Saffin brings home the bacon for Lismore

Federal Labor MP for Page Janelle Saffin again demonstrates that she is an effective advocate for her electorate with the announcement that the Rudd Government is funding eight extra Medical Assessment Unit beds at Lismore Base Hospital.

"This is in addition to over $600,000 recently provided to the hospital for new surgical equipment under Stage Two of the Rudd Government's Elective Surgery program.....

The Commonwealth is providing $4.1 million in operational funds and $5.7 million in infrastructure funds over two years to establish the University of Western Sydney's new Rural Clinical School in Lismore and Bathurst.....

The Lismore Integrated Cancer Centre is a NSW Government project to be located at the Lismore Base Hospital. The centre will include radiation oncology, medical oncology and haematology services. The Rudd Government has delivered $15 million for the Centre to be fast tracked."

After years of being taken for granted by the Nationals when the Coalition last held federal government, Ms. Saffin's ability to keep the electorate and Lismore on the national health agenda is most welcome.

Let's hope that she has as much success with ongoing funding for Grafton Base Hospital and the smaller district hospitals within her bailiwick.

The recent announcement of electoral redistribution may naturally enough have Janelle focusing on the north-west section of Page right now, but she needs to remember that the Clarence Valley and the rest of the coast delivered for her in November 2007.

Transcript of Lismore doorstop interview with Kevin Rudd on 24th August 2009.

Whatever happened to our blogging PM and why is he failing to connect with regional voters online?

If anything clearly points to the fact that the Australian Government still doesn't get the communications revolution it is the fact that, after creating a PM's Blog with a gentle riff of publicity and posting two one-way 'discussion' topics, the blog has gone into dead time.

The Prime Minister as KRudd still uses hisTwitter account from time to time, but those short tweets just remind voters that he is alive - they don't add much to the national conversation on political, social, economic and environmental questions that concern the country.

Kevin Rudd obviously didn't fancy the blog format all that much, because since 10 August 2009 he is now selectively inviting 20 Internet users to have a Web Chat when the mood takes him.

Of course such chats omit so many low income households in regional areas from the conversation as it is obvious that a dial-up connection is not about to get you a timely invitation to 'chat' because all day online is not possible and, yes, rather more understandably those chats are now in dead time also.

The Prime Minister might like to tell the world that he rather likes Twitter, however he doesn't use these tweets to really connect with regional Australia. Today Kevin Rudd is said to be in Lismore on the NSW North Coast as part of his inspection of health facilities across the country, but one wouldn't know it from his public tweets on the weekend.

The fact that he is in the Northern Rivers is of some interest to local voters as our public hospitals are under sustained cost-cutting attack by the North Coast Area Health Service and just last Saturday The Daily Examiner reported that it is on the cards for Grafton Base Hospital to lose another 10 ordinary beds and fail to gain funding for 17 new beds that are part of the promised departmental upgrade.

Hopefully, when it comes to old fashioned face-to-face contact, Kevin Rudd will fare better as the Rudd Government is fast becoming our last faint hope for decent regional hospitals, as one wouldn't know how dysfunctional matters are becoming if one reads the 2007/08 NSW Health annual report and it is obvious that maintaining the health system is getting beyond the capacity of the state governments.

Show me the money Mr. Crawford says NSW Industrial Relations Commission

The NSW Industrial Relations Commission has temporarily short-armed the North Coast Area Health Service's drive to shed another 300 jobs.
Chief Executive Officer Chris Crawford has been asked to show proof of current savings and outline savings anticipated by further staffing cuts.
Fractured fairytales coming up!

Can't get to see your G.P. for a month? Worried about that long wait at accident and emergency? Been on an elective surgery list for a year?

Can't get to see your G.P. for a month? Worried about that long wait at hospital accident and emergency? Overwhelmed by the thought of a day-long trip to see a specialist? Upset by the fact that a family member is hundreds or thousands of kilometres away receiving in-patient treatment? Concerned that you won't survive a life-threatening disease because poorer health outcomes sometimes correlate with life in the regions? Indignant that you can get elective surgery within two months if you have the money to pay but are on a waiting list for twelve months if you are poor? Think your local district hospital won't be there at the end of the year if this area health service cost cutting keeps up?

