Coalition push to dismantle health system

A ‘save Medicare’ rally in Sydney on February 15. Photo:

The Tony Abbott government, in line with its ruthless drive to privatise all remaining public sector assets, last month announced a plan to sell off Medibank Private during the 2014-15 financial year. Following the secret recommendations of the government's big-business-controlled Commission of Audit, the federal budget in May is likely to include further attacks on Medicare — undermining its character as a national, universal health-care system.

In addition to the growing privatisation of the federal health-care system, state government-run health services, including the public hospitals, are gradually being eroded by private hospitals and clinics. The ideological pressure to expand the coverage of private hospitals over public is increasing, but is also being strongly challenged.

Alison Verhoeven, chief executive of the Australian Healthcare and Hospitals Association (AHHA) said on October 14 last year: "Privatising the governance of public health-care, as proposed in a report released today by the Centre for Independent Studies (CIS), [a right-wing think tank], is not an optimal solution to address rising health expenditure.

"The CIS report ... is based on a number of assumptions which the AHHA challenges. Firstly, the report suggests a direct relationship between increased public health expenditure and inefficient delivery of services in the public health-care sector ... Most emergency services, intensive care and non-elective surgery (by their nature, largely more costly and resource-intensive) are provided by public hospitals. There is no robust evidence to suggest that private hospitals would deliver these services any more efficiently or cost-effectively than public hospitals, despite this being the basis of the CIS report's proposals."

Neoliberal lobbyists like the CIS are supporting the current trend for federal and state Coalition governments to outsource hospital and specialist health care to the private sector — despite the evidence and public opinion favouring a universal, public health-care system at primary care and hospital levels.

The Australian Financial Review said on April 13 last year the Coalition would press "for an increase in the number of public hospitals run by private operators if elected, expanding on models developed in the Liberal-led states of Queensland and Western Australia. The move would be a boon to private health providers in the country, including listed private hospital operator Ramsay Health Care."

The NSW Coalition government announced last May that a private or not-for-profit operator would run a new hospital for Sydney's northern beaches. Labor state opposition health spokesperson Dr Andrew McDonald told ABC News: "This happened 20 years ago at Port Macquarie and that was a game that ended in tears. I've got major concerns about the ability of the private sector to deliver health care to everyone who needs it, irrespective of needs or ability to pay, for the next 20 years.”

In March, NSW Nurses and Midwives Association (NMWA) secretary Brett Holmes called on the NSW government to "come clean about its plans for the new Maitland hospital at Metford ... We have a right to know if the government intends to continue shirking its responsibility to provide public health services, favouring profits over patients and a universal health system.

"History shows a alarming rate of failed public-private hospital partnerships across the country, including Port Macquarie Base Hospital, Victoria's La Trobe Regional Hospital, Modbury Hospital in South Australia and Queensland's Robina Hospital.

"Last December, the Queensland government reversed a decision to privatise the new Sunshine Coast Public University Hospital, citing 'the private sector can't match the public service on cost.'

"Meanwhile in Western Australia, the newly privatised Fiona Stanley Hospital is already suffering from a postponed opening date and staff shortages across a number of specialities.”

In addition, the creeping privatisation of specialist health services, including under the previous Gillard Labor government's National Disability Insurance Scheme (NDIS), continues. In New South Wales, the O'Farrell Coalition government "rushed through with obscene haste laws that codify privatisation as the only option," the NMWA said in December last year.

"Buried deep in the [NDIS] agreement is a clause which states: 'following the commencement of the full NDIS, the NSW government will not provide any residual specialist disability services or basic community services’.”

Holmes said: "The NDIS is a worthy reform that is long overdue and strongly supported by nurses and midwives. But it has never been put before the community that it is to be a fully privatised system."

More recently, the NMWA has campaigned against plans by the NSW government to shut down the public disability care Stockton Centre in Newcastle and to privatise all disability services in the state. Holmes said on March 11: "Thousands of vital nursing jobs across NSW are at risk as a result of the O'Farrell government’s privatisation plans, with no assurances current public sector pay and conditions would be offered by private agencies.”

The Coalition push to privatise health care at all levels echoes the Conservative Party’s drive to destroy Britain's iconic National Health Service (NHS) in recent years.

The NHS is being dismantled from within, by piecemeal privatisation of key elements of the public system, while retaining the NHS label.

In addition to the attacks on Medicare, and the plan to sell off Medibank Private, Coalition governments around the country are stepping up the outsourcing and creeping privatisation of hospital and other specialist health services.

The labour movement and the community urgently needs to declare an end to the further privatisation of the health-care system.