March 20, 2014 | Graham

The hospitals that ate the budget

It seems that the Queensland government and the Senior Medical Officers at state government hospitals are still at loggerheads over pay and conditions with the Courier Mail reporting that over a 1,000 of them voted against the contracts at a meeting last night. This was after significant concessions by the government.

There are a few things about this issue which seem to have slipped through the cracks of the debate.

One is that the current negotiations are round two. Round one occurred in 2006 when the previous Labor state government was in similar negotiations with doctors. Then premier, Peter Beattie came in over the top of his minister and offered doctors a honey pot through their “right of general” practice.

This was a de facto wage increase, but one which didn’t affect the headline number on their pay because it related to money that they could earn through treating private patients through the public health system. As some doctors get a lot more opportunity to do this than others, apparently a system has evolved where everyone gets a share of this pot.

The result is a mess, with around $800 million of patients costs being paid by state tax payers instead of the private health insurers.

That means that some of the poorest citizens of Queensland have been dipping into their own pockets not just to pay for some of the richest, but to help them to avoid things like waiting lists.

This issue was picked-up by the state auditor general in a recent report. As well as abuses of the system by doctors who, for example,  pocketed money for overtime, even when they were on holidays.

So the current round of contracts on offer is meant to address some of these issues.

Another thing it is meant to address is the exponential increase in hospital costs, vividly illustrated by the graph below, prepared from figures in the Commission of Audit. At the rate of increase over the last decade in the Queensland Health budget, by 2020-2021 health expenditure is closing on 40% of the budget, leaving precious little room for that other big ticket item, education.



The 2040-41 figure is obviously fanciful, as are the doctors’ dreams that things can go on as they have been. Since the GFC many of us have had to pull in our belts. They should be no different.

Things will change, and we won’t make the 2040-41 project, and the sooner the better.

Posted by Graham at 7:48 am | Comments (1) |
Filed under: Uncategorized

1 Comment

  1. I think we need yet another honey pot Graham, and not too different to that which a very wily old fox, negotiator par excellence, Peter Bettie offered; namely, defacto general practice rights!
    These rights ought to include some CAT scan/MIR time. If only to ensure, these resources, give full value for the capital outlay, and keep experienced clinicians where we need them!
    We need to take a good long hard look at what is happening, and those of us who can afford it, and are currently uncovered, need to take up private health insurance.
    Surely, it can only be a question of time, before once again, a cash strapped Queensland health care, provide only emergency and means tested health care, even in our so called public hospitals.
    And if you are covered, you need never face an ambulance bill in the thousands, just to ensure you get emergency transport when you need it.
    Anyone can suffer a fall, or accident, usually when you least expect it, and can least afford it.
    I mean, how often do we hear or see where a cyclist has been bumped by a car?
    And if it happens at commuting speeds, and at the hands of a tired shift worker, returning home after a double shift?
    They may only start to brake after they’ve hit you, thereby compounding your injuries?
    And if you think the ambulance transport bill is unaffordable for the average Joe, wait until you receive the bill for specialist care and rehabilitation!
    A fully imported luxury car, could cost less?
    If we, all who can afford to do so, take up private health insurance once again, [and we now need to,] we will then be able to afford more beds, and better pay scales for those who work at the coal face of the health system!
    Alan B. Goulding.

    Comment by Alan B. Goulding — March 21, 2014 @ 12:32 pm

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