Well these are pretty common worries for many Australians living in rural and regional areas. But never fear - Prime Minister Kevin Rudd is out there clutching his copy of A healthier future for all Australians - Final Report June 2009.

The National Health and Hospitals Reform Commission may say that; The health of our people is critical to our national economy, our national security and, arguably, our national identity. Our own health and the health of our families are key determinants of our wellbeing. Health is one of the most important issues for the Australian people, and it is an issue upon which they rightly expect strong leadership from governments.

However don't expect significant federal-state consultation on the report's recommendations before the next federal election.

The Liberals and Nationals won't add anything constructive to consideration of the public health service as they don't want timely consultation because it will take away an election campaign stick that it can use to beat the Rudd Government about the head and, Labor won't be rushing forward either because it will be easier to continue promising golden health reform in the lead-up to polling day than it will be to defend leaks about inevitable federal-state consultation hiccups.

As for those medieval guild relics, the 'gentlemen's' unions covering general practitioners and medical specialists - well they won't be doing more than blowing obstructive hot air until someone promises them that there will be a larger user pays component favouring their pockets in any national health system.

So. Can't get to see your G.P. for a month? Worried about that long wait at hospital accident and emergency? Overwhelmed by the thought of a day-long trip to see a specialist? Upset by the fact that a family member is hundreds or thousands of kilometres away receiving in-patient treatment? Concerned that you won't survive a life-threatening disease because poorer health outcomes sometimes correlate with life in the regions?Indignant that you can get elective surgery within two months if you have the money to pay but are on a waiting list for twelve months if you are poor? Think your local district hospital won't be there at the end of the year if this area health service cost cutting keeps up? Get used to it and hope that you survive until that shining day when Kevin Rudd finally 'fixes' the public health system.

A healthier future for all Australians - Final Report June 2009:

Executive Summary

Recommendations

End-of-life decision-making: a disturbing observation by the NSW Ombudsman

Click image to enlarge

Excerpt from NSW Ombudsman March 2008 submission to the Special Commission of Inquiry into Acute Care Services in NSW Hospitals.

How many acute care beds are there in NSW North Coast hospitals?

North Coast Area Health Service (NCAHS) covers an area of 25,570 square kilometres extending from Port Macquarie in the south, Queensland in the north and westward to the Great Dividing Range and there are over 480,675 people living within these boundaries according to the area health service.

Also according to the NCAHS website in 2005 there was a total of 21 public hospitals, with approx. 1384 acute care beds offered at the public/private hospitals in the Area.

Which works out at no more than 2.9 acute care beds to every 1,000 North Coast residents and, even less available to patients without private medical insurance if one was able to extract private hospital beds from the bundled NCAHS 2005 figure.

In 2007 Peter Roberts and Paul Cunningham told a NSW inquiry that NSW had only 1.1 acute care beds in private hospitals per 1,000 population and 2.7 acute care beds in public hospitals per 1,000 people.

Now Professor Peter Collingdon informs us in 2009 that:
In Australia we have 38% less beds than in 1981 when there were 6.4 acute care hospital beds for every 1000 people. There are now only four beds per 1000 people available. Only 2.7 of these beds are available in the public sector -- where the sickest patients are looked after. [Crikey.com.au,20 July 2009]

Which indicates that little is changing for the better in health services when it comes to bed numbers.

Given the relentless NCAHS cost-cutting, staff and bed reduction drive of recent years, perhaps Chief Executive Officer Chris Crawford could favour us all with details of the current ratio of acute care beds in NSW North Coast public hospitals to every 1,000 head of population.

Local doctor shows a surprising level of intolerance - wonder how full his waiting room is this week?

Lengthy waiting times to see specialists practicing on the NSW North Coast and longer waiting lists for surgery are apparently not the fault of an ailing public health system, it's really the patient who is to blame.

Here are a few quotes from the owner of Iluka's Wellness Centre in How to avoid the long hospital queue:

"Diseases like diabetes, bowel cancer, heart disease and the affects of smoking are illness that are often brought on because people made bad choices,"....

"People are entitled to eat junk food and smoke cigarettes, and sit on their backside and not exercise but if you want really good health I believe you've got to make some contribution yourself.

"And because this is such a lovely place to live we've got a huge influx of people coming here, and the queues to see specialists are getting bigger and bigger.".....

