Court kills a health system

Article published in The West Australian (27 September, 2000)
Reprinted with the permisson of Tony Rees

In dismissing the concerns of doctors at the ravaging of Princess Margaret and King Edward hospitals, Premier Richard Court has probably made the biggest mistake of his career.

Admittedly, he had a few beauts to beat - the misreading of public feeling on continued logging in old-growth forests and his apparent indifference to the plight of investors ripped off in the mortgage broking scandal - but the health crisis is Waterloo material.

Mr Court showed last week that he, too, has been bamboozled by the State's health bureaucrats when he issued his contemptuous and contemptible statement that medical staff unhappy with the new regime were in the minority and hell-bent on undermining the hospitals' credibility.

What a bizarre and unkind twisting of the truth this is. Just how unkind and bizarre I have learnt since I first wrote four months ago of rumblings in the medical ranks over changes to the health service.

The reaction to that column in Big Weekend was astonishing. Copies appeared on notice boards in public hospitals around the State. Doctors, nurses and other health workers rang and wrote to me. I cannot recall in nearly 40 years as a journalist such a unanimous and clamorous response.

An unusual aspect of this feedback was that it came from professionals used to working in a culture of confidentiality and caution. Journalists are the last people they customarily talk to. It is a measure of the depth of their concern and desperation that the system was ignoring them that I found myself on the receiving end of their confidences.

Lest the powerbrokers in the health service accuse me of partiality, let me state that I am no champion of the medical profession. I have written unfavourably of the excesses and incompetence of some of its members and will do so again if the opportunity arises. Neither was I acquainted with any of the doctors who contacted me with their apprehensions.

However, I came to share their fears for the future of the best public health system in Australia as they revealed to me the extent of the State Government's plans to emasculate the role of the teaching hospitals and devolve health care delivery through cheaper peripheral centres under the sanitised euphemism "clinical streaming".

When I wrote about this Health Minister John Day invited me to a "briefing" with two senior Health Department officials, one a medical doctor who explained enthusiastically the benefits of delivering health services where the patients lived. It sounded terrific and I went away to read a weighty, very classy and very expensive publication called Health2020, which outlined the brave new world of medicine delivered by accountants.

The conclusion I reached is that, like most people - particularly the sick - I would rather have it delivered by doctors.

A further article led Mr Day to question, in a letter in the Australian Medical Association journal Medicus, my understanding of what his Government was trying to achieve and accuse me of cynicism.

Well, Mr Day and Mr Court, I have listened to your experts. I have read their propaganda. I have listened to questions in Parliament, and your responses. And I have been unable to discern anything that effectively refutes the assertions to me by medical professors, surgeons, paediatricians, senior nurses, anaesthetists, physicians, obstetricians, orthopaedic specialists and medical managers that your Government is determined to sacrifice first-class public health care on the altar of cost-saving. And that it would prefer a seamless transfer of treatment to the private sector.

Your recent reappointment of Alan Bansemer, a former Federal Government head-kicker, as Health Commissioner, and your choice of Andrew Weeks, an accountant whose scalpel is used only to cut costs, as head of the Metropolitan Health Service, are clear indications of your intentions. If confirmation was needed, it is provided by the continuing employment of PMH-KEMH chief executive Michael Moodie, who has single-handedly offended almost every senior medico at both hospitals, brought morale to an all-time low, damaged the future recruitment of qualified staff and, through these actions, threatened the provision of first-class paediatric and obstetric care previously given in this State.

Mr Moodie resigned from his last post, as chief executive of the Greater Murray Health Service in New South Wales, having earned a reputation as a slash-and-burn merchant with poor communication skills and scant regard for the niceties of professional health care delivery. The fact that clinical staffs at KEMH and PMH passed overwhelming and unprecedented votes of no confidence in their chief executive soon after his appointment should have indicated to Mr Court was this was not a bothersome minority of whingers but a sincere majority with deep concerns.

He should have listened to them, sent Mr Day on extended leave and sorted out the mess. That he didn't can only be interpreted as an indication that the Government is prepared to accept lower public health care standards if this will save money, though the financial repercussions of second-rate hospital services may well prove a false economy as malpractice actions increase.

This brings me back to my earlier point about the bizarre and unkind twisting of the truth. It is grotesque for Mr Court to imply that hospital doctors and nurses have some sinister political motive in protesting against his Government's policies. Of all public employees, these must be the least adequately recompensed for the job they do. They stay in the public system while their mates in private practice earn small fortunes, because they believe in it. They are proud to provide world-class treatment and proud of their teaching institutions. They work ridiculous hours, perform miracles on a regular basis, suffer their sadness in silence and, through it all save lives. His peremptory dismissal of their selfless dedication is a disgrace.