The Liberal Party has artificially inflated its election health package by over $200 million by including Commonwealth funding in its totals – but without saying so.
The Labor package, nominally $560 million, does not include federal funding. But when the Liberals’ nominal $753 million spend is put onto equal terms, it is likely that the Labor policy is worth more.
After this was revealed, Health Minister Michael Ferguson admitted, and sought to justify, including Commonwealth funding in his party’s totals.
Close examination of the Liberal election documents also shows most of their promised extra beds would not be in place until after the 2022 election. They would have to be re-elected twice for this to happen.
The Commonwealth pays for 45% of the cost of treating every patient and there is a further 7% from the Department of Veterans’ affairs, private health insurance, workers’ compensation and accident insurance. As well, there is 100% Commonwealth funding for many of the most expensive drugs.
At the Royal Hobart Hospital, the package promises an extra 946 staff for 250 beds at a cost of $299 million over six years. However, they say elsewhere that the first of these beds will not be opened until a year after the rebuild is complete. That pushes it out to 2021, three years from now – assuming no further delays. Although a few of the staff may be recruited beforehand, most will come much later.
That concentrates the staffing cost into the last three years, and particularly towards the very end of that period as beds are gradually opened.
The average salary-only staff cost is $106,000 per head per year, an average ranging from senior consultants to cooks and cleaners. That means the total salary costs for the extra staff at the RHH would be $100,276,000 per year. With on-costs (mainly superannuation) included, that figure is likely to rise to around $140 million.
At least half of that money, though, comes not from the state itself but from the Commonwealth and various patients’ insurance cover. That means the cost to the state is likely to be around $70 million a year, or an absolute maximum of $210 million over the three years and probably substantially less.
But the Liberals’ document claims to be putting in $299 million. The only way of reconciling these figures is if they are including Commonwealth funding in their claimed totals, which the Labor Party package does not. Ward fit-out costs are listed separately from these figures and not included in the $299 million.
There are similar results for the north and north-west of the state.
Another problem with the Liberal package is its concentration on Hobart and its almost complete neglect of the northern half of the state.
Apart from the rebuilding program at the Royal Hobart Hospital, which it inherited, the government has not initiated any significant hospital building. The Launceston General Hospital, in particular, is in urgent need of much more space.
The Liberals have promised a somewhat derisory 40 beds, most of which will not be in place until 2023.
Senior doctors have again cast doubt on the ability of the government to recruit large numbers of new staff, even if they want to. Positions already open have not been able to be filled, particularly in the north-east. Unless more senior staff are put into place quickly we can expect more departments in Tasmania’s main hospitals to lose their training accreditation and to be ever more incapable of dealing with sick people needing care.
In the meantime, the problems at the RHH will continue and get worse for at least the next three years. Budget restrictions and administrative incompetence meant the government failed to create enough temporary beds before the hospital’s former B block was demolished.
The result has been a litany of crises, scandals and patient deaths, some of which have been the subject of damning coronial findings.
The hospital has one of the most over-stretched and chaotic emergency departments in the country. National figures show that even before last year’s flu season, it was the third-worst major hospital in Australia for bed block – that is, for patients needing a bed on a specialist ward but being unable to find one.
Since then, leaked figures from within the hospital, published earlier on the Tasmanian Times ( HERE: Hospital emergency crisis revealed in leaked document ), show how much worse the situation has become in the past few months.
*Martyn Goddard is a public policy analyst based in Hobart.