"The other thing important since I graduated is life expectancy. It has probably increased 20 years," ....

"So those people who aren't attending to health issues now aren't going to have a very pleasant last 20 years."....

"If you can afford to smoke and eat sausage rolls and fish and chips, then you can afford private health insurance."

To be fair The Daily Examiner also reports:

Dr Richards said the medical industry in the 20th century promoted dealing with the symptoms instead of preventing the illness in the first place.

He said this was convenient for doctors who were more concerned with 'paying off their mortgages'.

Still, it irks somewhat to find that this Iluka gentleman appears to believe that all would be well with the health system if there were either less people using it or more people paying to use it.

As to his claims about the affordability of health insurance - single aged pensioners in Iluka (with no other assets) who rent their homes for around the current average weekly cost and who get maximum rent assistance will still only have about $142 to $162 left each week to provide themselves with groceries, clothing, footwear, travel, medicines, et cetera even if they manage to keep their utility and telephone accounts at or below the low government subsidy.

Providing themselves with rather basic health insurance is likely to reduce that weekly amount in the pocket by another $15 to $30 per week and would likely see such pensioners have to do without a range of healthy foods or adequate clothing.

It was with some amusment that I noted the absense of alcohol consumption from the doctor's list of unwise lifestyle choices. But then quite a few in his profession are known to like a quiet drink or two.....

Image from Wikimedia

Stop it or they'll go blind!

Now I've heard everything! The Rudd Government is reducing the Medicare rebate for cataract surgery from $831.60 to $409.60, according to the Minister for Aging and Member for Richmond Justine Elliott.

There are already quite a few worrying out-of-pocket expenses associated with eye surgery for those pensioners without savings or investments (as well as waiting lists which can still see a older person wait up to a year for publicly-funded eye surgery) and now the federal government is about to put such surgery almost out of reach for people living below the poverty line.

Right now if you have the money up front or private health insurance a cataract operation can usually be performed within 6 to 8 weeks on the NSW North Coast (by the same specialists and hospitals which make the poor wait and wait for exactly the same medical procedure), so the health system is already biased against those poor sods with no money in the bank.

Bluddy Kevin Rudd and his merry troop have just made this unfair state of affairs even worse and their piddling little national grant for rural & regional areas will go nowhere.
This counter-productive cost cutting stupidity ranks alongside the Clayton's public dental system - obviously those in power won't be happy until pensioners and those on low incomes are blind as well as toothless!

Federal Labor and Health Minister Roxon crossing a bridge too far

The Federal Minister for Health Nicola Roxon has announced a national health data base which can be accessed by hospitals, doctors, paramedics, dentists and chemists - every Australian will be assigned an individual identifying number attached to their digital medical history.
Eventually a special hi-tech Medicare card will hold an access chip/key.

Access to this data base will only allegedly be allowed with the freely-given permission of the person seeking medical treatment, dental work or a dispensed prescription.

I use the word allegedly because the voluntary nature of this data base access plan will not last more than a day or two after legislation is effected.

Public hospitals and medical practices will in short order insist that a person cannot be seen unless permission is given to access digital medical records and, as the Minister has little or no control over state area health service policy practices she will be rendered impotent.

Indeed Ms. Roxon statements to the media this week indicate that she will enable any bar an individual may have in place to be overriden at will by hospitals and ambulance services.

This scheme is in effect information acquisition and dissemination by stealth, as Ms. Roxon would be well aware that she is unable to contain the genie the Rudd Government is determined to let out of the bottle.
In fact her statement about the voluntary nature of this new health information scheme is almost a bare-faced lie.

So many Labor election promises made in the lead-up to the November 2007 election has either been inadequately legislated, so poorly funded that they are only window dressing, resulted in both new and amended policies either running on the spot or being studious delayed - now it seeks to implement a policy before the next federal election which will eventually see every medical Tom, Dick and Harry trawling though personal health information.

What is it with Labor? Don't they want a second term in federal government? Is it trying to alienate its 2007 support base because the Opposition benches are beginning to look nostalgically oh, so comfortable?

eHealth? eDisaster.

