Health deal 'may boost bureaucracy'

The woman behind the Rudd government's health reform blueprint believes a compromise
deal struck with Labor states was a political fix that could result in a larger
bureaucracy.
Christine Bennett chaired federal Labor's National Health and Hospitals Reform
Commission (NHHRC).
Its final report, released last year, formed the basis of Prime Minister Kevin
Rudd's health deal negotiated in Canberra this week.
But Dr Bennett says a compromise that will see the federal and state governments
pool health funds wasn't necessary from a policy point of view.
"The pooling mechanism ... was part of a political process and part of achieving the
comfort of the states to sign on to the package," she told AAP.
"They (state-based pools) may not get in the way (but) I'm not quite sure how
they'll add value."
Dr Bennett hopes the funding authorities will simply channel payments to 90 local
hospital networks.
"But if it is a level of decision-making and governance with an actual bureaucracy
that's quite a different structure," she said.
"I can understand the concern that many are voicing, whether it's going to increase
the bureaucracy and complicate and overly focus on the hospital part of our system."
The new intergovernmental agreement, released on Wednesday, states the funding
authorities will "not play any role whatsoever beyond the functions of receiving
payments from governments and making payments to local hospital networks".
But that doesn't cut the mustard, according to another former NHHRC member.
Former AMA president Mukesh Haikerwal has labelled funding pools a "cop-out".
Mr Rudd initially wanted his health and hospitals network to be "funded nationally
and controlled locally".
Now it will be jointly funded, although the commonwealth will provide the most
money, contributing 60 per cent of hospital costs and 100 per cent of primary and
aged care costs.
Dr Bennett says that's a positive and "a significant breakthrough".
"Similarly the consistent use of activity-based funding is a major part of our reform."
Apart from agreeing to jointly-managed pools, the federal government pledged an
extra $5.4 billion to get the Labor leaders on board at COAG.
Western Australia's Liberal premier, Colin Barnett, refused to sign because that
involved handing over a third of his GST.
On Thursday, federal Health Minister Nicola Roxon said if Mr Barnett didn't play
ball WA could miss out on its share of the extra funding for elective surgery,
emergency departments, hospital beds and GP training places.
"Of course a risk if you are not part of a deal that has been reached with every
other state and territory is that the benefits may not flow then to your
constituents," Ms Roxon said.
Mr Barnett argues it would be "unconscionable" for federal Labor to discriminate
against WA's sick and elderly.
Federal legislation is needed to redistribute the GST. Tony Abbott's coalition could
try to block that in the Senate.
"Mr Rudd needs to give us the legislation before he can possibly demand that we vote
in favour of it," Mr Abbott said on Thursday.
If the coalition does vote against Labor's draft laws the government will need the
support of the Greens, independent senator Nick Xenophon and Family First's Steve
Fielding.
But Senator Fielding isn't convinced Labor's plan will benefit patients.
Like he did with the government's emissions trading scheme, the senator is planning
to get his own experts to analyse the detail.
"I'm for health reform ... (but) I'm seeking to get four or five independent experts
to sit with me and go through this," he told AAP.