The Advocate (2 December, 2019) reported on the recent Tasmanian Chamber of Commerce and Industry (TCCI) 2019 Tasmania Report, noting it paints 'a grim picture of the state's future if targeted investment into critical services is not achieved.'
The underlying issue, that almost everyone avoids talking about, is the government's unsustainable fiscal position. The State government is in the same position now as it was when it won government in 2014. We spend more than we receive. The imbalances will worsen. There are no cash buffers. There are no funds set aside for a rainy day.
The economic success and benefit is not being shared as the gap between economic and social outcomes has failed to close.
The problem requires acknowledgement and tangible solutions.
The economic success in not being translated into areas including the delivery of healthcare.
The economic success in not being translated into areas including the delivery of healthcare. Tasmania has an aging population and high rates of chronic illness. However, this isn't the main reasons for rising costs and blown budgets every year.
Health budgets are destined to fail each year as each year the government's health budget is less than the preceding year's actual spending on health. When more money is needed, as it always is, the government repeats the mantra 'record spending in health' as the additional amounts are found from elsewhere. Thus other areas of government activity, usually infrastructure spending, is curtailed to meet health cost demands. Last year $120m less was spent than budgeted on infrastructure.
In the recently completed year 2018/19 hospital (THS) was $164 million over budget. In 2017/18 the overrun was $161 million. The budgets for this and next year are both less than the amount spent in 2018/19. It is hard to accept that after a year marked by ambulance ramping, emergency department overcrowding and real risks to patient outcomes, the government is planning to spend less.
The cost of health care delivery is growing faster than other areas. Given current circumstances, as a minimum, a health budget needs to be based on the previous year's actual spending plus five per cent as recently highlighted by Treasury, and is based on past outcomes driven mostly by new technology and treatment methods.
Surely the Government doesn't believe its own rhetoric that we're basically on track. Otherwise why has it allowed the health crisis to spiral out of control in the way it has? The Opposition doesn't admit to major underlying problems, nor offer tangible solutions. We don't need more inquiries. We've had so many saying similar things. We simply can't waste time waiting to confirm what we already know. Adversarial politics at the State level has failed to provide meaningful options. Robust adversarial contests of ideas, long championed as the hallmark of our parliamentary democracy, have been reduced to sniping battles between the disingenuous and the frightened.
We need a new way. I have written to both the Premier and the Leader of the Opposition detailing my concerns, suggesting the establishment of a non-partisan, strategic health reform panel with membership comprised of all parties. I don't make this suggestion and offer to participate lightly. The delivery of health care must be above party politics requiring a future focussed, cooperative approach to reforming the health system. As a health professional in my earlier life, I have a valuable insider's view how the health system works.
This is not another committee or inquiry. Rather the panel's role will include development of short, medium and long term strategic reforms and actions to address current and future challenges; recommend, oversee and monitor agreed reforms; be supported by Department of Premier and Cabinet to ensure a 'whole of government' approach; and meet on a monthly basis, reporting regularly to Parliament and thus, the people of Tasmania. It will not interfere with other government operations. Once a health operating budget is agreed the Minister can get on with the task of administering it with willing assistance of the panel.
A non-partisan approach has the capacity to enable open, frank and bold discussions about the future of health services with a better chance of progressing to necessary, courageous decisions which are often too difficult in an adversarial environment.
There are lots of things we can do if we are prepared to work together. We need to question everything we do and not be afraid to try something new.
Our future depends on it.
The Advocate Friday 6 December, 2019