Saffin highlights problems with Maclean Hospital senior management staff cuts

On 3 June 2009 the Labor Member for Page, Janelle Saffin, stood in up the House of Representatives and spoke on behalf of the people of the Lower Clarence:

While Maclean District Hospital sits just outside my electorate of Page in Cowper, thousands of my constituents in the Lower Clarence rely on it. Many constituents hold real fears about the future of their hospital, particularly if the EO/DON is transferred to Grafton Base Hospital 45 kilometres away to become the DON for both Clarence Valley hospitals. Ordinarily such a centralisation proposal, obtained by the Daily Examiner newspaper, might make sense. However, coming at the same time as the North Coast Area Health Service is deleting a total of 400 positions from Tweed Heads to Port Macquarie for budgetary reasons, my constituents see this hospital management restructure as a body blow to their smaller hospital. The ladies of the Maclean Lower Clarence Hospital Auxiliary have written to me saying they cannot see how one director of nursing can be expected to provide fair management to two hospitals. Neither can I. They say:

This could well be a precursor to our hospital being downgraded even further and therefore jeopardising the level of service provided to our community, which continues to grow steadily, thus putting more pressure on the hospital and its staff.

While I understand the need for belt tightening in the context of responding to the global recession, I share the community concerns that the target of 400 positions will put too much pressure on front line health workers and potentially affect the quality and viability of hospital services. As a starting point, I am asking that the existing management arrangements for Maclean and Grafton hospitals remain in place and unchanged. I note in today's Northern Star, the newspaper at the other end of my electorate, that the editorial heading is 'Health system needs injection of sense'. I agree.

On a positive note I report that two of my major election commitments from 2007—redevelopment of Grafton Base Hospital's operating theatres and emergency department and the fast-tracking of Lismore Base Hospital's radiotherapy unit—are progressing well. At the end of budget week I returned to Grafton to see the North Coast Area Health Service Lodge a DA for three new operating theatres with the Clarence Valley Council. This was a milestone event for everyone who supports the hospital, particularly its Medical Staff Council Chair, Dr Allan Tyson; Grafton Community Health Committee Chair, Shirley Adams; Area Health Service Advisory Council member, Sandra Woods; and Clarence Valley Mayor, Councillor Richie Williamson. The council is expected to approve the planning application within weeks. The main building works tender will be let in September 2009. Construction is due to be completed in December 2010.

In this year's budget there was an announcement from Minister Roxon that the government would invest in a $560 million network of state-of-the-art regional cancer centres with associated accommodation centres. I am encouraging the Lismore district's medical fraternity and other community leaders to work with me to secure one of up to 10 such centres, enhancing the one that we have under development. We could have our PET scanner and accommodation service.

If you have not yet signed the petition to the NSW Minister for Health asking for reconsideration of these senior staff cuts, contact Jim Agnew on (02) 6646.1685 after 5pm each day for current locations of this petition.

Petiton against the decline of Maclean District Hospital autonomy

The Daily Examiner 13 May 2009

Lower Clarence Valley residents, unhappy with the proposed loss of the positions of chief executive officer and director of nursing at Maclean District Hospital, have started a petition to the NSW Minister for Health.

This petiton can currently be signed at Yamba.

As the flood waters are receeding it is expected that from today on copies of the petiton will also be at Iluka, Maclean, Woodford Island and villages elsewhere on the Clarence Coast.

If you consider that a hospital is better run when it is managed locally then this is your chance to say so.

If you want to check where the nearest copy of the petition is, call Jim Agnew on 0419 193 525.

Are NSW Health electronic patient records vulnerable to criminal hackers?

This was posted on Wikileaks on 3 May 2009:

On Thursday, April 30, the secure site for the Virginia Prescription Monitoring Program (PMP) was replaced with a $US10M ransom demand:
"I have your shit! In *my* possession, right now, are 8,257,378 patient records and a total of 35,548,087 prescriptions. Also, I made an encrypted backup and deleted the original. Unfortunately for Virginia, their backups seem to have gone missing, too. Uhoh :(For $10 million, I will gladly send along the password."
The site, https://www.pmp.dhp.virginia.gov/pmpwebcenter/login.aspx appears to have been entirely disabled and is presently unavailable.

On 8 May The Wall Street Journal confirmed this ransom demand but details of patient data vulnerability are unclear.

