Nicola, Mr Rudd’s health policy is inchoate. Mr Rudd is on record as saying that the states have a couple of years to fix things and failing that he’ll step in and assume control of all hospitals with the concomitant reduction of GST paid to the states. Are we to believe that the states will accept a reduction in GST? I’d like to see that.

Our politicians don't have a solution to our hospital woes. What are we to make of all those o'seas fact-finding-missions? It looks like health facts are very hard to find.

I couldn't understand what Labor's health policy is from this article but I do know that Howard is committed to selling Medibank Private after the election and moving to user pays health care.

It's disingeneous of federal politicians to blame state governments for failing to spend money on health care or education because state governments have been starved of funds. Since 1996 although taxes as a proportion of GDP has risen, the states share has fallen from 7% of GDP to 5% of GDP.

John Roskam, of the IPA, Liberal thinktank, has an article in The Age that suggests that under a Labor government Victorian hospitals would lose funding. http://www.theage.com.au/news/opinion/under-federal-control-all-hospitals-would-have-to-compete/2007/08/28/1188067108369.html

Nicola, the ALP has no hospital fix up plan. To have a plan requires commitments of dollars, staff, changed process and procedures for managing the hospitals.
The ALP so far has $700,000 per hospital and a commitment of a meeting in 2 years to see how it's going. Let's see, that would buy about 5 medical staff for 1 year and nobody left to attend the meeting a further year out.

Like so many of the ALP "promises" this is no more than a commitment to have some meetings after the election to determine if anything is ever going to be done. Exactly the way labor manages it's various crises in NSW.

About 14 years ago a newspaper article which said that Public Hospital spending needed to be increased, not decreased. Public Hospital budgets needed to be increased to take into account, increased technology, inflation, wage and salary and an ageing population.

Paul Keating was Prime Minister, and economic reform was introduced. It became a catch cry for Public Hospitals in Australia of improved efficiencies, improved performance and cost effectiveness.

Whilst other public service departments at least had their budgets increased by the CPI. The budgets for health were increased at a rate lower than the CPI.

The numbers of available public hospital beds have decreased, and perhaps the decrease is much greater considering how bed availablity is calculated was changed. Rather sneakily day surgery beds and chairs have been added to calculations.

The GP super clinic sound grand, except for one thing they are not going to make one iota of difference to the patients waiting in emergency departments for a public hospital bed and it is doubtful if they will make any difference to the other patients who spend hours in emergency departments waiting to see a doctor.

For more than a decade each government has come out with it's own grand sounding plan to fix health and things just keep getting worse.

Sure with a population of only 21 million it seems to be idiotic to have two levels of government dealing with the health care system.

To fix our public hospital system will take time and even if an extra 50 billion was available tommorrow, it will still take at least 5 years.

Why?

Because the two resources needed are not there. That is beds and staff to staff those beds. It take time to build more hospitals and to train more staff.

And that is going to take buckets of money, because of decades of poor planning it is going to cost a lot more and provided the extra money is not creamed off the top by the bureacrats.

It is disappointing that so many people have felt able to comment on the ALP health policy without reading it. In fact, there is very little in the Plan which is at all contentious. The changes proposed are strongly in line with the submissions of the Australian Health Care Reform Alliance to COAG and address the most obvious problems. The cost of public hospitals, of medical technology and pharmaceuticals is becoming unsustainable. Numbers of doctors and nurses are already far below what is needed except in the most affluent teaching and research hospitals. The shortages will get very much worse before they can begin to improve. Therefore, means must be found to reduce the pressures on acute care. We must rather begin to ask: what must we do to keep people well?

