So the Federal Government is considering using the next Health Care Agreements as a means of forcing AWAs into one of the major areas of coverage of protected State Awards. The Government’s denials have a “never ever” quality so there must be a plan! It would be WorkChoices on a grand scale with literally hundreds of thousands of workers affected.

Some might say that it’s not such a bad idea. Health is one of the last bastions of protective cartels and unions. Professional entry quotas and work demarcations are strictly enforced. Any policy that can let some 21st Century light into 19th Century workshops is well worth a look. One need look no further than the 2006 report of the Productivity Commission on the Australian health workforce to understand the price the health system pays for some of these workforce restrictions.

This government has consistently espoused the view that the running of hospitals is a matter for the States and that they will not tell the states how to run them. Any move by the Feds to involve themselves in the employment arrangements for hospital staff would represent a major policy shift.

A more adventurous Federal policy involvement presented by the Health Care Agreements would be to use them as a lever for health policy reform, not just workplace union-bashing.

The next Health Care Agreements will be the vehicle for transferring over $50 billion of Federal funds to the States to help run the public hospital system from 2008 to 2011.

What a great opportunity for the Feds to require the States, in return, to provide some public accountability to the Australian taxpayer. Accountability could be for a range of factors: waiting times for various services, efficiency and, most importantly, safety.

We know from Australian and overseas research that every year several thousand Australians will be injured or even killed in public hospitals simply because of medical or other errors, not because of the illnesses for which they were admitted in the first place.

However, there is no publicly available data to help us find out which hospitals are riskier than others or whether the problems are being tackled and, if so, whether any improvement is occurring.

The States could easily be required to provide, by public hospital, easily understood information on key safety data. This data is already collected but not generally publicly reported.

Any plan by the government to use the Health Care Agreements for more than just a transfer of billions of dollars is welcome. What a great idea it would be for those plans to be directed to improving patient safety.

Peter Fray

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Peter Fray
Editor-in-chief of Crikey