Reports which leave an uncomfortable feeling behind when I recall that the data centre and software which run NSW Health electronic patient records have experienced extensive systems failure recently.

North Coast Area Health Service "stealing from your child's Christmas account": Steve Cansdell

It's not often I find myself in agreement with the NSW Nationals MP for Clarence Steve Candsell, but when he likened the North Coast Area Health Service's fund transfers - from special purpose and trust funds holding money raised by the community for specific hospital services - as being like "stealing from your child's Christmas account" he was spot on. (Clarence Valley Review on 18th March 2009)
The fact that the NSW Auditor General has called for a formal review of how the NCAHC is handling these funds is little comfort for the region.
The health service has been sprung doing this before and will do it again, because the sad fact is that overall lack of adequate health funding plus slapdash management has meant that public health services on the NSW North Coast are operating on a wing and a prayer.
The situation makes the Rees Government's talk of a billion dollar upgrade for the Sydney Opera House look heedless and heartless.

Don Page speaks up for the Northern Rivers

It's a bit hard to have any respect for the Coalition these days, so it's easy to miss those times when a Nat does his best for the Northern Rivers.
Last week Don Page MP for Ballina rose to his feet and gave a serve over the dismal situation our health services are in.

"Mr DONALD PAGE (Ballina) [5.56 p.m.]: I outline my concerns about health services in the electorate of Ballina. I want to discuss the apparent doctor shortage at the Ballina, Byron Bay and Mullumbimby hospitals, and the loss of the mobile breast screening vans, which were visiting Ballina and Byron Bay. The media revealed this week that Ballina District Hospital is facing a doctor shortage, leading to the hospital reducing the number of patients it can accept. While I understand that the rosters have been filled for all shifts over the past 12 months, and are covered for March, it would seem that there simply are not enough doctors being rostered on.

Doctors are now very publicly complaining about their excessive workloads and the potential risks to patients. Byron Bay and Mullumbimby hospitals have also stated that they are in danger of not having enough doctors to provide emergency treatment to patients. Should this be the case patients are likely to be diverted to Tweed Heads, as all surrounding hospitals are facing similar doctor shortages. I am extremely concerned about this situation and implore the Minister for Health to urgently allocate the resources required to fix this potentially life-threatening situation. If the situation continues, and emergency patients are diverted from Ballina, Byron Bay or Mullumbimby to Tweed Heads, there will be very real risks to the wellbeing of patients."

Good one, Don! Though I notice you're not so proud of your time in government because there is nary a media release or speech from that time posted on your website.

A Healthier Future For All Australians Interim Report transcript: a revolution has been recommended but will Rudd and Roxon listen?

The A Healthier Future For All Australians interim report was released today.

At first reading it is somewhat like the curate's egg - good in parts - and although this report is heavy on broadly worded aims and a fair degree of wishful thinking it does have one startlingly good recommendation that the Commonwealth should assume responsibility for primary health care (outside of the public hospital system).

What the report recommends regarding oral health:

11.1 We propose that Australia should have a scheme 'Denticare Australia' for universal access to preventive and restorative dental care, and dentures, regardless of people's ability to pay.

11.2 We propose that 'Denticare Australia' be based on a mixed approach of public and private cover. The additional costs would be funded by an increase in the Medicare Levy of 0.75 per cent of taxable income, with people opting either to become a member of a dental health plan (with a private insurer), or to use public dental services.

11.3 We support an equitable approach to financing a universal dental scheme. Under the proposed approach, the funding of dental services will be linked to ability to pay through an increase in the Medicare Levy.

We estimate that under this approach:

• Many people will pay no more than they currently pay for dental care – the increase in Medicare Levy of 0.75 per cent of taxable income will be smaller than existing out-of-pocket costs for dental services for many people.

• People on low incomes will pay considerably less and have much better access to dental health services.

11.4 We support the introduction of a one-year internship scheme prior to full registration, so that clinical preparation of oral health practitioners (dentists, dental therapists and dental hygienists) operates under a similar model to medical practitioners.

11.5 We propose the national expansion of the pre-school and school dental programs.

11.6 We propose that additional funding be made available for improved oral health promotion, with interventions to be decided based upon relative cost-effectiveness assessment.

