Ideas@TheCentre
Canberra kickers kick own goals
State governments are always keen to kick Canberra to generate cheap political thrills, especially when the incumbent federal government is on the other side of politics and on the nose with voters.
But that is no excuse for the Coalition state governments trying to restrict the role of the National Health Performance Authority (NHPA) as proposed by the Gillard government.
This is one of the few initiatives worth salvaging from the wreck of the Rudd-Gillard national health reforms. The NHPA is designed to operate as a stand-alone statutory authority in charge of collecting and publishing transparent information about public hospital performance in all jurisdictions.
As the Business Council of Australia (BCA) has stressed, independent oversight and a minimum, meaningful and comparable national data set are needed to drive health reform. The ability, for example, to benchmark public hospitals against more efficient private operators would encourage state governments to pursue innovative policy such as extensive outsourcing of publicly funded care to the private sector.
But according to the WA and Victorian governments, states’ rights are under threat. The Gillard government’s legislation, which could be blocked in the Senate, would allow the NHPA to deliver performance reports directly to local hospitals. WA and Victoria want all direct contact declared illegal to prevent bypassing and undermining the role of the state health departments as ‘state-wide system managers.’
This argument is being made despite the Coalition (at both federal and state levels) claiming to support the devolution of public hospital management to the local level. Ironically, the NHPA is a major step towards improved governance as enhanced local control will only be possible when combined with robust, arms-length accountability.
What is even worse is the joining of forces with the last of the true believers in public sector monopolies run by Soviet-style centralised bureaucracies. WA Premier Colin Barnett and the Victorian Health Minister David Davis have taken the side of the health unions and their mouthpieces – Australian Healthcare and Hospital Association (AHHA) – who, as always, are keen to avoid external scrutiny and stymie any measure that will facilitate the downsizing of the bloated health bureaucracy.
We are accustomed to state politicians doing the bidding of the noisy lobby groups and putting sectional interest ahead of the public good. The attack on the NHPA is in keeping with the NSW Coalition’s opportunistic decision to reject electricity privatisation and school league tables.
Some view this kind of ‘positioning’ as smart politics, despite the whatever-it-takes betrayal of fundamental principles. In truth, this is the path to the ‘Californification’ of state economies.
Furthermore, it is always a bad look for state governments to oppose federal policies plainly in the national interest. Ultimately, this encourages the view the ‘hopeless’ states should cede responsibility for important policy areas, like health, to the Commonwealth.
The Canberra kickers are kicking own goals against both hospital reform and States’ Rights.
Dr Jeremy Sammut is a Research Fellow at the CIS and the editor of No Quick Fix: Three Essays on the Future of the Australian Hospital System (October 2010).
