tip off

Newman v the doctors: a political fight that is poisoning the LNP

The Queensland government his locked into a nasty dispute with doctors, and voters are sick of it. Mark Bahnisch, commentator and Centre for Policy Development fellow, says the result is considerable ill will.

If there was one issue aside from privatisation that doomed Anna Bligh’s government to defeat, it was healthcare. Health had been a running sore for successive Labor administrations in Queensland. If it wasn’t the spectacularly expensive payroll bungle, it was the revelations, aired in a royal commission and successive criminal trials, of alleged criminal malpractice by Jayant Patel, nicknamed “Dr Death”. Or it was a self-styled Tahitian Prince living it up on embezzled millions.

Add that to the usual pressures on a public health system and you have a toxic mix. Bligh herself gave credence to the salience of the issue by promising to “blow up” Queensland Health. (Although arguably she was onto something, as the bureaucracy is notoriously cumbersome and unresponsive.)

Now the Campbell Newman government finds itself in an epic fight with public hospital doctors, a fight it cannot win in the court of public opinion if we go by recent polling. Doctors are being asked to sign new employment contracts by April 30. All indications are that mass resignations from the public system are being contemplated.

Newman and the Liberal National Party claim to be acting on the advice of the Auditor-General, who raised concerns about private practice arrangements for salaried specialists. Many doctors argue that the “rorts” were a consequence of an ill-designed scheme by the former government to retain staff. It’s crucial to understand that unlike other states, many of Queensland’s public hospital doctors (particularly in specialties like anaesthesia) are employees rather than visiting medical officers.

Very little rationale has been offered publicly about the shift from award and enterprise agreement-based employments to individual contracts, and it’s not clear that it’s a necessary consequence of the deficiencies in accountability and remuneration identified by the Auditor-General. The contracts, read in conjunction with changes to the Industrial Relations Act, deny salaried doctors unfair dismissal protections, control over work location and timing of shifts, and require doctors to take direction on appropriate medical care from hospital and health service administrators.

The suggestion is that, having failed to find private operators for public hospitals that could actually provide cheaper services, the government’s agenda is to substitute bureaucratic cost controls for clinical judgement. That’s something the federal policy shifts towards paying hospitals for the “efficient price” of a procedure encourages.

Unsurprisingly, doctors are up in arms. The Queensland Health Director-General was affronted by being presented with a pineapple at a public meeting (the protesting doctors are calling themselves the Pineapple Group, after meeting at the Pineapple Hotel), Health Minister Lawrence Springborg has been loudly decrying “interstate union thugs”, and now the government is taking legal action against unions for “deceptive and misleading conduct”. Assistant Health Minister Chris Davis, a former Australian Medical Association president himself, has barely been corralled within the government’s ranks. The AMA is running TV ads, the Facebook “Keep Our Doctors” page has 8846 likes, and on Tuesday night, doctors rallied along with other public servants outside Parliament House.

None of this is a good look for a government that recently lost the Redcliffe byelection to Labor with a massive swing. Polling conducted by ReachTEL for the Australian Salaried Medical Officers’ Federation in Ashgrove (the Premier’s seat), Cairns, Ipswich West and Mundingburra shows massive public opposition and significant impacts on the LNP’s vote. Newman would easily lose his seat to the ALP on these numbers, and it could be reasonably inferred that the LNP’s majority would be in danger. (It would be fascinating to see polling in seats higher up the pendulum).

Perhaps most inflammatory is the Premier’s suggestion (on which some hospital and health services are reportedly now acting) that interstate and overseas doctors will be recruited to replace specialists. There’s also talk of contingency plans to pay private hospitals to provide services for public patients, an objective in any case common to the state LNP and federal Coalition governments.

The Newman government faces a potential meltdown of the public hospital system in May. While Springborg has given some ground in negotiations, taking the system to the brink of disaster in a dispute with a profession overwhelmingly trusted by the public is hardly a savvy “crash through or crash” strategy. And this from a government that’s found it hard enough to successfully demonise bikies.

Meanwhile, in pursuit of its new focus on consultation, Treasurer Tim Nicholls has been touring the state touting the benefits of privatisation. It seems that memories are short in George Street.

*Dr Mark Bahnisch is a fellow of the Centre for Policy Development. He has covered several Queensland election campaigns for Crikey and has worked in health policy and health professional education since 2010. He blogs at The New Social Democrat.

