Image for Public Hospitals: Cost up, Services down, Safety poor

A new report on Tasmania’s public hospital performance has found the number of hospital doctors fell by 206, or 21%, on a full-time equivalent basis in the two years to June 2013.

But the average salary paid to each remaining doctor rose by 31% in the same period. This is due to individual ‘sweetheart deals’ that many surgeons, and some physicians, have been able to negotiate with hospital administrators, outside of the official industrial relations system.

For junior doctors, who are bearing an ever-greater share of responsibility for patient care, salaries have not moved.

Nurse numbers fell by 167, or 6% but the cost of employing each remaining nurse rose by 12%, mainly due to increased overtime.

The analysis of official national figures was compiled by independent health policy analyst Martyn Goddard.

In other findings:

• Key measures of the safety and quality of care, released for the first time, show Tasmanian public hospitals are among the least safe in the country, far more likely than their interstate peers to harm their patients.

• Tasmania has far fewer hospital beds per capita than any other state or territory.

• This state treats far fewer patients, on a per capita basis, than any other state or territory.

• Overall costs of running our hospitals have risen substantially faster then the national average.

“This report shows that the damage inflicted on the health system by the former government’s budget cuts of 2011 was not being repaired, as the former Minister repeatedly claimed at the time, but was accelerating,” Goddard said.

“We already knew Tasmania had the least efficient, most inadequate and worst managed hospital system in the country. What we did not know is how much worse it became in such a short period.

“These figures show the Tasmanian hospital system is at a crisis point. And with the further cuts outlined in the federal budget, that crisis is about to become even deeper.

“A fundamental redesign of the state’s hospital system is now urgent. All aspects need to change, from overall governance to the way things are done on the wards. Doctors and nurses must be empowered to drive change and efficiency within their own areas.

“Above all, we must have a system which puts the Minister for Health in final charge. One of the reasons for the current chaos is that, because of the way National Health Reform was implemented in Tasmania, nobody is in control. The buck never stops with anyone. It just keeps going round and round, and ‒ as usual ‒ the people who suffer are the patients.”

Download Costs up, services down, safety poor: A new analysis of Tasmanian public hospital performance by Martyn Goddard


*Martyn Goddard was a journalist and documentary producer, mainly at the ABC in Sydney and Melbourne. He has also worked as a publicist for the Adelaide Festival and publicity manager for the South Australian Theatre Company, and set up ABC-TV’s first national arts current affairs program. His current primary focus is as an independent health policy analyst based in Hobart. He has been a member of several key Commonwealth committees, including the peak ministerial advisory group on AIDS and hepatitis, and was the first consumer member of the Pharmaceutical Benefits Advisory Committee, which evaluates drugs for listing on the PBS. He has conducted many policy reviews and submissions for Commonwealth and other organisations, and is a former health policy spokesman for the Australian Consumers’ Association.

Martyn Goddard’s extensive analyses of Tasmania’s health system - and other articles - are available HERE

Cassy O’Connor: Time to Rationalise the Three Tasmanian Health Organisations into One