Hang On – Are Local Hospital Boards Really A Good Idea?

The Coalition released their health and hospitals policy today, including a pledge to establish local hospital boards. Before the paperwork stacks up too high, Jennifer Doggett has a closer look at the policy

For a party that professes to support efficiency and aims to reduce bureaucracy, the Coalition’s policy to establish local hospital boards for every public hospital is curious.

There are 737 public acute hospitals in Australia. Tony Abbott’s proposal will create 737 new local hospital boards. This means the creation of 737 Board secretariats, 737 sets of meeting papers to be prepared every time the Boards meet, 737 sets of resolutions to be recorded and monitored and reported against and 737 separate bodies fighting each other for a share of the health resource pie.

This is bureaucracy gone mad.  It will tie up valuable resources, impose a massive administrative burden on hospital management and establish hospitals as competitive fiefdoms rather than collaborative partners in an integrated health system.

Abbott’s plan will create no incentives for hospitals to achieve efficiencies across the spectrum of the heath system, for example, by reducing unnecessary hospital admissions. In fact it will encourage wasteful duplication of services as hospitals compete with each other for limited health funding.

Of course it is essential that doctors and nurses have input into hospital management. However, it makes no sense for hospitals already struggling with workforce shortages, to take doctors away from patient care to discuss non-clinical issues such as the location of a new car park or the tendering arrangements for the hospital canteen.

Similarly, while it is vital that the community has input into the allocation of health resources and the provision of health services, there are more effective models for achieving this aim than the inclusion of a single community representative on a hospital board.

Citizens’ juries are a proven mechanism for obtaining community views on priorities for resource allocation across the spectrum of the health system, not just for one service in isolation. Another preferred model for engaging the community is to involve consumers in broader governance bodies, such as local area health authorities which have jurisdiction over a range of health services. This gives the community a real say in where resources are allocated and the ability to promote greater coordination and integration across different sectors of the health system.

Abbott’s plan for hospitals will entrench the worst features of the Australian health system and do nothing to drive the improvements needed to ensure we can meet the health care challenges of the future.