Managing national public hospitals federally a better choice

Comments on "Rudd set to leave health to states", ABC report, 1/03/2010, http://www.abc.net.au/news/stories/2010/02/28/2832348.htm?section=justin

With Australia's small population, it should be much more efficient to have one layer of administration of the national health system, removing duplications between the federal and the States, and the unaccountability or responsibility shifting between the two layers of government.

The key is that there should be an effective strategy to federally administer national public hospitals.

It will and should not be difficult. There are less than 25 million people in Australia, equivalent to a large city in many populous countries.

Why should run the hospitals that difficult? It is the geographic distribution. A nationally managed hospital system should be better in that regard.

But the key strategy for a national management system of public hospitals should lie in the following:

1. Funding nationally administered, assessed and allocated.
2. There can be a few regional offices or regional health boards. The regional hospital boards should be regionally elected by those people.
3. Each hospital of a group of hospitals can sign a contract with the federal health department.
4. Each hospital is independently run subject to funding from federal health department and is accountable for its outcomes.
5. The Health department and Productivity Commission will assess the performance of each hospital and publish the assessment each year and monitor them quarterly. Alternatively, some representatives from hospitals or regional boards can participate in the process of assessments.
6. The regional boards or each hospital staff committee should have the right to choose their board members, CEO and CMO.
7. If a hospital or hospitals in a region continue to fall below set standards, the federal health minister should intervene to appoint a new board.
8. Total hospital funding should be objectively planned and set every 5 years in advance.
9. Private hospitals can get funding if they perform public hospitals roles, with due funding implications for related public hospitals. This will introduce additional competition.
10. The GST to the States should be reduced accordingly and fairly.
11. The health minister should set advisory priorities for public hospitals as a whole and for come individual ones in particular. Those should be part of the assessment.

I think the above should be much better than the current system of State administered and with federal partial funding supports.