The solution, already being applied in many comparable countries such as Canada and New Zealand, is to fund multi-disciplinary primary health care centres, each servicing a population catchment area of 80,000-100,000 people, open 24/7. These “integrated care centres” to use the Tasmanian term, would be staffed by GPs, nurse practitioners, and a full range of other health professionals - physios, OTs, podiatrists, mental health and dental therapists - all working to prevent simple problems becoming complex and requiring acute care. These Centres will be the source of health education and preventive programs in their community. They will take a great deal of the load from Emergency Departments of public hospitals. And they will have an immediate, positive and long lasting impact on the health of the community.

All this is foreshadowed in the ALP policy. Obviously, changes of this kind need research and development, but there is nothing in what the Opposition proposes that runs counter to the thrust of health reform thinking in Australia. If criticism is justified, it should be leveled at the inadequate attention the policy has received and the wholly unjustified weight given to the Minister’s pathetic attack

Dearie me, the Labor party is at it again with borrow and spend. If Kevin Rudd is elected he will have to be very careful, particularly if he wants to bring our troops back from Iraq, that he doesn't go the way of David Longe. You will remember that Longe was elected in NZ in 1984, when NZ was up to its ears in debt, and decided to play silly buggers with the US over nuclear powered warships. After NZ was kicked out of ANZUS, Wall Street decided it would be a great time to call in the NZ foreign debt, and if my memory is correct housing interest rates there went up to around 25%.

This would certainly mean that we could forget about Keating's 17%.

Anyone with any feeling for the world monetary situation would know that this is not the time to go further into debt, and every effort should be made to reduce our debt while we still have the time. Thank heavens the Howard government has paid off our federal debt, and we only have private debt (albeit around $550 billion) to worry about.

If Labor want to throw billions at hospitals, fair enough. But they should do so by raising extra tax money to pay for it. Strangely enough, we never hear about that bit.

I really cannot see the hospital system in Victoria getting any better. I work in the Victorian system as a nurse and I must say things are not looking good.

Nurses in Victoria fall into two basic categories, Division 1 and Division 2. Consider this! Div 1 nurses pay good money to attend a three year course at uni, some incurring a HECS debt into the bargain. After they graduate, they have to find work, which is readily available, but they're often thrown into the "deep end" with little support. They also often find themselves in clique groups and struggle for recognition. Some give up their dreams and either leave the system altogether or work in positions not in keeping with their desires. With the introduction of Workchoices, the same Div 1 might even find themselves being replaced by endorsed Div 2's and non registered health care workers, the latter of which can hand out medications with very limited training.

Yet Div. 2's fare little better. Thanks to Workchoices, Div.2 nurses in some private settings are being sacked for "operational reasons" and then asked to return as personal care attendants (PCA) or assistants in nursing (AIN) positions at a lesser pay rate, a pay rate that is little better than the newly introduced minimum pay rate of $16 an hour. To top that off, the Victorian Gov. is trying to screw them down to the lowest possible salary and conditions during the present EBA negotiations, offering a salary which doesn't come close to the inflation rate. Add to that the ridiculous amount of paperwork required to satisfy the Government that nurses are doing their jobs, which takes them away from patient care for ever increasing periods of time and we see morale plummeting.

The hospital system cannot continue to run while nurses continue to be poorly paid, easily displaced and with morale so low. It's got me beat why anybody would consider taking up nursing at the present time.

Sage. Your comment too is incomplete. What are your suggestions, solutions? You say politicians can't fix it. So who can?

I basically agree with you but how the hell are we, or anybody for that matter, going to get change?

My only suggestion is to kill off political Parties. Which is just as impossible as fixing a health system without politicans who are actually running it. Running it is a bit strong by the way. More like preten responsible for it.

So where do we go? Anyone?

It's truly unfortunate that the discussion has centred on the question of State or Federal responsibility for public hospitals - neither option will address ever-rising demand for health care, itself partly fuelled by new treatments and tests. By far the more important facet of the ALP policy is the nod in the direction of more effective primary care in "Super GP Clinics". Unfortunately, it's still just a nod. While it's unglamorous, long-term, and runs counter to the parties' belief that they can "manage" any problem, what we should REALLY be focussing on is a system of EFFECTIVE & DIRECT REWARDS for individuals and families to take responsibility for their own health and fitness. What's clogging up the public hospitals more than State and Federal bureaucracy is epidemice-scale chronic disease, much of which is largely or completely preventable. This is where the policy action should focus.

