Proposal flags stripping specialist services from smaller hospitals

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A report into Tasmania’s problem-plagued health system flags stripping some specialist services from smaller hospitals.

The Tasmanian Government has released a green paper as the first step in a process it hopes will lead to better coordination of the state’s 27 public and 14 private hospitals and health centres.

It outlines the need to centralise complex services and make better use of private providers in the state’s fragmented health system.

It was at least the fourth report in a decade to make the case.

Health policy analyst Martyn Goddard said the report was promising, but would involve difficult decisions about centralising specialist services.

“I think this is the most far-reaching and promising of all the reviews that have taken place,” he said.

“The things that are more likely to be centralised are those things that are complicated … difficult, complex conditions requiring highly trained doctors and nurses and lot of equipment.

“We can’t afford to have those senior expensive people duplicated around the state.

“There will be a political cost to making these changes because necessarily it is going to mean taking some services out of some areas and putting them somewhere else.”

Fears budget cuts will hamper change

Mr Goddard warned the Government’s attempts to improve efficiency could be undermined by its budget cuts.

“What concerns me is that the Treasurer and Premier are so intent on cost-cutting that that they’re going to make the system less capable, less responsive by not putting in enough money,” he said.

“That would be an immense shame but we are already seeing that with public service cutbacks under both governments.”

Despite moving to cut 244 full-time positions from the health and human services department by July, Health Minister Michael Ferguson said funding had increased.

He said the proposed changes were not designed to save money, but improve quality.

“We’re asking the health system to do more with the additional funding we’re providing,” Mr Ferguson said.

“One thing that we need to do is shift the conversation away from having more and better access to services, we need to shift that to be access to better services, access to better care.”

The report also suggests strengthening the partnership between the public and private systems.

The head of the State Government’s new health advisory body, Professor Denise Fassett, said the nature of the problems with the health system were not well understood.

“This is a time for us to look at perhaps some confronting and challenging evidence,” she said.

“We need an opportunity, we’re one state, we don’t have a large population, we need to have a complete overview of one health system.”

The Government has urged clinicians and consumers to have their say by late February.