What’s wrong with giving nurses a go at improving public healthcare?

By Brett Holmes

Rather than heading towards privatised US-style healthcare, nurses want to help protect a fair system accessible to all.

NSW Opposition Leader Luke Foley
NSW Opposition Leader Luke Foley proposes establishing four community-based nurse-run health clinics to help take pressure off hospital emergency departments. Photo: Brendan Esposito

NSW Opposition Leader Luke Foley’s health policy plan to establish four nurse-run clinics has been criticised by the peak doctor-led medical body, the Australian Medical Association. We feel this is unfair.

On a daily basis, nurses and midwives are confronted with extraordinary circumstances as they provide unequivocal care to patients in hospitals run by teams of doctors and in nurse-run hospitals. A testament to the nursing profession is a propensity to offer reassurance or to calm heightened anxiety, and be content with a smile or an occasional thank-you in return.

The ability to provide that level of compassionate care is slowly being undermined by shifts in the way our health system operates. As nurses and doctors battle away on the frontline delivering safe patient care, behind the scenes, the government has been picking off parts of our public health system and paving the way for a heavily privatised US-style health system to evolve – where patients pay much more and health outcomes are far worse.

In the US, more than 123 people die each day because they cannot afford the cost of adequate health cover and exorbitant medical expenses. Nurses in the US are distressed about the challenges within their own health system. Calming patients’ anxiety over soaring bills is now part of a nurses’ duty to patient care and they have become accustomed to witnessing bewildered patients confronted with crippling expenses. Alarmingly, more than 60 per cent of US bankruptcies are due to medical expenses.

Analysis by the Institute for Health and Socio Economic Policy in California shows rising hospital charges have contributed to the number of Americans who are priced out of access or pushed into financial ruin. From 2009 to 2011, US hospital charges surged upward by 16 per cent, while hospital costs only increased by 2 per cent. Hospital profits, pushed upward by the high charges, hit a record $US53.2 billion ($68.5 billion), while nurses witnessed hospitals cutting patient services and limiting access to care.

Do we want this situation, rather than at least trying a system of nurse-run walk-in clinics – along the lines already operating in the ACT?

Hallmarks of an Americanised health system began to surface in last year’s federal budget. The GP co-payment, cuts to preventative health funding and cuts to the states’ health budgets all represent a significant dismantling of universal health, under Medicare. Coupled with the privatisation of public hospitals and health services, the government’s ideological commitment to boost private sector involvement in health care is evident. This is despite our current health system being the envy of the world and considered one of the most efficient among comparable OECD countries.

In NSW, our health system is already under threat. In the space of one term, the state government has privatised sub-acute mental health services, new palliative care and disability services.

In December, Sydney’s new Northern Beaches Hospital was signed over to a private operator, Healthscope, under a public-private partnership. The public hospital planned for the growing Lower Hunter region will likely suffer a similar fate, while surgical services at the new Byron Central Hospital are already being “market tested”. Yet, history has shown us public-private partnerships and “price signals” are bad for our health system – let’s not forget the Port Macquarie Base Hospital experiment, which cost NSW taxpayers hundreds of thousands of dollars when the state government was forced to rescue the hospital from a failed private deal.

Sensible government should be safeguarding the provision of equitable access to healthcare, rather than opening the door for corporate shareholders to make profits on taxpayer-funded services and treating health like a commodity – just like America.

All nurses fear the detrimental impacts of the United States’ costly health system. As proud advocates for safe patient care, they are horrified by patients suffering due to poor access to healthcare in the US and the additional burden placed on nurses. What’s wrong with giving nurses a go at improving the quality of public healthcare in NSW?

Evidence of an Americanised health system materialising in our society inspires us to fight for a fair and equitable health system in NSW, where patients come before profits and no one is ever turned away.

Brett Holmes is general secretary of the NSW Nurses and Midwives’ Association.

Source: Sydney Morning Herald

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