By Leslie Warne
WOLLONGONG — "This hospital is essential to the ongoing welfare of mineworkers and the community", mineworkers' union organiser Bob Graham told a 1000-strong rally at Bulli hospital in early April. The Greiner government's cuts to local health services are causing deep anger and protests throughout the Illawarra region.
Since January, local services have been hit by a round of high-level resignations including Health Board chief executive officer John Rasa, chairperson John McKenna and his deputy, John Hinton. Two further resignations from the board are expected as protests continue over cutbacks recommended in the government-commissioned Reid-Harris report.
The cuts come as the area's health needs are increasing due to population growth and large numbers of retirees moving in. As well, John Rasa estimates that demand on Illawarra public health services has increased by around 5000 over the past two years because of people dropping out of private health funds as a result of the recession.
McKenna's and Hinton's resignations were a direct response to the closure of Kiama hospital after the NSW Health Department rejected a board-backed proposal that a local cooperative be allowed to run it as a self-financing, mixed public-private facility.
The Kiama closure and proposals to downgrade Bulli are widely seen as part of an attempt to privatise the most profitable parts of the health service by cutting public health facilities. Both hospitals have operated largely within their budgets. There are also suspicions that the attacks on them are due to their location on valuable real estate.
As well, residents are concerned about threatened reductions of ambulance officers in the Shoalhaven region, serious problems in pensioner dental clinics — including official waiting times of 18 months — and inadequate services in local hospitals, which are thought to have caused the death of a baby girl.
Speakers at a recent Politics in the Pub discussion said the Reid-Harris report was not based on community consultation, and merely aimed to shift some health care costs out of government budgets. The report failed to consider changes to clinical practices that could greatly reduce health costs while maintaining high quality services.
Anna Whelan of the Save Bulli Hospital Committee says small hospitals such as Bulli and Kiama play an important role in health care, because they are more accessible and can provide services at lower cost than larger institutions. In Britain, community hospital closures were an early part of the Thatcher privatisation drive, but now pressure on forcing the Tory government to reopen some of them.
Statewide, the Greiner government wants to cut beds in local hospitals from 21,000 to 17,000. This is in line with a federal Labor government calculation that the state is oversupplied with beds and should aim for a ratio of 3.5 per 1000 people, lower than any other state.
Adding to the pressure on local health services is the government's policy of appropriating 50% of revenue they generate into general revenue. It is expected the drain on government health services will continue as private operators move in on the more profitable areas, while exploiting high-cost services in the public sector to subsidise their operations.
This will become even more systematic as patients from private hospitals (often on the same site as public facilities, as in the case of North Shore in Sydney) are shuffled to public hospitals for expensive procedures financed by the public purse, then returned to the private hospital, with the lion's share of fees going to private doctors.
If the government has its way, the situation for public health services is about to get worse; the Liberals' rationalisation program requires a further 3% productivity saving from the health budget in the coming year. Asked how this could be achieved, John Rasa said he assumes this is the purpose of Greiner's new industrial relations legislation.