Stupid government formula responsible for hospital disaster

Basing funding on actual demand was too simple for these brainiacs. Result was a famous meltdown at the RNS hospital

A NSW Health executive told a forum of 150 senior managers and clinicians that the high rate of health insurance in northern Sydney was taken into account when funding public beds at Royal North Shore Hospital, a senior doctor said yesterday. Yesterday, Danny Stiel, clinical director for the Division of Medicine and Aged Care at the hospital, confirmed with the Herald that he had asked the then acting chief executive of the Northern Sydney Central Coast Area Health Service, Terry Clout, whether the level of private health insurance was taken into account in the funding formula. Mr Clout, who was recently appointed chief executive of South Eastern Sydney Illawarra Area Health Service, rejected the comment yesterday.

The exchange took place at a question and answer session at the Northern Sydney Central Coast Area Health service managers forum, held at the Central Coast Leagues Club on August 29. "We've never previously had anyone admit openly that it is taken into account," Dr Stiel said. "Colleagues have said to me I've never heard anyone actually confirm that that is the case and now that we know that is the case we can at least take it into account. "My main issue was bed block . it seems to me that ours is worse because we seem to be less bedded because of this type of formula. We think we're particularly disadvantaged by our otherwise good fortune in having people with private health insurance." Another hospital administration source, who did not want to be named, first contacted the Herald about the exchange. "The question was, is Royal North Shore funded based on the fact that we have a wealthy population and we have a high rate of private health insurance, and Terry Clout said absolutely, without a doubt," she said. "His answer was 'yes, Danny, you're spot on, that's how the hospital was funded' . most people weren't really that surprised."

This follows the revelation in the Herald on September 28 by a former staff specialist, Linda Dayan, that staff were told 10 months ago it was Government policy to slash the budget because "people on the North Shore had money" and could afford to use private hospitals. The Health Minister, Reba Meagher, rejected that claim.

Dr Stiel said yesterday that he asked Mr Clout specifically if private insurance affected how many public beds were funded. "The question I was asking was, when people determined how many public beds there should be, is the private/public mix in a particular geographic area taken into account in that decision-making, so if an area is very heavily insured . is that taken into account, and the words that he said were 'absolutely'," Dr Stiel said. "What he said was 'yes, by doing that the number of public beds is likely to be less than it would have been if there had been no private beds in the area', and that explained to us that that could be why we have worse bed block than other areas."

Dr Stiel said "as a consequence [of an assumption] that you don't have to worry about funding these people because they have private beds and we can now fund areas of need, one of the unforeseen consequences of that is bed block . "The point I make is it is true, that that's taken into account. Maybe people should rethink the funding formula."

Mr Clout said yesterday the funding formula is a "health-needs adjusted, population-based formula". "What I then said was that there is clearly some correlation between a population that have a, that is more affluent, and the rate of health insurance . and to that extent there is a relationship - that's how I answered that question." He denied ever saying the rate of private health insurance was taken into account. "It's not in any way, it's not. It's a clear formula. It's those determinants of health that I have indicated to you," he said.

A spokesman for the North Sydney MP, Joe Hockey, said the hospital was also used by people from out of the area, and not all locals could afford insurance.

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Labor party to keep private schools funding

Careful hewing to the (conservative) status quo again

KEVIN Rudd will retain the Howard Government's controversial private schools funding system until 2012 if elected, in a major pre-election pitch to parents. Abandoning plans to introduce a "needs-based" funding model that takes into account private school fees and income in his first term, the Opposition Leader will guarantee parents the existing framework will remain for five years. The policy shift, which was welcomed by private schools, delivers a blow to the Coalition's attempts to run a fear campaign over Labor's education policy.

Although Mr Rudd has previously promised to abandon the "schools hit list" policy promoted by former Labor leader Mark Latham, the ALP has until now retained the needs-based formula that underpinned the hit list. The change follows years of Labor criticism that the socio-economic-status model was "dysfunctional and unsustainable" and did not take into account the individual wealth of private schools. It follows similar reversals over the Medicare Safety Net, which Mr Rudd recently announced would be retained if he is elected. The major shift in ALP schools policy also ensures Catholic schools will not lose funding.

