I’ve recently been trying to prise some information out of the media office at the Department of Health and Ageing. It’s taken two weeks and probably more sweat than it took to break the Watergate scandal to get it to reveal a list of six MBS item numbers that will disappear when the federal government starts paying general practices lump sums to employ practice nurses.
So it was with some excitement that I settled in front of the TV the other night to watch the new multimillion dollar “awareness campaign” on health reform. Here was an alternative source that didn’t need a fortnight’s notice and numerous emails and phone calls to offer some detail about, in the words of the advertisement itself, the “most significant improvement to our health system since the introduction of Medicare”.
It starts with lots of pencil lines connecting to circles with things such as “cut inefficiencies” or “a greater local say” written within them. It is, I guess, the graphic representation of a health and hospital network to which Rudd is now committed except that the lines in the advertisement are straight rather than spaghetti-wired, which would offer a better guide to the network we look likely to get.
The voiceover makes comments such as “training more doctors and nurses”, “expanding the number of GP services” and “providing more hospital beds”. The finale comes when the words health reform fill the screen.
OK, no great enlightenment there either. But given that health is now meant to sit at the heart of Kevin Rudd’s re-election campaign, these advertisements are controversial. Even before this week’s scandal of the government using taxpayers’ money in its TV crusade to bolster its proposed resources tax, the health reform advertisements were raising the debate over whether the public purse should be raided to fund party propaganda dressed up in a see-through negligee masquerading as important “public information”.
Rudd came into power pledging to end the abuse writ large under John Howard. Howard, shockingly, splurged an estimated $200 million on government advertising in his final year in office, the Work Choices ads notorious among them.
So for the first 18 months of the current government’s life, it experimented with rule without self-interest. An advertising code was bought in ensuring information campaigns would no longer be directed at promoting party politics. The Auditor-General was to screen the campaigns before they went to air to prevent the taxpayer dollar being wasted on political fluff.
This system collapsed in March under what looks to the cynic and non cynic alike as the pressure of available opportunities for re-election. An independent review set up by government made various recommendations that mainly involved dismantling the safeguards that were in place. The Auditor-General was stripped of his role. He was not happy. And the task of assessing government advertising was farmed out to an independent committee working to rules imposing the same kind of constraint seen at the Sydney Mardi Gras.
This committee recently backed the commercials you now see on TV. They are part of a wider health reform “awareness campaign”, announced in the Budget last month, that will cost some $30 million over four years.
Ironic then that the health reform advertisements are not offering any kind of useful advice that usually forms the basis of a good old-fashioned awareness campaign — say, telling you that smoking kills, that it’s wise to get your kids vaccinated or carrying excess kilos is a health risk.
Yes, there are some factual tidbits. It is true that there are meant to be more doctors and there will be more hospital beds. But if you want to stick strictly with the facts then these ads should also be saying the government is setting up an enormously complicated funding structure, it seems to have little idea of the actual governance arrangements in this new system, and yes, there will be new performance standards but beyond a four-hour waiting time for ED, no one is quite sure what they are.
So what is the precise public benefit of these ads?
The other issue is the timing. Even if you believe that patients need to know this stuff, stuff already given blanket media coverage in the past three months, it’s hard to argue that they need to know this stuff right now. Most of the reforms won’t be implemented this year or even next year. They will only come after the federal election — provided Rudd wins.
We are talking about 2012 for those practice nurse payments and GP registration for diabetic patients, 2013 for all the Medicare Locals to be up and running. And given the time it takes to churn out medical practitioners, it’s going to be a longer wait before the new army of fully trained doctors march on the health system in great numbers.
So it is curious that that the independent review committee managed to judge it was worthwhile that the bulk of the taxpayer-funded cash for this “awareness” exercise (about $18 million) should be spent in the next 12 months.
But then the next 12 months will see a federal election. It is this, of course, that makes these advertisements less about health reform and more about raising the public’s awareness of the government’s cynicism.
*Paul Smith is the political editor of Australian Doctor. This is an edited version of his column, which appears in the latest edition