Charles Worringham
Independent candidate for the Federal seat of Ryan

In Western Australia, the hospitals are in a dreadful state with ambulances queueing in lines for hours, patients on stretchers for hours, emergency is one big chaotic mess.No hospital beds, nurses leaving in droves.
Crime is out of control with drug addicts beating up old people ,home invasions, street hoons killing other road users. Education is a mess with no end in sight, the most expensive state to live in with the highest state charges in the country. And on and on.
While the government ponders over sports arenas,bills of rights and various other "priorities"
Guess which government!Labor of course.

Well PP, it might be time to bell the cat. Let’s rid ourselves of one tier of government by dumping state governments. They are anachronistic. Next we can focus on the biggest growth area in the hospital system which is hospital administration. I’ll bet Aime has an administrator – clip board at the ready – looking over her shoulder asking if Form 34C/008 has been submitted. And someone suggested a campaign directed at changing our lifestyles. Why not deter people from eating junk food by placing a higher rate of tax on certain foods while healthy foods are tax free. Governments had little trouble bumping up the price of fags in an effort to deter us. Junk food isn’t the only thing that impacts health but it’s a starting point.

The ball’s rolling.

Sage, don't get me started on forms and paperwork. Not only are nurses bogged down in piles of destroyed forests (paper), but those forms are also overseen by at least three tiers of unnecessary management above us.

In reality, I very much doubt there can ever be a well functioning health care system again. Back in say, the 50's, things were beautifully simple. Very few people made it into their 80's. People died from things that are virtually curable today. It was a natural progression. You were born to work all your life, make it to retirement if your were lucky, only to die shortly there after. Your GP knew his/her stuff using the boundaries of 1950 medicine and technology, but as time went by, big business demanded bigger money for R&D. More people demanded that they be treated for non life threatening health issues as well as cosmetic surgery, which pays extremely well for doctors in that field. It also diverts doctors away from the general health system. Big business corporations obtain obscene profits from simple medicines which continues to push health care costs higher. A bigger population requires more medical expertise which earns even more for the corporations. "Healthcare" could rightly be renamed "Health Rip-off."

And where will it end? Well.....it won't. The haves will continue to demand better treatments at the expense of the have nots. Costs will rise and the user pays system will flourish. It's simply a sign of the times and of a society that places the value of money above all else.

Not long ago, we gasped in horror at the conditions of third world hospitals. Soon, it will be the same here for those unable to pay the exorbitant fees to secure good health outcomes.

Rudds Community Health focus is a primary health economic cost saving strategy and will do much to stimulate long-term primary health resources, building a new primary care infrastructure which includes a formal idenified role for local GPs(rural areas) and the idea of GP Super clinics. (Toward a Nation and State 'No Wrong Door Policy')

Health Care is not on the agenda of the federal Health Minister Tony Abbott as he continies to refuse good fair reason with faceless motives saying:

"The important task at the present time is to get re-elected and that is where my energies are focused."

I believe the states and territories through a modern primary health combined infrastructure can and will do much to reduce unnecessary hospital admissions, non-urgent accident and emergency presentations and I believe under a ALP Federal Governmnet the States will leap forward resolving many problems before the 2009 proposed deadline.

'Alma Ata - Health for All' policies under the ALP will invest in more primary care services in local communities, to keep people in good health and take pressure off public hospitals.

Of most importance; A Federal ALP government will unlock efficiencies, reduce duplication and overlap as well as the ROADBLOCKS offered presently by the Federal Governments election focus.

I believe there is a lot to economically look forward to in the Rudd health plan.

