A week and a half ago I wrote about the sudden, unprecedented and drastic cuts that Victoria’s public hospitals are being told they must make before June 30th – apparently funding’s been reassessed in the middle of the financial year, and we’ve come up short to the tune of just over $107 million for 2012/13, with a total of $455 million to cut over the next four years.

The Federal government says it’s the State government, who in turn blame Canberra. And stuck in the middle are hospitals who are already running more efficiently than ever before. Ideally hospital occupancy rates are generally considered to be around 85% (though some question this), but Victorian public hospital occupancy rates have been at or above 96% since 2002/03 (p. 162). That not only increases the risk of errors, microbial cross-infection and other reducible errors, it gives hospitals nowhere to go when admissions spike. I know I’ve worked on many occasions when we’ve exceeded our bed capacity, sometimes putting patients in the treatment room because we have no patient rooms available.

Premier Baillieu promised 100 new beds (which is short hand for nurses-and-midwives-and-doctors-to-care-for-patients-in-beds) by the end of his first year, and 800 in his first term – we’ve just passed the two-year mark and I don’t see them. 2011/12 financial year. Health Minister Davis has tried to claim outpatient numbers, thorough hospital-in-the-home programs as beds – no, Minister Davis. And there aren’t 800 new positions in those programs, anyway – though maybe it’s just too soon to tell: “Asked for details of the beds this week, a spokeswoman for Mr Davis said data for 2011-12 would be reported by the Australian Institute of Health and Welfare in about a year” (emphasis added).

Here’s what’s clear – there aren’t going to be new beds, or new services, while we’re aggressively cutting costs. And we already have 805 graduate nurses and midwives without consolidation programs for 2013, in Victoria alone.

I wonder if the Baillieu government hoped to gloss over the missing funding and focus on trying to achieve by stealth what they failed to achieve during our EBA negotiations. If so, they once again failed to take into account the determination of Victoria’s health care providers to protect the public we serve – and the clarity of the ANF (Vic. branch) Executive. Because ten days ago ANF (Vic. branch) Secretary Lisa Fitzpatrick called upon Dr Peter Frost, the Victorian Acting Auditor General, and upon Mr Ian McPhee, the Australian Auditor General, on behalf of members, to investigate and provide independent accounts of the disparity (you can read her letters here and here).Lisa - Austin Dec 12

And while we wait for a response, then wait for action, services that Victoria needs will be increasingly curtailed. Though a spokesperson for the Austin said in August that paediatric beds wouldn’t be cut:

  • rural and regional hospitals will be hit hard (including Echuca, Swan Hill, the Wimmera, and Ballarat (source);
  • St Vincent’s was already struggling, with blowouts in waiting times, significant failures to meet admission time targets, and cancellation of one in sixteen elective surgical cases (source);
  • Southern Health will cancel 1,800 elective cases and close a 26-bed ward (source):
  • the Royal Women’s will cut theatres and services for women and babies (source);
  • Royal Melbourne will effectively lose 700 surgeries over summer (source),
  • CEO’s at the Royal Children’s and the Northern hospitals will also cancel theatre sessions and “The board chairs predict the funding cuts will cause the closure of 440 beds or the cancellation of more than 21,000 elective surgeries in the next six months (source)”
  • Eastern health will close five psychiatric beds, 20% of their unit (source);
  • and nurses at the Royal Children’s Hospital have been asked to consider reducing their hours (source) – and fewer nurses means closed beds, so maybe what’s true in August isn’t true four months later.

In total, one report estimates, the State-wide effect of these costs cuts will mean
20,000 elective surgeries being postponed (potentially indefinitely, as new theatres won’t be opening within four years); 200 current beds closing; and 1,400 lost jobs.

When nurses close beds, even though paediatric, oncology, critical care and dialysis beds are exempted, it’s “a crisis” – when the government closes beds it’s an operational matter…

And while Victorian Health Minister David Davis (who’s demonstrated duplicity in the past when dealing with our health care system) asks if Ms Fitzpatrick “is an apologist for Labor, or is she prepared to take the stand for Victorian hospitals?” adding “[Federal Health Minister Tanya Plibersek] appears to have a heart of stone. The fact is Tanya Plibersek will be the cruellest health minister in Australian history unless she reverses these cuts,” (source) a spokesperson for Minister Plibersek said that the Commonwealth funding was still increasing by 26% over the financial years to 2016/17, and:

The Baillieu government decides how to distribute the money, not the Commonwealth. Any cut to local health services is being made by the Baillieu government, and follows $616 million in Victorian budget cuts to health.