METASTASIZING BUREAUCRACY

This is how all public medicine systems end up. It's similar in Britain too

The number of bureaucrats working in Queensland Health has almost doubled in nine years while the state faces a "brain-drain" of doctors. The number of pen-pushers has climbed at seven times the rate of nurses. Health inquiry boss Tony Morris this week said four in every five of Queensland Health's 64,000 employees were in non-clinical roles. One in five of the 43,782 full-time equivalent staff employed by the crisis-ridden department is in management and administration – now the second-biggest category after nurses.

Australian Medical Association Queensland president Steve Hambleton said: "The growth of spaces in the bureaucrats' car parks has been the biggest change in the health system in recent years. "The bureaucracy has spawned more bureaucracy. The health planners got it wrong 10 years ago."

While the number of managers and clerical workers soared 84 per cent between 1996 and 2005, the nursing ranks grew by only 12 per cent. The proportion of nurses in the Queensland Health workforce fell from 43 per cent to 38 per cent over the period. The growth in management and administration staff is one of the issues being investigated by the Forster inquiry appointed by the State Government.

Dr Hambleton said a "brain-drain" of doctors was crippling the health system. "Queensland has the lowest number of registered doctors per head of population of any state and territory," he said. Queensland's rate of 241 doctors per 100,000 population falls well short of the national average of 283. Premier Peter Beattie says the shortage of doctors is at the heart of the health system problems. He blames Canberra for not training enough doctors. "Under Federal Government policies controlling the number of university places, 224 doctors graduated in 1976 – and still in 2004, almost 30 years later, 224 doctors graduated," he said.

Last month, Mr Beattie announced his Government would fund 235 doctor training places at Griffith University in addition to the 80 paid for by the Federal Government. Mr Beattie said Queensland was caught up in an international tug-of-war to attract and retain surgeons, anaesthetists and other doctors amid a worldwide shortage.

Dr Hambleton agreed that "we have to recognise we are in a national and global market and do everything we can to retain our doctors". But he said the State Government had driven doctors out of Queensland to seek work in other states and countries. "Our doctors are the worst-paid in Australia and our nurses, I believe, are the second-worst-paid," he said. Dr Hambleton said many Queensland professionals would be tempted overseas unless there were improvements here....

Mr Morris has been a strong critic of Queensland Health and the amount of money it spends on bureaucracy instead of doctors and nurses. "It seems extraordinary to have four people behind the scenes in support of one person in patient care," Mr Morris said.

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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