Introduction
Over the recent past, the issue of transferring financial control of public hospitals from State Governments to Commonwealth Government has been controversial. Some people have been opposing the idea while others have strongly supported it. The proponents of this idea have various reasons for supporting it.
The Commonwealth mostly funds health care services through general taxes which represent 56% of the total funding (Hilless, Healy, 2001, p. 81). This level also funds health services through Medicare levy on taxable income. On the other hand, the state government has been getting its funding for the health services from the specific revenue grants and commonwealth general revenue and from the state’s general revenue (Hilless, Healy, 2001, p. 81).
General Review of the Topic
There are several arguments why majority of the people are supporting the transfer of financial control of the public hospitals from State Governments to commonwealth Government. According the report announced by the Prime Minister, the Common wealth government is expected to bring many developments in the Australian health and hospital system under the new reforms (Queensland, 2010, p. 1). According to the proposed reforms, the Commonwealth Government will be responsible for the funding of public hospitals (Queensland, 2010, p. 1). The Commonwealth Government will also be responsible for the health care services. Over the past, the Australian Government has been funding the public hospital system jointly with the state and territory governments (Anonymous, 2011, par 3).
The National Health and Hospitals Reform Commission are responsible for structuring of the long-term health plans (National Health and Hospitals Reform Commission, 2008, p.1). This plan for reforms was developed after a concern of the poor quality health care services provided in Australia. It was also formed with an aim of finding solutions to any problems which may rise in the future.
Under the proposed reforms, the Local Hospital Network will be given the responsibility of running of hospitals. In other words, the local communities through small groups of the public hospitals as well as the professional practitioners will be able to present their views on how the health services are delivered. This will play a very significant role in health services. This is unlike the centralized system when it was difficult to pass one’s views. This system can maintain a high level of patient satisfaction since the services will be provided based on their views.
Under the new reforms through Commonwealth Government, the formed networks will be funded from the national level and this will be carried down by the Local Hospital Networks (Queensland, 2010, p. 1). This system of running will encourage flexibility in the system as well as innovation. This system also encourages the participation of the public in sensitive matters concerning health services they receive (Duckett, not dated, par 5).
In the new system, Commonwealth will use the territories and states in carrying out the intended operations. Commonwealth differentiates between different branches in the provision of health care. These include primary, acute care and the community care.
The Major Arguments for Transferring Financial Control of Public Hospitals from State Governments to the Commonwealth Government
By taking the financial control over the public hospitals, the Commonwealth Government intends to fund 60% of the efficient price of the services provided by the public hospitals (Queensland, 2010, p. 2). This is an increase by a margin of 25% from 35% under the previous system. This is one of the main arguments for Commonwealth taking financial control over the public hospitals. The implication of these statistics is that Commonwealth will improve the quality of the services provided. This will significantly contribute in improving the health in the entire nation. According to Larbi (1999), most public operations have failed due to the structure of the management (p. 17). Reforms are therefore very important in improving the quality of services.
Before the changes in financial management were made, Commonwealth funded most of the primary care through Medicare (Gillespie par 1). It would therefore be more efficient for it to continue with the funding of community nursing and other primary care services. By giving Commonwealth control over the entire primary care services, it will be easier to make necessary reforms. It will also ensure accountability in the activities. It will also be easier to coordinate different activities.
Commonwealth has recognized the importance of investing in research. This system proposes to spend 60% of the recurrent expenditure for the purposes of training and research (Queensland, 2010, p. 2). Research and development plays a significant role in the health sector as it improves the quality of services provided to the patients. It also helps in improving the quality of drugs hence improving the quality of services provided.
According to Gillespie (2010) shifting financial responsibilities to Commonwealth Government is the best way through which the problems of laying blames on each other can be solved (par 4). This plan targets at making radical changes in the health care in order to improve on the services provided to consumers (patients). The Commonwealth management is aims at maintaining accountability in the management.
The high level of unaccountability on public hospitals has reduced the public trust and morale. By shifting financial responsibilities to the Commonwealth government, the public will regain the lost confidence as Commonwealth will be held responsible for any activity in the public hospital. It becomes easier to criticize the system as there exact person to hold responsible because responsibilities will be clear. This will significantly increase the public trust for the public hospital management. Under the previous system, it was difficult for the public to identify who is responsible for what.
Gillespie (2010) observed that the only feasible solution through which the problems in public hospitals can be minimized is by giving one level of government all the responsibilities in the entire health system (par 5). In an effort to achieve these changes, National Health Partnership agreement proposed a plan by allocating the responsibility of funding public hospital system through the Commonwealth Government.
Commonwealth has also planned to improve the public hospital infrastructure which is already in a bad condition. It has put aside 60% of the capital expenditure for these purposes. This is another reason why many people have opted for Commonwealth taking control over the financial control of the public hospitals.
In Australia, the ageing population is expected to increase (National Health and Hospitals Reform Commission, 2008, p.1). There is therefore a need to make the necessary adjustments in the health services in order to meet the demand of health care services in the future. The planned changes in the financial responsibilities is just one of these reforms which will ensure that every person get the necessary care services.
Another argument for shifting financial control in public hospitals from State Governments to Commonwealth Governments is to form an independent price setting system (Queensland, 2010, p. 1). Through the Commonwealth Government, the price setting process will be efficient than before. In addition, decision making in an independent body is faster than when there is high level of dependence.