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  • 1
    rhwombat
    Posted Thursday, 3 April 2014 at 3:08 pm | Permalink

    Noddy and his well educated Health Minister are just following Peter Costello’s prescription. The SMO cats that they are trying to herd are very bright, very dedicated and very angry. Noddy & Springborg are mincemeat.

  • 2
    zut alors
    Posted Thursday, 3 April 2014 at 4:09 pm | Permalink

    Newman seems to think he can re-enact the unprecedented coup Sir Joh pulled when he replaced the striking SEQEB employees in 1985. In a sensational move he sacked hundreds & advertised their jobs in full page ads in The Courier-Mail & interstate newspapers.

    Newman is planning the medical version of putting power workers under the thumb. However, Sir Joh was rat cunning - whereas Newman lacks the vital cunning bit.

  • 3
    ianjohnno
    Posted Thursday, 3 April 2014 at 4:51 pm | Permalink

    I doubt if Newman has a clue what happens in QLD public hospitals, or what these talented and dedicated medicos actually do.

    The average engineer - like Newman - is not anywhere near.

    Perhaps he is pandering to the element that think it wonderful that cuzzin Brayddonn is earning $100K driving trucks in the Pilbara, but are outraged that talent orders of magnitude superior are paid so much more.

  • 4
    Noelene Turton
    Posted Thursday, 3 April 2014 at 5:17 pm | Permalink

    Newman is akin to one of the bwurocrats here in NSW who when he changed a staggerred shift system to everyone starting at the same time made the comment “Running a radiology service is no different to running a laundry system’ Alas they forget patients aren’t as easily managed as clothes.

  • 5
    AR
    Posted Friday, 4 April 2014 at 7:33 am | Permalink

    There’ll be a few well chosen words in Campy’s shell-like and pseshal provisions made for pseshal peoples like SMO & their ilk. The rest can go hang, just like laundry.

  • 6
    Dubious Virtue
    Posted Friday, 4 April 2014 at 10:04 am | Permalink

    bureaucracy is notoriously cumbersome and unresponsive.’

    Examples please.

    If I can’t respond to your query immediately, I’ll get back to you in less than 24 hours.

    I suspect you mean “bureaucracy is notoriously cumbersome and unresponsive” for complex mufti-department issues. It wold be no different to me asking you to give me a list of all the gifts you have given to your lovers over the past decade, the costs, places of purchase, and reasons for the gifts by the end of the week.

    Sure, we may have the paperwork for a project but there have been two staff changes since the project finished so we need to go back and look at things. Because if we provide information with the slightest bit missing there’s all hell to pay and some sound bite journalist will be then writing that we don’t know what we’re doing (ignoring the fact that to do things faster people will have to be taken off line from their regular tasks).

    By saying “the bureaucracy is notoriously cumbersome and unresponsive” all you are doing is just providing further ammunition to hate on the service, a great sound bite for the government, and further justification for privatisation. Thanks.

  • 7
    thelorikeet
    Posted Friday, 4 April 2014 at 4:11 pm | Permalink

    @dubious value - even Mark’s defence he seems to have been referring to the Queensland Health bureaucracy specifically. The charge may stick.

    More generally, Fallen Minister Flegg was on the radio this morning trying to explain the evils of the SMOs negotiators: the goalposts were always shifting; agree with one union and another union stands in the way! Poor possum didn’t seem to understand he was actually saying “we (the government) are incompetently negotiating”.

    Maybe Newman had again stuffed up with his Captain’s Pick of DG in Ian Maynard, another BCC boffin. No industrial relations background, no health background. But maybe I misunderstand the Scripture Union …

  • 8
    Blair Martin
    Posted Saturday, 5 April 2014 at 7:58 am | Permalink

    @thelorikeet - exactly “Scripture Union”. Beware the real devil (pun intended) in the detail here - Bruce McIver, president & founder of the Qld LNP, a nastier operator would be hard to find.

  • 9
    Chris Hartwell
    Posted Monday, 7 April 2014 at 7:50 am | Permalink

    The only issue causing slow-down is the need - state parliament mandated mind you - to go through oh-so-many checks at each step of the process. Our department regularly delivers, when called up at 4pm on Friday and told “Oh, have that ready by 10am Monday.”

    @ianjohno - I choose to interpret your comment as meaning that therefore exceptional engineers are the ones who keep things running. Thank you :)

  • 10
    ianjohnno
    Posted Monday, 7 April 2014 at 2:20 pm | Permalink

    Chris Hartwell @9
    …exceptional engineers are the ones who keep things running.
    Too right they do.

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