Grim guessing game for health sector
The shadow of a $332 million cut to the state’s health budget has speculation running about which hospital or services might be cut – but some early speculation seems wide of the mark.
The Advertiser is reporting that senior officials have singled out Modbury Hospital for potential closure, but InDaily understands that option is highly unlikely.
Treasurer Tom Koutsantonis yesterday made an unusual move in his first budget, saying that the Government wanted to talk to the health sector and the wider community about how to allocate a $332 million cut to health, flowing from the Federal Government’s budget.
However, he made it clear that the cut might not be made in the health portfolio alone – it might involve the closure of a hospital, specific services, beds, or even an entire government department.
This morning he said he wasn’t sure why Modbury Hospital was being singled out.
“I don’t know where this story has come from,” he told ABC radio. “What we said yesterday (was) it may mean a hospital closure, but we didn’t single out Modbury. I don’t know why Modbury all of a sudden is the one.”
He said Modbury was “no more, no less” vulnerable than any other hospital, but InDaily understands this isn’t quite the case.
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Given it has a busy emergency department and serves several marginal Labor seats, the Government would be very reluctant to close it. Many other options would have to be assessed and dismissed before a Modbury closure came under close consideration.
Koutsantonis again emphasised today that, while he’d be talking to doctors and nurses about “how best to implement these cuts from Canberra”, the pain would not necessarily be quarantined to health.
“It may not be changes to health care; it may be changes to the rest of the government or maybe more revenue increases,” he said.
The SA chairman of the College of Surgeons, Dr Peter Subramaniam, said that shutting down a metropolitan hospital might have a short-term fiscal impact, but it would simply place additional pressure on other parts of the health system.
“The 2014 state budget acknowledges the problem we have – a health system that was not sustainable even before the announced federal cuts and certainly a long time before this state budget was delivered,” he said.
“It is a positive and welcome step that the Treasurer and the government continue to desire input from doctors and other groups advocating for a high quality health system. The colleges and other representative groups can provide sound advice to government but we need to engage in a constructive conversation – where information from administration and executive is consistent and openly shared.”
Subramaniam said the Government’s response to feedback from health professionals had not been “particularly consistent” in recent times.
He singled out SA Health’s new e-health system – the Enterprise Patient Administration System (EPAS) – as an expense which should be up for discussion.
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“It has cost at least $480 million to date.
“In its current state it fails to do all that it was intended to do. And surgeons are concerned that EPAS in its current form is very likely putting patients at risk – with examples of reduced clinic numbers, frustrating difficulties accessing required patient records and, in at least one situation reported to the college, resulting in a delay accessing urgent surgical treatment because of an EPAS related issue with – fortunately – no adverse consequences.”
He said the college did not oppose EPAS, “however, we do not believe busy public hospitals should accept and install a product that required a significant outlay until that product does what it was designed to do”.
“This should form a part of the conversation the Treasurer, in handing down the budget, has indicated he would like to have with clinical groups on cost rationalisation in health.”
Shadow Treasurer Rob Lucas also highlighted blow-outs in SA Health’s IT projects as an area that required close examination in the context of controlling public sector over-spends.
“What you actually need is some tough financial management in relation to these departments,” he told FIVEaa.
“Last year they overspent overall by $300 million. Ever year they overspend by about about $300-400 million. You’ve got to learn to live within your means.”
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