Sunday, March 17, 2013

I Would Not Want To Be A Senior Officer In DoHA If Mr Abbott Wins The Election! Dead Ducks.

This article simply could not wait for the usual cycle of daily blogs.

Nothing healthy about department of stuff-ups

HEALTH is an area the Labor Party thinks it owns. According to the polls, Labor has generally been judged the better manager of health (and education) than the Coalition.
One of the worrying recent trends for Labor is that this ascendancy has been significantly whittled away. Labor now holds only a slim lead - down to four points -- as the better manager of health. (The gap for education is five points.) One of the more interesting aspects of government involvement in, and funding of, health is that monumental stuff-ups often go under the radar. There are programs that cost hundreds of millions, even billions, but which never generate the anticipated benefits. In some cases, they never generate any benefits. And then there are the forecasting errors of the Department of Health and Ageing that have led to extreme shortages of doctors followed by extreme surpluses.
More generally, we have a federal department - the largest "policy" department with 5500 workers - the head of which seems unable to really explain what her staff do or account for the results of their busyness.
Take the example of electronic health, one of the centrepieces of the health and hospital reforms, as a classic example of a stuff-up. Through the years, hundreds of millions have been poured into various e-health initiatives, with virtually nothing to show for the spending. The most recent program is the Personally Controlled e-Health Records system, which went live in July last year. At this stage, nearly nine months on, only 56,000 individuals have registered to obtain a record. And fewer than 1 per cent of doctors have signed up. The whole scheme, with a budget of more than $1 billion, looks like being a complete operational and financial fiasco.
We should not be entirely surprised. Having spent billions trying to digitise the National Health System records in Britain, the government essentially gave up several years ago. While relatively simple features of patient records - X-ray and pathology results, medications - can be recorded relatively easily electronically, there are other aspects of patient case notes that are not so amenable. Moreover, issues of confidentiality and access are critical in terms of ensuring patient safety and engendering confidence. Were an unauthorised person given access to records, changes could be made that could prove detrimental, if not fatal, to patients. In other words, the goal of achieving universal and comprehensive electronic medical records is unrealistic at this stage. But this has not prevented the federal government wasting billions of dollars finding this out.
….. (Workforce stuff ups omitted)
While e-health and medical workforce planning are examples of specific stuff-ups, at a broader level the whole Department of Health and Ageing is really a massive catastrophe, engaged in multiple, pointless and unaccountable activities while not running one hospital or other health service.
Take this explanation from the department secretary: "We have a budget structure and this includes the definition of subprogram. Then we have another level under this - several other levels. These groupings of things which kind of make logical sense, but are not reconcilable with the budget documents. So there are particular initiatives, some of which do line up, but mostly they do not." Are you following?
She continued: "So this is the workings and this is down to in some cases projects and in some cases thematic elements but is not consistent with universally, and in fact very often, the budget structure which is what we have in IT systems which enable us to produce information." As Manuel from Fawlty Towers would have said: Que?
On the face of it, it would appear that even the head of the department finds it hard to explain what activities are undertaken in her department, why they are undertaken and how they line up with each other. But, never fear, if only they had a better computer system.
"Let me tell you, the Department of Finance said recently that they wanted us to account down to these levels of detail, and our chief financial officer had a great deal of fun explaining to them that, actually, if they wanted that they were going to have to build us a new computer system - which we would quite like, can I say."
Fun? When you are dealing with taxpayer monies that run into the billions? I can think of other nouns, such as disgrace and waste.
Much much more here:
This really is an astonishing blast at DoHA. I wonder what part the shadow Ministers played?
Clearly it is going to be on for one and all as we get closer to the election.


Anonymous said...

There are some good things that DOHA do. Think of the Pharmaceutical Benefits Scheme.
But let's face it, they are just not very good at information management or IT projects either inside the department (managing their internal functions) or in building information technology based systems for the nation, such as the NEHRS.
But we all learn by our mistakes, so in that respect they are doing well.

Terry Hannan said...

David, I read Ms Sloan's excellent commentary yesterday and agree with you it is a very good broadside of DOHA. After all the ducks have been shot/bulldozed what will be the terrain/infrastructure on which the Coalition will build their e-health system? I do not hear trumpets from the victors bearing appropriate gifts. The concern is that they also have very little or NFI of where to start so who will they enlist for support? If they ask the right questions and people then maybe "e-health reform" will get a proper start.

Anonymous said...

Abbott was led astray by the Secretary when he was health minister in the same way as Plibersek has been. There is no reason to think it will be any different with a change of Government.

The incomprehensible rubbish the Secretary is reported to have said to Judith Sloan is the very same incomprehensible garbage that she delivers up time after time to the Senate Estimates when asked about NEHTA and eHealth.

Anonymous said...

On the face of it, it would appear that even the head of the department finds it hard to explain what activities are undertaken in her department, why they are undertaken and how they line up with each other.

It does not require a genius to deduce that there can be ONLY ONE explanation why she (the Secretary) has difficulty explaining what activities are undertaken in her Department AFTER HAVING BEEN HEAD OF THE DEPARTMENT FOR 11 (ELEVEN) YEARS!!!!

Bernard Robertson-Dunn said...

Anonymous said...
"There are some good things that DOHA do. Think of the Pharmaceutical Benefits Scheme."

Have a listen to the Health Report,
Monday 18 March 2013 5:30PM.
podcast here:

A report called 'Australia's bad drug deal - High pharmaceutical prices' has just been released. We talk to Dr Stephen Duckett from the Grattan Institute, who is one of the authors of this report.
End quote.

Dr Duckett claims that Australia is paying $1.3billion per year too much through the PBS.