Saturday, October 23, 2010

Bureaucratic strangulation of Australian public hospitals set to get worse

Dr Jeremy Sammut

The key insight into the hospital crisis is that the public hospital system exhibits all the systemic failures typically experienced by stultifying Soviet-style monopolistic, central plan bureaucracies.

So-called reforms that tinker with the scale of the bureaucracy will never fix the fundamental problem, which is the faulty way state governments have chosen to run public hospitals.

The federal government’s National Health and Hospitals Networks Plan will not devolve operational management to the local level as promised because the state bureaucracies are still in control of the overall management and funding of the system.

Creating ‘local hospital networks’ staffed by seconded state bureaucrats will only impose an additional layer of bureaucracy. Bribing the states with billions of extra taxpayers’ dollars to sign up to a national agreement that does not significantly alter the existing administrative arrangements, other than making them more complex and confused, is a betrayal of hospital staff, patients and voters, who deserve and expect better.

The only way forward is to unshackle public hospitals from the bureaucracies that otherwise will continue to restrict the hospital system’s ability to meet the health needs of the community.

Abolition of the bureaucracy can only be accomplished if administrative responsibility for each public hospital is devolved to autonomous boards of directors.

But hospital boards are only the first step. It is not a quick fix.

Genuine hospital reform requires genuinely responsible federalism and genuine local autonomy and accountability. Judicious use of financial levers and competitive pressures, combined with managerial flexibility, must drive improved performance and the return on each health dollar spent on public hospitals.

Administrative reform must therefore occur in tandem with comprehensive structural and funding reform to transform public hospitals into what they are not: independent, competing, consumer-oriented, and financially accountable.

Rather than be mired in the usual political wrangling about the problems in the health system, policymakers must focus on policy details that all credible reform plans must contain.

The above is a press release from the Centre for Independent Studies, dated 22 October. Enquiries to Snail mail: PO Box 92, St Leonards, NSW, Australia 1590.

Bible ban 'political correctness gone mad'

AN unholy row has erupted over the hand-out of Bibles at citizenship ceremonies. Hobart and Clarence councils this year stopped handing out Bibles after they were told by immigration officials they were no longer needed, The Mercury reports.

Liberal senator Guy Barnett said the move was "political correctness gone mad".

Clarence mayor Jock Campbell said his council had been told by the Department of Immigration and Citizenship that if citizenship candidates wanted to swear an oath on a holy book, they needed to bring their own.

Hobart Lord Mayor Rob Valentine said his council began advising candidates this year they needed to bring their own. "We were told by immigration, quite some time ago, not to give Bibles out anymore," Ald Valentine said.

Ald Campbell said until this year Bibles supplied by the Bible Society of Australia had been handed out to participants who opted for the Christian oath. "I'd see it as an unnecessary change," he said.

Ald Campbell said the council had contacted the Bible Society for advice on what to do with 72 spare Bibles.

A Department of Immigration and Citizenship spokesman said last night it was not appropriate for organisations hosting citizenship ceremonies to give holy books as gifts and this had been the position of the department since 2003.


More computer mayhem in Queensland

This comes on top of Queensland Health still not being able to get its payroll software working properly -- after MONTHS of trying

QUEENSLAND police are spending almost $6 million on a new computer package to process gun licences after a report found their own $100 million system was too slow and a similar program used by Queensland Transport was not secure.

The confidential report, obtained under Right to Information laws, investigated several options to replace the current licensing system that requires gun owners to go into a police station and fill out paperwork.

The options included the extension of the police computer program QPRIME and the system Queensland Transport uses for driver licensing, known as TRAILS.

But project manager Trevor Holmstrom found QPRIME had increased data entry times for police by 115 per cent since its introduction in 2006 as a replacement for a number of other systems.

If the same system were used for weapons licensing, another 61 staff would be needed and applications would take 85 per cent longer to process, the report said.

Queensland Transport fared no better with Mr Holmstrom finding the department had "no pre-existing good record of looking after customers" and no experience dealing with security-sensitive information. A lack of a 24/7 culture at QT was also an issue, he said.

Instead, his 67-page report recommended police adopt a new computer program known as Sword Ciboodle at a cost of $5.8 million – despite it having no Queensland support office.

Opposition leader John-Paul Langbroek said the fact two existing systems were ruled out was further evidence the Government "could not get the basics right". "The problems with QPRIME and the length of time it takes police now to fill in crime reports and process warrants have been concerns the Opposition and police have been raising for years, but Labor has been in denial," he said. "This review further confirms the rollout of QPRIME has been a debacle."

