Nothing healthy about department of stuff-ups
- by: JUDITH SLOAN
- From: The Australian
- March 16, 2013
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:
Clearly it is going to be on for one and all as we get closer to the election.