Block funding welcomed
Thursday, 25th March, 2010
A promise that "block funding" will be given to small hospitals under changes to the health system has been welcomed by the Greater Western Area Health Service'sadvisory council.
During his debate about the health system with Opposition Leader Tony Abbott on Tuesday, Prime Minister Kevin Rudd said that "some sort of block funding" would be given to small hospitals as part of his reform plans. The announcement follows concerns from NSW and other states that country hospitals will suffer under"activity-based" funding whereby money is only paid per patient treated .
Greater Western Area Health Advisory Council chairman, Dr Steve Flecknoe-Brown, said this funding model was unsuitable for hospitals in the far west. Yesterday Dr Flecknoe- Brown welcomed the prime minister's announcement, which he suggested was a direct result of the GWAHS highlighting the issue.
"It was such a relief to see that because we thought that either nobody was listening or that their ears were closed," he said."But that was a very important concession."
Dr Flecknoe-Brown said the GWAHS was the first health service to "identify and respond publicly" to the issue when the government revealed its health reform plans two weeks ago. The State's concerns were based on economic modelling by the University of Woollongong which found that hospitals with beds of 10 or fewer and up to 50 were vulnerable under activity-based funding.
In the far west this includes hospitals or clinics in Tibooburra, White Cliffs, Wilcannia, Ivanhoe, Menindee, Wentworth and Balranald.
"(For) All of those it would be almost impossible to fund them on the basis of activity," Dr Flecknoe- Brown said. "The Commonwealth recognised it wasn't just an issue) from the far west of NSW, it's a huge problem all over Australia and the prime minister acknowledged that there would have to be special arrangements for small rural hospitals."
Larger base hospitals like Broken Hill would likely need a different funding model again, according to Dr Flecknoe- Brown. "Broken Hill is almost unique in Australia and it's not likely that Broken Hill hospital can be funded by either model exclusively," he said. "We must have an obstetrician available 24 hours a day, even though we may be delivery only 400 babies a year."
He said Broken Hill was "probably in the best position" to have the best developed case for this sort of consideration."It will probably be our circumstances that guide the response to other similar hospitals around Australia," he said."Knowing that that concession has been made I have confidence that the unique circumstances of Broken Hill .... will also be taken into account."
Dr Flecknoe-Brown, who met with local health advisory councils yesterday, said that one health advisory member suggested that access-based funding for small or remote hospitals was the solution."It's been discussed academically but this is our opportunity to make sure that it gets on to that national health reform agenda."
While the Federal Opposition is yet to reveal its health policy, Dr Flecknoe-Brown noted that it had promised to reintroduce local boards to "significant" hospitals."How they define significant hospitals will be the key and I doubt very much if that will make any difference to most of the hospitals in the greater western area."