to local health issues and to this project, were shocked. That night they expressed their displeasure about what was occurring. [my red bolding]

The Government is unwilling to tell the community why surgery services have been dropped or what process is being undertaken to ensure that Byron shire retains those important services. A new proposal should be developed and presented in a manner that conforms with normal processes so the public can access it conveniently. The process must be transparent. There has been misinformation but the important issues are service delivery and good public health services—about which I have put a question on notice. Tourism is also an important consideration. Unfortunately, visitors who engage in dangerous and adventurous activities often use local health services and facilities. I welcome this important motion but I caution members to recognise, observe and acknowledge the history of this matter. The Byron shire community have put in a lot of effort to ensure they get a hospital that meets their needs. I look forward to these issues being considered and resolved.

On a vote in the Lower House the motion passed and the Baird Government is now obliged to supply to Parliament all documents, including but not limited to ministerial briefing notes, email correspondence, financial documents, memos, file notes, meeting papers and meeting minutes relating to the new Byron Central Hospital and Maitland Hospital.

These documents should be interesting to say the least, as one local resident in a submission to the NSW Minister for Planning & Environment in September 2014 outlined how planned surgical services were whittled away before being removed from the building design:

As a member of Byron Bay Hospital Aux, I have been interested in the planning process for the new Byron Shire Central Hospital since the first consultants were engaged by the Dept to consult with the local community, so probably for over 20 years. Along every step of this process I have attended numerous public meetings as well as meetings of the planning committee and was always assured that there would be no downgrading of the services available at the Byron Bay or Mullumbimby Hospitals until the new Hospital was built and we would keep all the current services available at both Hospitals and indeed add to these services, when the new hospital was built. I was astounded to see that the plans currently on exhibition make no mention of operating theatres or day surgery. The initial proposal incorporated two "state of the art" operating theatres. This later became theatres for day surgery procedures and now we have non{e} at all!. As Byron Bay Hospital has facilities for day surgery and has had some form of theatre since it's inception, I find it totally unacceptable that the new Central Hospital has none at all and I say this whilst being well aware that the Area Health Board is looking for expressions of interest for a private provider to build operating theatres on the site, for them to buy back services from. I wish to strongly object to the fact that there is not allowance for operating theatres in these plans. These plans must include provision for at least day surgery in the event that no private provider is found, otherwise the people of the Byron Shire have been duped by the Health Department. This Hospital underwent a very lengthy and painful community consultation, there was much ill feeling in both communities over the loss of both hospitals. The community only agreed to the one Central Hospital provided there was no loss of services. They would not agree to what is now proposed in these plans. 

Once again the North Coast Nationals appear to have blindly endorsed a flawed health services plan for the Northern Rivers region.