Accummulating good social capital through innovative cultural reform will support ground level "community engagements" presently in conflict with the present civic health system.

http://www.miacat.com/
.

Here is Labor off in fairy land again.They are going to fix it by throwing money at.Make anything free and people will abuse it.

Everyone should pay something to see their GP and pay to use specialists services.Why do the rich also get free health services?

Increase the pension and even pensioners pay for a visit for minor ailments with chronic conditions an exception.

Just watch when Labor gets in,they make Gough Whitlam seem like a very sober sailor.

"They will take a great deal of the load from Emergency Departments of public hospitals. And they will have an immediate, positive and long lasting impact on the health of the community."

Wrong! it takes time and commitment on the part of governments to keep funding these services. Change of government change of funding, if labor has a good idea, the coalition cans it, it the coalition has a good idea Federal Labor cans it. Simple Political parties wreck each other and us along with it.

"herefore, means must be found to reduce the pressures on acute care. We must rather begin to ask: what must we do to keep people well?"

Johntas, Wednesday, 29 August 2007 12:16:09 PM

Well Johntas even as long ago as 1970 in the ACT had similar clinics. What happened, funding is what happened. any effort to ensure people stay healthy and out of hospital is a long term commitment, and I have heard that message ad nausem.

Now what happens by keeping people out of hospitals? Well then the ones who really need hospital are then usually extremely ill and extremely ill patients cost heaps.

Dr Micheal Sutherland wrote the rise and fall of the Country Hospital. What happens when services are reduced at a country hospital, the patients then move to next available hospital. What happens that the next available hospital, work load increases, cost increase, bureacrats have a pink fit. You must reduce costs they say, yet their decisions created the problem in the first place.

During the 1990's Booze Hamilton and Allen hired out and consulted on many public hospitals on how to reduce costs. Not one single person has published any papers reporting on how effect this was.

Hello, I wrote a big message about Halliburton KBR building a Military establishment in the Northern Territory and this is why they built and leased back the railway line and also why John Howard is pretending to be doing good things for the aboriginal,children, sure thats happening but only so he can mange their land and hand it over to the USA for their on shore aircraft carrier.
Halliburton KBR is always found loitering around major infastructure developments prior to a war,
Now God forbid these evils war mongers but all seems to be fitting into the nuclear waste dump and international uranium sales etc etc.
I also write a blog and would enjoy visits and comments from other souls interested in peace, love, justice and understanding in a sustainable world prepared to communicate and resolve issues without violence.
http://austpsychocouns.blogspot.com/ looking forward to comments. phD

This is simply the most strategic approach to the issues in health I have seen for Australia. There can only be two directions for solving our health issues. Taking a preventative approach through developing primary care, as this paper suggests, or building more and more hospitals to meet health demands that can only increase as the population ages, and as chronic disease increases as we adopt increasingly unhealthy lifestyles. I know I would like to see a fence at the top of the cliff rather than a hospital at the bottom. As Johntas points out this is consistent with many of the directions developed by the Australia Health Care Reform Alliance, a non-political group of health and consumer agencies, that has spent considerable time and effort in trying to improve the delivery of health services.

This is a policy document and we should not expect to see all the details. There are other models than the "super clinics" that may be more appropriate, especially in remote and rural areas but the general concept is sound.

At last we have someone who is interested in keeping us healthy rather than in treating us when we are sick. This paper deserves our detailed consideration. Well done.

"Taking a preventative approach through developing primary care, as this paper suggests,

At last we have someone who is interested in keeping us healthy rather than in treating us when we are sick. This paper deserves our detailed consideration. Well done."

Johnwellness

Well Rip Van Winkle, this has been the aim for at least 30, 40 or 50 years.

Why were vaccines invented?

Simple, to keep people well and to keep them out of hospital.

Why do we have food and health regulations?

To stop people from getting sick and out of hospitals.

In the last two decades our attitude to smoking has changed dramatically, during WW2 soldiers were supplied with tobacco by the government..