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.