Full copy of A Healthier Future For All Australians interim report is here.
Reform directions section is here.

See: Attention: Rudd, Rees, Roxon, Saffin, Elliot. This mouth has been almost a decade on the public dental treatment waiting list

North Coast Area Health Service debt in 2009

I guess that we should all be thankful for small mercies on finding that the North Coast Area Health Service debt of $9 million is the fourth lowest across New South Wales.
Still, the total picture clearly shows that it is time for the Commonwealth to resume total responsibility for the provision of public hospitals and health services.
Unfortunately, all Kevin Rudd promised in the lead up to the 2007 federal election was that he would take over the running of public hospitals if the states did not agree to a national reform plan by mid 2009.
Hardly the answer to so mammoth a problem, when the debts keep mounting and the states (especially New South Wales) are so obviously incapable of solving the financial and workforce crises in health services.

Debt List:
Sydney South West Area Health Service $0
Hunter New England Area Health Service $0
Children's Hospital at Westmead $4.5m
North Coast Area Health Service $9m
Greater Western Area Health Service $10m
North Sydney Central Coast Area Health Service $22m
Greater Southern Area Health Service $22m
South East Sydney Illawarra Area Health Service $24m
Sydney West Area Health Service $26m
NSW Health owes $117.5 million to creditors
(Debt figures according to The Sydney Morning Herald, 28 January 2009)

NSW Health enters a patient care phantasy land

NSW Health has released its plan to kill off the vulnerable and elderly in rural and regional areas of the state.

"DOCTORS will have to justify to bureaucrats why they admit patients with common conditions such as blood clots, breathing problems and cellulitis to hospital, following an order from NSW Health to slash the number of people given a bed.

The "please explain" directive comes as hospitals try to meet a demand from the director-general of health, Debora Picone, to reduce so-called "avoidable admissions" by 30 per cent this financial year.

Medical groups say they are sick of administrators telling them how to care for their patients and argue the policy contradicts an undertaking yesterday at a Garling report forum by the Health Minister, John Della Bosca, to improve communication between clinicians and hospital management.

NSW Health's Acute Care Taskforce has identified 12 medical conditions, including pneumonia, bronchitis, urinary tract infections, chest pain and gastroenteritis as suitable for community-based acute treatment, such as hospital-in-the-home, where nurses visit patients to administer medication."

Area Health Services in country areas have well-documented problems with levels of funding and attracting staff and now these peak bodies are being asked to hide sick people in their homes and rely on patchy community nursing to provide treatment.

What a laugh - those poor nurses are often so stretched that it is impossible for them to provide daily care for every referred patient and on weekends care in the home is frequently completely absent.

Della Bosca and Debora Picone should hang their heads in shame.

Unfortunately that won't stop deaths occurring as the wheels fall of this insane policy.

Have either of these two looked at the age demographics for the NSW North Coast or considered the fact that many of the retirees living here do not have family support in the area?

Northern Rivers message to Della Bosca - no cuts, no way!

In The Daily Examiner last Monday:

Health protest rallies, such as this one at Market Square in Grafton, were staged throughout the North Coast on the weekend.
On a steamy, hot Saturday afternoon people came out in their hundreds to deliver a clear and unequivocal message to the Rees Labor Government cuts to health services will not be tolerated.
Scores of people, most of whom would never have protested against anything in their lives, braved the conditions to get their message to government.
Grafton doctor Hugh Calvey, who stressed he was speaking as a private citizen and not as a contractor to the North Coast Area Health Service, said there was a clear reality if the Government proceeded with plans to strip 30 jobs from the Grafton Base Hospital and seven from Maclean and that would be a cut to services.
"The reality is that we would lose nursing staff and if that happens you have to shut something," he said.
"We need all the facilities we have got. Whatever they decide to shut will affect you.
"It is a very serious crisis. The immediate effect would be disastrous; the knock-on effect worse."
Rally organiser and Member for Clarence, Steve Cansdell, said the North Coast Area Health Service had been underfunded for a number of years.
"The funding (resource distribution) formula has been ignored for a number of years," he said.
He said the region had missed out on $70 million a year.
"You can understand why the health service is struggling," he said....

