“There is a hung parliament, the states are not being cooperative, and the commonwealth budget is under even more pressure,” Dr McGirr said. “It looks like the health reform and the extra funding for growth will be gone.”
“Where will this leave our health services already struggling with costs?” Dr McGirr said.
Dr McGirr has been a consistent critic of recent health reforms by NSW: he has questioned the degree of control local services actually have and their level of funding. Further changes could make this even more confusing especially if hospitals have to report to the commonwealth and the states.
“This is becoming a bureaucratic nightmare”
“The community wants to know: who is running local services, how they are funded, who is accountable and at the end of the day be in a position to clearly see the outcome of these services as they are implemented in the area in which they live,” he said.
“Above all they want services created which are and clearly and adequately funded.”
In addition rural and regional services have unique pressures – staffing and travel costs are a huge factor. This means that implementing Health initiatives for Wagga Wagga as an example are significantly higher than the metropolitan areas. These costs need to be assessed over a broad area and taken into account in any funding formula.
Dr McGirr does believe the proposal for the commonwealth to fund hospitals directly, rather than through the states, could have benefits – as long as the funding is sufficient, and, it is clear how funds are given and the pressures on regional and rural services are taken into account.
“Funding services directly would make things clearer – which is critical”, Dr McGirr said. “But will there be enough funds for regional centres?”
NSW has made some changes, although Dr McGirr believes state pressures drove this more – especially the unpopularity of the large Area Health Services.
“The Area Health Services were seen as needing reform – my question still is – how much reform do we have? Or are our services still being run from Sydney?” Dr McGirr said.
And the concern about federal funding raises questions for a new Wagga Wagga Base Hospital.
“After the current round of infrastructure funds are gone, it looks like there will be no point going to the Commonwealth for more money. It will be back to the state government – so once again we need the major parties to commit to a timeline for the complete new WWBH.”
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