Mr Langbroek said the review's finding that Queensland Transport was dogged by "poor customer service and responsiveness" was a further wake-up call to the agency.

But a spokesman for Transport and Main Roads said the department had maintained a score of 7.7 out of 10 in customer satisfaction over the past two years in surveys conducted by ACNielsen.

The new computerised system for gun licensing is expected to be up and running by December, coinciding with an increase in the cost of a firearms' licence. The State Government hopes the switch to an online service will save about $7.5 million over five years in staff "efficiencies" and processing improvements. [Joke! Joke!]


Striking a balance in Australia's immigration future

By Pallavi Jain (Ms Jain is of Indian origin)

German chancellor Angela Merkel has spoken the unspeakable. In a brutally honest statement she has said that multiculturalism has failed in Germany. This statement comes close on the heels of the recently held elections in Sweden where the far right party, Sweden Democrats, won as many as 20 parliamentary seats, making a significant dent for the first time in mainstream Swedish politics. These developments reiterate the fact that immigration remains a hot button topic in most western democracies. But for all the rhetoric, how does Australia fare when it comes to immigration?

According to the Australian Bureau of statistics in the past year net immigration contributed 64 per cent to population growth while natural growth accounted for 36 per cent. Over the past five years there has been a substantial increase in immigration owing to government policy. It is not surprising then that in the recently held elections, immigration was often discussed in conjunction with increasing population. However, one wonders whether population growth itself would be an issue if it was not associated with a high rate of immigration and was just a result of natural increase.

Over recent decades Australia's per capita income has risen even as its population has increased including a huge influx of immigrants. Moreover given that Australia is ranked second on the UN's Human Development Index which assesses education, health and life expectancy as well as economic factors it is not hard to believe that by global standards Australia is doing well on almost all counts. But is there more here than meets the eye? Are the old and new members of this remarkable country really at ease with each other?

It is perhaps as unwise to criticise immigration altogether and paint all immigrants with the same brush as it would be imprudent not to express apprehension about increased immigration out of political correctness. While a gradual influx of immigrants of all hues and cultures may be tolerated at the worst and welcomed at the best, substantial increases in immigrant population, coming in sudden spurts, may lead to social tensions. Such is human nature.

Every country has a right to decide who should enter their country. In fact extra care should be taken when deciding who can come in, to ensure that a few bad apples don't give all immigrants a bad name. And while it might be difficult, the government must make a thorough assessment of aspiring immigrants. In addition to skills, it is important to establish what they think and feel about the value system that prevails in Australia.

If there is a conflict of interest cultural or otherwise that cannot be resolved, then it may even be better for the person not to immigrate, since there is a high probability of disappointment and alienation. At a macro-level such feelings of discontent could be a recipe for social friction. Last but not the least, there is one important reason why immigrants from all over the world often want to come here. It is not just about the money (immigrants to countries like Saudi Arabia, Libya or Kenya can also make money). It is at least for some about the life choices that Australia offers. It is about fundamental human rights like dignity of life, freedom or a certain level of security.

I have personally been at the receiving end of tough immigration policies when I could not gain full time employment in the UK due to visa restrictions. But even after being denied that opportunity, I did not change my views on immigration into the developed world.

I firmly believe that every nation has a right to decide who can and should stay in their country. In some cases countries may miss out on an outstanding talent because of an error in judgement, or they may sometimes allow in people who perhaps should not have been given entry. But even though one can doubt the wisdom of a specific immigration policy, a nation cannot be denied the right to make that choice.

Yes Australia is not perfect, but by many standards it is one of the best places to live on the planet. You can eat or wear anything, practise your religion, speak your mind without fear — choices that are a luxury in many parts of the world. Moreover in my opinion the task of assimilating into Australian society rests with the immigrant who has made a choice to come here. Assimilation here does not require compromising your identity in any way but rather offers a chance to expand it, making you part of the global narrative. On the other side though, it is important that Australia lives up to the immigrant's expectations of being a fair, egalitarian and free society.

Australia is one of the most developed countries in the world but to maintain that in an increasingly globalised world, it is imperative that it manages its immigration policy well. Very low immigration will deny Australia the benefits of the best minds in the world. Too much immigration may give rise to unforseen social unrest, apart from being a huge burden on the infrastructure and the environment. Striking this balance will be a key to Australia's future.


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