Speakers called on residents to write personal letters to the Premier Nathan Rees the premier@www.nsw.gov.au, Health Minister John Della Bosca office@smos.nsw.gov.au, Prime Minister Kevin Rudd via www.pm.gov.au/contact/index.cfm and Federal Health Minister Nicola Roxon Nicola.Roxon.MP@aph.gov.au.

Photos from The Daily Examiner and The Northern Star

'This rancid government': Northern Rivers not impressed with NSW Health

I have to say that few people in the Northern Rivers region would be surprised with the observations on regional hospitals found in the Garling Report released this week.

The Northern Star reported:

Commissioner Garling said he was told the North Coast Area Health Service got about $70 million less each year than it should under the current funding formula and the inequity had been in place since the 1980s.“We should be getting our fair share,” Dr Pezzutti said.He said the money should be shared out among the health services based on their demographics.“Each area has a certain number of aged people, disabled people, mentally ill, poor, rich and tourists,” the doctor said.“It’s a complicated formula, but we should be getting more funding.”Instead of spending more money, the Garling report said greater efficiencies should be achieved. Dr Pezzutti said the health service could be more efficient but it would cost money.The report recommended setting up four new bodies to improve the quality and effectiveness of the health workforce.“If the government does not provide additional funds for this, it will have to come out of the current funding,” he said.“It is clear they have got into trouble this year already.”

While in an 'editorial' in The Daily Examiner on Saturday David Bancroft put matters very bluntly:

Now, on top of being short-changed $70 million a year, a razor gang is making its way around the region identifying where it can cut 400 full-time equivalent jobs.

There is already thought that Grafton Base Hospital's high dependency unit and maternity unit might be at risk.

These are the cuts the health service simply cannot bear.

And we, as taxpayers and users of the health system, should not tolerate them.

We need to demonstrate at public rallies in Grafton and Maclean today our support for improved, not reduced, health services.

Public pressure might, just might, convince this rancid government to change its mind.
(The Daily Examiner, 29 November 2008, page 12)

The Federal Member for Page, Janelle Saffin, in the same issue of The Daily Examiner did not back away from supporting the Northern Rivers community:

"Its clear locals need better services and I support them in their expressed concerns about the proper delivery of health and hospital services in our area," Ms Saffin said.

We need more health services and staff across the Northern Rivers, and for anyone to suggest that less is better for us is nonsense.

"This is not the time for cutting front line positions in health care."

The North Coast has known for a long time that state governments tend to ignore us.

When in power the Liberals and Nationals appear to believe the region does not have to be courted because it is seen as a Nationals stronghold.
Likewise, the Labor Party seems to believe that the region deserves a minimum of serious attention for that very same reason.

Both groups, in their profound ignorance, failing to consider the altered political demographics that sea and tree changers have brought into the mix and both ignoring their responsibilities to equally distribute a fair share of government funding and services regardless of the political imperative.

For all major political parties in New South Wales the large metropolitan centres have always come first simply because the sheer weight of their voter numbers are seen as more important to the outcome on election day.

The Rees Government should remember that regional and rural seats matter and if enough voters within them are dissatisfied with health care, then his government will fall at the next state election.

Full text of Garling's final 2008 report into NSW public hospitals

From the NSW Dept of Premier and Cabinet:

The Special Commission of Inquiry into Acute Care Services in New South Wales Public Hospitals was established on 29 January 2008.
The New South Wales Governor commissioned Mr Peter Richard Garling SC to conduct an inquiry into and report on certain matters relating to acute care services in NSW public hospitals.

The full Terms of Reference for the Inquiry can be accessed here.

The Report of the Special Commission of Inquiry into Acute Care Services in NSW Public Hospitals was provided to the Governor on 27 November 2008 and was released by the Government on the same day.

The Report can be accessed here.

• Overview
• Volume 1
• Volume 2
• Volume 3

The Report's Executive Summary and Recommendations can also be accessed here.
In addition, a first report was issued on 31 July 2008 and this report can be accessed here.

* The Northern Rivers needs to take special note of this report as it indicates that the North Coast Area Health Service has been consistently short-changed with regard to funding in the vicinity of $70 million annually.

UPDATE
If the above links are difficult to access go to this link for a full copy of the report: 
nsw.gov.au/Lawlink/Corporate/ll_corporate.nsf/pages/attorney_generals_department_acsinquiry