| Thinking Lateral |
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The Hospital in the Home (HiH) service is to be cut. Part of the 3% savings from the Health department, apparently.
Until it was cut, I had never even heard of HiH. Still, it sounds like a good idea. Not every sick person needs full hospital care. Not everyone wants to be isolated from friends and family just because they are or have been sick or injured.
Oh well, 3% must be saved...
But wait! The Health Minister says that the HiH service will continue! "So," says Kim Hames, "we'll be making sure the services themselves stay but there will be more contracting out to Silver Chain." (The West, Anger over shake-up of hospital in home service, 18 Feb 09)
Let's follow the "logic"...
- HiH is said to save about $25 million a year. We cancel HiH and have an immediate cost of the $25 million, in hospital beds that are now required.
- But we have saved the cost of HiH. Let's pretend that that is $1 million.
- Now we pay Silver Chain to provide the HiH service. So we are back to saving that $25 million. (What do you bet, that that will be counted as part of the 3% savings!)
- Can Silver Chain provide HiH for the same $1 million cost? When you add the cost of setting up and managing a contract -- probably not. Can Silver Chain hire nurses for less than RPH? Probably not. Does this mean that the total cost of the outsourced HiH contract is higher than having it done by the Health department? Probably.
So why will HiH be stopped, to be replaced by an outsourced HiH? Because... there will be an apparent saving of $1 million... And -- when the smoke and mirrors are fully in place -- the Minister will be able to announce a $25 million savings in hospital beds. All because he was clever enough to outsource HiH...
Oh, sure, it will cost more in reality. But what politician -- or senior bureaucrat -- ever cares about reality?
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1 comment:
I'd also never heard of "Hospital in the Home". Perhaps it's the intensive care unit of "Home And Community Care" (HACC).
Subsidy payments for both HACC and Carer Allowances are very small compared with nursing home costs. If a more equitable funding format was introduced, many more frail people could remain at home.
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