Seven year hospital wait

In one of the world's oldest (from 1944) "free" hospital systems



It took five years for this woman to get a seven-minute operation. The queues are growing and people are ... still waiting. Dorothy Bauer does not believe the State Government when it says Queensland's beleaguered health system has improved. Not when she waited five years for an eye operation that takes seven minutes. The Bundaberg 84-year-old still needs surgery on her other eye, joining another 36,000 Queenslanders on waiting lists for elective surgery. "Anything can happen. Nobody has any guarantees today with this health system," Mrs Bauer said.

It has been 1000 days since the State Government promised to fix the health system. Then-premier Peter Beattie made the pledge after scathing findings from the Davies inquiry helped expose the real waiting lists and systemic problems within Queensland Health, a development headlined by The Courier-Mail as The Truth At Last. However figures released yesterday show waiting lists for elective surgery have blown out by almost 15 per cent in those 1000 days. And the list of people waiting to see specialists has rocketed by 50 per cent to a record of almost 160,000. Only 900 hospital beds have been added in the same time.

Health Minister Stephen Robertson insists the system is working better than in September 2005. "We are reforming the system root and branch," he said. Premier Anna Bligh yesterday defended the system. "We have a larger, stronger workforce and are treating more Queenslanders than ever before," she said.

Queensland Health yesterday said $4.3 billion of $10 billion it had pledged to be spent by 2010 had been used. However it hasn't been enough to allow Mrs Bauer to have cataract surgery on both eyes. The former school teacher was forced to give up charity work because she couldn't read music to play the piano at fundraisers. Then late last year Queensland Health finally arranged for surgery for one of her eyes. The dramatic change allowed her to return to charity work and to care for her sister, who is 86. Mrs Bauer praised the doctors and nurses who treated her, but condemned politicians and health bureaucrats who "played God to people's lives".

Seven people who were profiled in the 2005 Courier-Mail series, The Truth at Last, say they owe their lives to getting off elective surgery waiting lists. All eventually had their health issues resolved, and some credited media attention for accelerating their cases.

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Surgery blowouts hit reform agenda

A blowout in the number of clerks and administrators would be more accurate



QUEENSLAND Health says it is being swamped with patients as it defends blowouts which have pushed surgery waiting lists to record levels. A Queensland Health bureaucrat said the state's public hospitals treated 825,725 people last year - up 6 per cent or three times population growth. However the key barometers - waiting lists - have ballooned by a greater margin. In the 1000 days since then premier Peter Beattie promised to fix the health system:

* The waiting list for elective surgery has increased by almost 15 per cent (31,478 to 36,030).

* The list of patients waiting to see a specialist is up by almost 50 per cent (108,568 to 159,223).

* In comparison to other states, Queensland spends less per capita on health and the number of hospital beds and medical staff per 1000 people is lower, according to the Productivity Commission. The Government says it is closing the gap.

* There has been an increase of only 900 hospital beds despite a 100,000 population gain.

* In the past 12 months, the number of patients waiting longer than the expected 30 days for the most urgent Category 1 surgery has blown out by 112 per cent.

* The number of patients waiting for Category 2 surgery, which has a 90-day benchmark, has increased by 16 per cent but the figure for the least-urgent Category 3 surgery (365 days) has decreased by 19 per cent.

Dr Stephen Duckett, Queensland Health's executive director for health reform and development, said the system was improving. "There is no doubt in my mind we are much better than we were three years ago," he said. "We're up 20 to 30 per cent in doctors and nurses, and have many, many more beds." Dr Duckett said public hospitals had treated a record number of patients in emergency departments last year. But concern continues in the community.

Deception Bay resident Sally Stanley remains upset after her brother died while waiting for a cardiac defibrillator. "The promises made didn't get kept," Ms Stanley said. "I think staff are doing the best they can with the resources they have. Politicians give them a bit, but it's not enough."

Australian Medical Association state president Ross Cartmill said the health system remained "chronically underfunded" by both state and federal governments. "I find it frustrating that the two levels of government are always arguing about which one hasn't paid its way," he said. "For health, we don't need a 2020 Summit, we just need to fund things properly." Dr Cartmill acknowledged the state was pumping an increasing percentage of funds into health, "but because we started so low, we still have not reached the level of other states."

Opposition health spokesman John-Paul Langbroek, a former Gold Coast dentist, blamed poor management and planning for inadequate beds and staff, while a bureaucratic culture continues to drive away doctors.

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Australia in the grip of a baby boom

AUSTRALIA is in the middle of a new baby boom, with the nation's birth rate the highest in 10 years. The nation's statistician says women can now expect to have 1.8 children during their lifetime. There were 265,900 births registered in 2006, the highest number in 30 years, the Australian Bureau of Statistics said.

The Australian Government has in recent years tried to encourage a higher birth rate to combat the ageing of the population. Former treasurer Peter Costello urged families during one famous Budget news conference to have "one for mum, one for dad and one for the country".

