Health costs: Truth or lies

Health costs: Truth or lies

It's great to see Gareth Parker supporting the Premier. Or is the political reporter for The West speaking with tongue firmly planted in cheek ? Or is it me that's skipping between irony and sarcasm...

"Time for health workers to take a dose of reality", The West, 5 Dec 2015

Parker writes, "Wild claims by the AMA... of 1500 job cuts were exposed as scaremongering this week when the Premier said there would be only about 200 voluntary redundancies."

So Parker trusts the Premier -- notorious for broken promises, backflips, unjustified decisions and wild statements which severely test the bounds of truth. Did Parker consider asking the Minister for Health ? You know, the man who supposedly is in charge of matters such as job cuts in Health ? Or is that like asking the dog, when the owner has already spoken...

And Parker does not trust the AMA, with their "wild claims". Well, okay, the AMA are also notorious, for defending their own turf. Mind you, "their own turf" does happen to be the health system. But what would they know ? They just work there.

I think that a serious journalist would ask questions before believing -- selectively believing -- biassed public statements. One claim may be more accurate than the other. A serious journalist would justify his decision to support -- with emotive language -- one claim over the other.

Or -- in the most positive interpretation -- perhaps he should leave the attempts at ironic humour to the cartoonist.

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On a separate issue, from the same article:

"One wonders what [Fiona Stanley] thinks" ... of having a disaster-prone hospital named after her.

It doesn't really matter what Fiona Stanley thinks. The hospital was not named for Fiona Stanley. It was named for the potential positive PR spin. Just like the Polly Pipe...

Take a piece of major public infrastructure. One which generates a lot of public antipathy. The public don't like it. The political opposition attack it. So what to do ?!

Name it after a popular folk hero !

Name the tunnel after Polly Farmer... no one would say anything nasty about such a popular ex-footballer. Name the super-expensive hospital after a popular medical person... no one would say anything nasty about such a dedicated and successful medical researcher.

Mind you... Fiona Stanley is a paediatrician. I bet the politicians are wishing they'd spotted the link and saved her name for the still-under-construction children's hospital. It's looking as though that one will also need a popular name to deflect criticism...

But Fiona needn't worry, not with me, anyway. I like to think of our brand new hospital as simply, The Big Fi.

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Why don't we just cut costs ?!

Parker states that, "Health is a chronic over-spender." He lists a couple of expensive failures, including the expensive IT system. So what to do ?!

A few years ago there was a well known management consultant with the nickname Chainsaw. He saved several companies by the simple expedient of cutting costs -- including staff costs -- to the bone. When the same techniques were tried on an Australian medical services company -- it failed. Miserably.

Medical services -- health -- are not cut and dried processes. Even the "evidence based medicine" advocates admit that. A disease does not stand alone, it is just one aspect of an individual's being. And each individual is... well... an individual. Medical treatment must make allowance for the individual.

The health system must deal with large numbers of individual -- unique -- patients. This requires a lot of individual attention. This all takes time, staff time.

And when it comes to treatment... There are now more options, more possible treatments for a wider range of health issues. And the treatments cost money... If perfect health is the target then the cost is perfectly enormous.

So... Is perfect health the target ? If yes, then health care will be very, very expensive. If no, then that needs to be stated. And we need to know just what the target is.

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On a more practical issue: what can be done to save our health system ?

Health care has, traditionally, an in-built conflict between administration wanting to save money, and health care staff wanting to save lives. Or possibly between administration wanting a more effective use of available finds, and medical staff wanting more money and power for themselves. This is a management issue.

Effective management would attempt to build a positive working relationship. Perhaps offer compromises, so both sides can satisfy their professional imperatives. Certainly, effective management would try to solve rather than to create problems.

There are plenty of textbooks offering good management techniques. Some of these techniques could possibly work in our own health system. If only someone would make the effort.

What we see, are unilateral statements from each of the conflicting parties. Making demands doesn't work. Giving orders doesn't work. Denials and sudden changes are not much good, either.

The various parties need to actually talk with each other.

First, agree on some targets for our health care. Real targets. Targets which can be put to the public -- supported by all major players -- and which will show some long term direction. Something reassuring. As though our health system were intended to do more than just spend or save money.

Identify problems. Is there really, to use Parker's words, "a revolt led by unions" ? Are there really "modest attempts at cost discipline" ? Avoid the emotion and bias. Find an acceptable compromise that clearly states the actual problems.

And yes, there may be actual problems which contradict each other. State them. Accept them as being real problems.

Then work together to try to solve some of those problems.

Okay, that's not as practical as I hoped :-) "Try to solve some of those problems" !

First, the various parties need to "work together". Which requires someone who is able to talk to all parties.

And, to listen.

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"A city without trees is not fit for a dog"... per Ginger Meggs