In a previous post I pointed out that public service growth has far outstripped population growth. A couple of commenters, one from the trade union Together Queensland, suggested that the growth had been in the service sector, particularly health, education, child protection and police.
So I decided to investigate.
I don’t have a lot of time at my disposal for forensic analysis of public sector budgets, so I’ve just dipped into health a bit, and if money has been going into frontline health services, you have to wonder which ones.
Hospital beds are a generally accepted measure of service delivery in state health, which is primarily about hospital management, and searching on “Queensland growth hospital beds” Dr Google led me to this Courier Mail article with the headline “Queensland has fewest hospital beds per head of population in Australia, new report reveals”.
The Australian Medical Association released its annual public hospital analysis in Brisbane on Thursday, revealing Queensland has 2.4 beds for 1000 people – lower than the national average of 2.6.
The report card shows Queensland had 10,911 public hospital beds in 2009/10 – up 106 from the previous year.
AMA Federal president Steve Hambleton said that nationally, only 378 new beds were opened in 2009/10, about a tenth of what doctors believed were needed.
So, we’re doing worse than average, but we did open a few more beds per capita than the average of the other states, extrapolating from the last para.
Maybe we’ve always been below average and are just catching up.
Unfortunately not. The ABS has an extract from Regional Statistics Queensland 2000 which reveals that:
Queensland had a total of 15,939 hospital beds, in 1998-99. Of these, 10,643 beds were in public hospitals and 5,296 were in private hospitals (including day surgery hospital beds). The total number of hospital beds in Queensland represented 4.6 beds per 1,000 persons. This rate compares with 4.1 beds per 1,000 persons in New South Wales and 3.8 in Victoria.
So, in thirteen years hospital staff per capita has expanded, but hospital beds per capita has contracted. In 1998 we were 12% above NSW and 21% above Victoria yet in 2011 we are 8% below the national average.
The Costello Audit (pdf 6mb) provides an insight on p. 118 into how this trick might have occurred. While it has detailed analysis of the increase in salaries and capital expenditure combined with a decrease in efficiency the best illustration of the problem for me lay in its description of the cost of building a Queensland Children’s Hospital, which replaces services currently provided by the Mater and the RBH.
The initial cost of the hospital was estimated at $690 million. Since then, costs have more than doubled, to a revised figure of $1.5 billion, including the additional $80 million being expended on the Academic Research Centre, as shown in Chart 8.5.
Based on these latest cost estimates, the average cost per bed is around $4 million. However, in terms of incremental bed numbers, the cost rises significantly to more than $17.7 million per additional bed.
No wonder hospital bed numbers are going backwards in Queensland if they cost an effective $17.7 million each!