The new data also reveals 63 per cent of mothers, with children aged under 15 years, were employed in March 2008, compared to 54 per cent a decade ago. As the number of mothers employed increased, so too did the use of formal childcare. The percentage of children under the age of 12 years attending formal care increased from 14 per cent in 1996, to 23 per cent in 2005.

In the same year, 44 per cent of employed mothers with children under two had jobs with flexible hours, 39 per cent were permanent part-time workers, while 27 per cent worked from home. More than two-thirds (67 per cent) of mothers in a relationship with a child under 15 said they "always or often felt rushed or pressed for time" compared to 61 per cent of single mothers in the same category.

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No change so far to freedom from information practices

Kevin Rudd insists his Government remains committed to honouring its pre-election pledges to enhance Freedom of Information laws, despite suggestions Labor is providing no greater access to documents than the Coalition. The Prime Minister yesterday stood by commitments Labor made to the Your Right to Know coalition of media organisations, which includes The Weekend Australian. "We said prior to the election that we would be implementing to the letter the commitments we gave in response to the Right to Know coalition - that includes FOI reform," Mr Rudd said. "Those commitments I reiterated in a speech I made in Sydney (on Thursday) and we stand by every one."

However, the Government has come under mounting criticism over its failure to improve access to information. Rick Snell, one of the nation's leading experts on FOI, said the Government had "set themselves up for a fall" on the issue. Mr Snell, senior lecturer in law at the University of Tasmania, said the Government was "continuing the old regime" of the Howard government and "the old ways of processing FOI requests". Earlier this month, federal Treasury refused an FOI request by the ABC to release documents on the inflationary impact of the Government's proposed changes to industrial relations laws.

Mr Rudd said the Government would introduce legislation to reform "the particular objection which news organisations have, which is the previous government's use of conclusive certificates" to block FOI. There have been claims that Mr Rudd's chief of staff, David Epstein, has taken an interest in FOI applications, but the Prime Minister insisted he and his ministers would back the official decision-makers. "On the question of individual FOI decisions within departments ... that lies with individual FOI decision-makers within the bureaucracy," he said.

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The Rudd vision

This could easily be the agenda of a conservative government

Kevin Rudd has an economic policy - but in the budget process his mind has turned to an economic narrative. It is urgently needed. Australia under Rudd faces slower economic growth for three years, high interest rates and ongoing spending restraint. Witness the latest monetary policy warning from the Reserve Bank that the slowdown must be protracted. In this climate, 24-hour spin will not suffice. The Labor Government needs a story to explain the slowdown and a story that reveals a long-run vision. These stories will start with the budget.

Rudd is passionate about burying what he calls short-termism. He wants to project a long-term narrative and that rests upon three priorities. They are: a sustained restructuring of national spending to revive Australia as a low inflation nation; an integrated reform of the tax/welfare/retirement income provisions to maximise personal incentive and reduce the call upon the state; and an interventionist strategy to lift productivity by investment in human capital, infrastructure, a better working federation and more competition policy. For Rudd, this gameplan runs beyond the initial three-year term. The challenge is in delivery and in branding.

There is one notion gaining oxygen that Rudd wants to kill: that his Government is a national version of the state Labor incrementalism. He knows this is a political death warrant and it offends his policy credentials. Rudd's ambitions mean the budget has a dual role. As well as giving immediate effect to Labor's agenda, it signals the long-term path and priorities of the new Labor Government.

The first message from Rudd and Wayne Swan is that containing inflation is a lengthy project. That means spending restraint now and in the future and a re-ordering of spending priorities. It is about making a virtue of being a fiscal conservative, a position that Brendan Nelson's Liberal Party has surrendered in an act of folly.

Rudd's second priority is the most complex. In the long run he wants lower tax rates, a more competitive tax system, elimination of barriers in the welfare-to-work transition and better superannuation provision by utilising the surplus to boost individual superannuation accounts. These superannuation options were examined in the budget context but deferred.

The third priority is a cluster of productivity-enhancing measures. It is also the most risky because it means a more active government role in industry policy in fostering what Rudd calls "the culture of innovation".

He wants to project an interventionist government delivering better broadband, improved infrastructure, better school retention rates and more rigorous education, easing urban congestion, promoting biotechnology and industries of the future along with the "seamless national markets" from the 2020 Summit that caught his attention.

Paul Keating was a master of the economic narrative. It is appropriate that, on budget eve, Keating's former senior aide, Don Russell, in a recent speech divided politicians into two categories: those who were nice to the voters hoping the voters would be nice to them and those who felt that leaders must be useful and become "doers". Rudd sees himself in the "doer" category. The proof, one way or another, is at hand. Faced with the current economic slowdown, political "doers" would seize it as an opportunity to introduce reform as part of a new narrative.

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