In order to realize the projected developments effectively, Commonwealth Government increased more finances on training of the nurses and doctors. More investment was also directed to general practice services and personally-controlled electronic health records (Queensland, 2010, p. 1). The Commonwealth Government management in public hospitals also targets to improve services by providing training in areas where there had been shortages under the former system.
Under the Commonwealth, the Local Hospital Network will receive funding directly for each hospital service they provide (Queensland, 2010, p. 1). This system of disbursing funds is very effective as it discourages misuse of funds. It ensures that every amount of money released is spent. This will significantly lead to the improvement of health services to the people.
Under the Commonwealth Government control, one of the major developments is the introduction of the National Health and Hospitals Network (Queensland, 2010, p. 1). The main reason for the formation of these networks is bring together the eight states together. This will help in improving the quality of services provided in hospitals.
In the modern world, the level of technology has raised up significantly. Therefore, there is a need to employ more cost effective methods in running public hospitals (Armstrong, 2007, par 4).
Over the past, the health system had been characterized by a complex management system where funding and responsibilities were distributed among different levels of governments (Queensland, 2010, p. 1). This has reduced the performance in the health care services. There is a need to have one level of government which will be assigned the management of various activities. Otherwise, the performance will remain low. When the responsibilities are distributed between different levels, the level of accountability tends to be low. This will lead to poor services in the health care services.
Another reason which has been used to justify the financial responsibilities to the Commonwealth Government is to speed up rate at which patients are attended to. For instance, members of the public have been forced to queue for a long period before they are served (Anonymous, 2010, par 3). Reforms are expected to increase the level of efficiency.
The State Government and the Commonwealth government have been competing over the interests and affluence from the citizens. The relationship between these two sides is characterized by antagonism. Consequently, each side has been blaming the other when certain field in the system fails. In order to eliminate these blame games, common wealth should be allowed to control all financial activities (Pincus, 2009, par 9).
According to Pincus (2009), the Rudd government had threatened to take public hospitals from the states if they don’t correct problems (par 15). This implies that the State government has not done enough in the health care. This is despite of the importance of the health care services to the nation and therefore changes in financial management are justified.
Main Issues and Problems in Provision of Health Services
In Australia, there are eight different state health systems. The distribution of responsibilities between the different levels is unclear which results into a high level of inefficiencies (Anonymous, 2011, par 3).
In the same time, the health services costs are increasing at a very high rate (Lutter, 2010, p. 2). This is one of the main factors which have led to increase in these costs is the blame games among the management. The former system is inefficient and therefore related with high level of operational costs. Consequently, these costs are passed to the public who ends up paying high charges for health services. The new reforms will help in reducing health services costs by improving the level of efficiency.
In Australia, the number of the youth who are likely to acquire sexually transmitted diseases has increased by 6.5 times in the indigenous youth (Mackean, not dated, par 8). Therefore, it is necessary to have proper management to combat these infections. However, the quality of the health services in Australia has been falling each day (Dwyer, 2008, par 2). Thais has raised a concern since the demand fort these services have been increasing. The situation therefore poses a big problem in the future.
A study by Brown et al (2010), shows that there was poor care and poor health outcomes of the services provided in public hospitals (p. 8). There is a big gap between the community and the community care. That is, the community is not involved in decision making. There is therefore need for reforms to improve on these.
Over the past, the budget has been constrained the public service which has forced people to seek for private health care services (Oxley & MacFarlan 1995, p. 18). There is also increased waiting period where the patients takes a long period before they get treated. This is another factor which has forced the majority to seek for private health care services. In Australia, there are both private and public health care system (Hall, 2009, p.1). However, the health services provided to the consumers still remains unsatisfactory. Congestion still remains very low with people waiting for so long before they get attended to.
The problems of the chronic disease has also been increasing hence increasing the burden (Australian Government; Department of Health and Ageing, 2011, par 1). In order to tackle this problem effectively, it is advisable to have changes in the management of public hospitals. Necessary changes should be made in order to meet these costs.
As already noted, there has been a lot of blames between different levels of government over the past. This situation has complicated provision of the health care services. As a result, very poor services are provided to the consumers. This has also lowered the public’s confidence on the public hospitals. It has also forced many people to seek for private hospital services. However, one has to pay for extra costs since one should have private health insurance (Hempton, 2009, par 4).
Therefore, reforms in the health care in Australia have a significant effect to the nation. It can clearly be seen that the changes on the new system will lead to developments in the provision of health services. In the former system, there was confusion of responsibilities since each could blame the other for the areas poorly performed.
In other words, the reforms in the health care are benefiting the entire nation. It has also improved consumer satisfaction. The government has invested a lot of money in order to ensure that these reforms are implemented. According to Biggs (2010), the budget sets National Health and Hospitals Network which aims at changing the processes in which the public hospitals are funded (par 1).
Conclusion
In conclusion, this discussion has clearly shown that transferring financial control of public hospitals from State Governments to the Commonwealth Government will significantly lead to improvement in the health care. This is because the new system is characterized by high level of efficiency and accountability.
Under the new system, any shortcoming in provision of the health services can be blamed on sole party unlike the older system where each participant used to blame each other when mistakes occur. The blame game and shifting of costs has led to inefficiencies in the health care services. The shifting of financial responsibilities from the State Government to the Commonwealth Government is therefore justified.
The new reforms also encourage research which has also contributed in improvement of the services rendered to the consumers. In other words, the new reforms have led to improvement of the health services.
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