The health debate in Australia is awful
The wrong language is used. Wrong choices are made. The real problems are ignored. No courage is shown. There is too much spin and pandering to the popular press and to the shock jocks. Our dedicated medical practitioners are working against the odds.
There is no morality in advocating tax cuts when there is hunger, homelessness and unmet need in so many areas. We need decent services - and should be willing to pay for them.
In place of focus groups we need leaders who tell us something new and who inspire us.
People are waiting too long for admission to hospital and people are being discharged from hospital prematurely. Staff morale is low. There are not enough trained people.
Doctors see problems in terms of the needs of the patients they interact with every day. Everything rotates around their patients: "If something can be done, it should be done." or "If this is done elsewhere, then it ought to be done here - and done now". But they show too little understanding of the resource implications of what they may be proposing.
Medical associations sometimes behave like militant trade unions - Painters and Dockers in white coats.
The bureaucrats are often obsessed with process and not with outcomes. They do what political leaders tell them to do - and sometimes it is the wrong thing to do. They are very aware of the power games that go on in Canberra and Macquarie St and they play in those games. For them it is the budget balance than counts - whatever the social effects.
For decades political leaders have been making silly promises in the health area - mostly close to elections, and expecting health workers to deliver on those promises.
Some initiatives just skew the system. We only became really knowledgeable about the exact costs in the months following an accounting period.
There are many good features about what we do have - particularly our universal insurance arrangements which were introduced only after a joint sitting of the Parliament, and over the angry protests of the AMA, the then Federal Opposition and the medical profession. But we do not have as good a system as we sometimes think.
In a recent study conducted by the Commonwealth Fund and involving eleven nations, Australia did poorly.
This is an edited extract of the Malcolm Schonell Memorial lecture given by the Honourable Emeritus Professor Peter Baume AC, Former Minister for Health, Aboriginal Affairs, Education at St George Hospital, Kogarah on Thursday February 17, 2011.
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