Yes minister, this hospital is full of patients

Those of us with an appetite for the absurd were served up an absolute treat this week by South Australian Health Minister Stephen Wade, who confidently joined the pantheon of comic greats such as Monty Python's hospital administrator who swoons over the machine that goes ping and Yes Minister's manager of the hospital with no patients.

Mr Wade was holding forth in SA's Legislative Council this week on the topic of a turnaround plan devised to extract the Central Adelaide Local Health Network (CALHN) out of a $300 million budget mire it appears to have got itself into.

CALHN, which manages the $2 billion new Royal Adelaide Hospital and the Queen Elizabeth Hospital, is apparently a budget basket case, according to a new report by advisory firm KordaMentha.

Releasing the report, Minister Wade declared that “the diagnosis for CALHN is extremely serious with a cost overrun of more than $300 million, poor culture and a complete lack of financial grip and control”.

“What’s more, CALHN is performing below its peers across a range of patient outcomes and accepted benchmarks.”

To remedy this situation, KordaMentha has been handed $18 million to deploy its plan to cut $276 million from the CALHN budget by 2021, with priorities including improving the efficiency of care, reducing unnecessarily long hospital stays, better workforce planning and increasing financial controls and accountability.

Putting aside questions about the wisdom of putting an insolvency firm in charge of a world-class tertiary hospital facility and its thousands of highly trained clinical staff in the first place, it appears that bed numbers will have to be reduced to achieve the necessary financial savings.

Mr Wade has been vociferous in his defence of the plan, but on Wednesday night he got a touch of the Humphrey Applebys when he declared that there was also a need to cut back on patient volume. “Our hospitals cannot operate effectively if they are constantly full of patients,” he proclaimed.

The SA opposition very helpfully put together a little montage of this utterance on Twitter, complete with a shot of Premier Steven Marshall facepalming furiously and a quick reminder of the time Jim Hacker visited the hospital in north London that had no patients.

“Doesn't it appall you that it's not being used?” Mr Hacker asks the administrator, referring to a brand new operating theatre. “Oh no,” she says. “That's a very good thing in some ways – prolongs its life, cuts down running costs.”

Mr Wade's utterance was obviously made in the context of getting patients out of hospital more quickly and the efficiencies that can achieve, but he's going to have a hard time living that one down.

His counterpart in Queensland meanwhile is putting money into technologies to get patients seen more quickly and cut down on waiting lists for specialist outpatients appointments. In our top story this week, SA firm Alcidion was named as the winner of a $12m contract to roll out some software from NextGate to develop a referrer directory for Queensland's public hospitals. This contract joins one won by New Zealand's BPAC Informatics to roll out its eReferral capability to GPs to make it easier for them to refer patients quickly and efficiently.

We also heard from Primary Health Care, now rebranded as Healius, which is investing a large sum in a new laboratory system, a new medical imaging system and which announced late last week that it had rolled out online appointment bookings for medical centres using MedicalDirector. Former IPN CEO Malcolm Parmenter has overseen a radical change in culture at Primary since the end of the Bateman era, reflected in the choice of new name, silly as it is.

Also this week we headed into the Medical Software Industry Association's annual forum. The MSIA has itself undergone a few changes over the last few years, running without a CEO and relying on voluntary contributions from members. It's looking to change that situation now, launching a search for a new chief executive to lead it into a new year that may see the My Health Record finally go opt-out, followed by a federal election campaign. We should have some news on that executive search before this year is out.

That brings us to our poll question for the week: Do you think the My Health Record will rate as an election issue?

Sign up to our weekend edition or Pulse+IT Chat to vote, or leave your thoughts below.

Last week, we asked whether you thought entering into commercial deals would damage the RACGP's reputation. Indeed, by a wide margin, our readers say: 89.5 per cent said yes, 10.5 per cent said no.

Comments  

+1 # Terry Hannan 2018-12-03 20:21
Kate, this absurdity revealed in your posting and with reference to Yes Minister has a concrete reality. In 1987 it was shown that 19-25% of health care costs went to administration with the predictions (now confirmed) that 33% of health care costs in 1999 would go on administration and in 2010 50% will be spent on administration. This has resulted in no significant improvement in health care delivery. [References available to anyone interested]
# QLD Health staffer 2018-12-06 10:34
@TerryHannan,
I would be interested in perusing the references you mention. It does not surprise me that administrative healthcare costs have risen so much over those periods, particularly with the (slow but steady) move towards greater digitisation of data. However, I would be extremely surprised to see evidence that this has not led to better patient outcomes. Better administration and patient records should lead to improved patient tracking, monitoring, and clinicial decisions. I expect that it would be difficult to measure improvements in these areas (since non-digitial records are, by their nature, almost impossible to analyse on a large scale), but I do also expect such improvements to exist. But I also don't know what methods exist in the literature for examining this. It would be surprising and interesting to see studies claiming no significant improvement.

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