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Govt should expand non-profit hospital role, says Catholic Health


If the Government wanted to put the dignity and interests of patients first, it should consider greater involvement of private, not-for-profit hospitals, Catholic Health's chief, Francis Sullivan says.

Mr Sullivan was responding to reported comments by former health leaders Michael Wooldridge and Russell Schneider who say that market pressures should be unleashed on doctors to reward those who get good results and penalise others, according to a Sydney Morning Herald report.

In an analysis for the Australian Centre for Health Research, Mr Schneider, the former chief executive of the Australian Health Insurance Association, says Medicare is doomed under the current system, in which doctors receive the same fees regardless of competence.

He says health funds should be able to share information such as hospital specialists' patients' readmission and death rates and decide which doctors are eligible for insurance payouts.

Mr Schneider said a fundamental change in ethos was needed: from "funding" health care, which meant health care workers got paid regardless of patient outcomes, to "purchasing" care on the basis of quality.

He cited a West Australian report on cardiac surgeons which showed one had a much higher mortality rate. But because the report was on condition of anonymity, not even the head of the state's health department could find who the doctor was.

Dr Wooldridge, a former federal health minister, backed the Schneider plan, and said the huge database held by Medicare offered the potential to gauge doctor performance and include incentives for better care.

Mr Schneider said schemes showing doctors' performance in the US had lowered mortality rates and reduced costs.

But the president of the AMA, Mukesh Haikerwal, said a British league tables scheme had turned surgeons away from difficult operations.

The Health Minister, Tony Abbott, welcomed Mr Schneider's contribution of "some challenging ideas" but said the Government supported current arrangements where people were free to choose their GP and by doing so were "voting with their feet".

However, Mr Sullivan pointed to another possible solution.

Expanding the role of privately owned public hospitals, such as the 23 Catholic-run hospitals, would enable communities to reclaim ownership of their health needs, he told the Sydney Morning Herald.


SOURCE
Push to base doctors' pay on results (Sydney Morning Herald, 16/11/06)

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Catholic Health Australia

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16 Nov 2006