The strategy, designed to shift attention to the ALP's plans to boost funding to primary schools, was hailed by private schools last night as a breakthrough. Independent Schools Council executive director Bill Daniels said: "It's a huge shift from the past and a clear acknowledgement that the policy they took to the last election was a mistake. We would support that because it provides stability and certainty."

The ALP's move angered unions, prompting Australian Education Union deputy president Angelo Gavrielatos to describe the policy shift as "indefensible". "It is indefensible in this nation that we continue to deliver such large increases to the wealthiest schools," Mr Gavrielatos said. "To maintain that indefensible model until 2012 makes a mockery of everything the ALP has said about introducing a needs-based funding model. "It ensures private schools will maintain a position of privilege."

The federal Government's funding model - known as the socio-economic-status model - does not take private school fees and income into account when determining funding. Instead, it links enrolment details of where students live with census data on average income and education levels. Under current SES arrangements, 60per cent of Catholic schools are guaranteed more funding than they would be allocated if the SES model were strictly applied.

The ALP's decision follows lengthy negotiations with the Catholic sector. At Labor's national conference in April, references to the Howard Government's funding arrangements as "unfair and divisive" were removed from the party's new education platform. Opposition education spokesman Stephen Smith also sought to dump a reference that criticised the SES formula as having "delivered the largest increases in commonwealth funding to some of the best resourced schools in Australia". However, at the time he did not indicate any plans to retain the SES funding model, instead maintaining that a Rudd government would pursue a needs-based funding model. Labor's new policy platform pledges that public funding should be subject to non-government schools meeting quality standards for curriculum and teaching.

Currently, the basic entitlement to commonwealth assistance under the SES model ranges from a minimum of just $989 a student to $5052. For secondary students attending a private school, it ranges from a minimum taxpayer grant of $1277 a student to $6524.

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Hopeless "child safety" bureaucracy

A MOTHER whose toddler son died while under the supervision of the Department of Child Safety has accused authorities of inadequate care. Joshua, 2, died after he was allegedly bashed to death by his father on September 25. His mother, who wanted to be identified only as Kristin, told Channel 9 she had dealt with six case workers. "The person who is working with you doesn't know the situation," Kristin said. She said many of the case workers were too young and inexperienced. "The Department of Child Safety change their case workers like they change their frigging underpants."

She also told Channel 9 she had contacted child-safety officers for help four weeks ago, but no one returned her calls. Government sources said Child Safety removed Joshua from his mother when he was three days old because of domestic-violence issues between his parents. He remained in foster care before he was gradually reunited with his mother last October.

Child Safety sources said the case was monitored by a Suspected Child Abuse and Neglect team which involved their department, police, health and education. The SCAN file was believed to have been closed in March, with the condition that Child Safety continue supervision.

The Sunday Mail has also learned a postmortem examination showed the boy had extensive injuries, including 271 bruises, a broken arm and a broken nose. Sources said some of the injuries appeared to be "quite old" and had occurred some time before the boy's death on September 25.

The boy's father, 34, has been charged with manslaughter and torture. He was remanded in custody to appear in Redcliffe Magistrates Court on November 27. A spokesman for Child Safety Minister Margaret Keech said the department could not comment on the case as it was before the courts and subject to a departmental review. The spokesman denied claims from within the department that two Child Safety officers stationed at Redcliffe were juggling 160 cases between them. He said that was the approximate number of cases for the whole office and the average caseload per person was 24.

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Nutty concept of "endangered"

These native Australian trees are found in thousands of Brisbane backyards -- as well as being a major crop in Hawaii



THERE are so few macadamia trees left in the wild that growers believe they should be given the same recognition as the wollemi pine. At least 80 per cent of macadamia rainforest trees have been destroyed for agricultural and residential development - sparking fears that wild varieties are at risk of extinction, especially with climate change impacts.

Lismore grower Ian McConachie has set up the Macadamia Conservation Trust, aimed at protecting the tree that is the only Australian native produce to have become a major international food. The trust's primary aim is to ensure wild macadamia numbers do not decrease any further. Mr McConachie, a commercial macadamia grower for more than 30 years, started the trust after searching rainforests and finding hardly any of the trees that are also known as Queensland or bauple nuts.

Queensland nuts are found along a 600km coastal strip between Grafton, NSW, and Maryborough, about 300km north of Brisbane.

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