13 February 2006

Mr Jamie Walker
c/- Courier Mail

'Sickness in the system'

I should like to congratulate you (and provide a little feedback) on a recent article which drew attention to the apparent failure of Queensland's governments to deal with some broader strategic questions that arise in relation to the public hospital system.

My interpretation of your article: Failings in Queensland's health system are symptoms of a wider malaise which was highlighted by the Forster review - there is a need for a choice about the levels of services provided by government and the tax revenues available. Productivity Commission report has showed that health costs are growing 5.8% pa in real terms at state level - far faster than economy. Queensland has run with Forster's proposals to throw money at the problem. Queensland Governments have long under-spent on health. Forster suggested three difficult options - (a) create 170 extra beds per year (b) cut services or (c) cease universal services. (Walker J. 'Sickness in the system', Courier Mail, 4-5/2/06).

By way of feedback I would firstly like to submit for your consideration that there may well be options to reduce the demand for health services, and these should be considered in parallel with options for managing the supply of such services that your article highlighted.

For example, chronic conditions appear to absorb rapidly growing resources within the health system partly because of potentially correctable deficiencies in the nutritional quality of the food available to the general community.

Secondly, I submit that there is an even bigger strategic issue than those related to the demand for, and supply of, health services. A crisis was necessary before Queensland's system of government was even able to start to identify challenges like those you mentioned. Why?

Your article spoke of 'sickness in the system' - referring to Queensland Health. Unfortunately, as I argued in an earlier email, Queensland's whole system of government (not just that in Queensland Health) is sick. Problems in the health system seem largely to be the consequence of much more general 'illness' (eg see Improving Public Sector Performance in Queensland and Systemic Deficiencies in Public Administration).

There seems to be even greater political reluctance to face up to these problems than to the very difficult options your article mentioned.

Regards

John Craig