Socialist Equality Party

Election Campaign

More public hospital cutbacks in Sydney’s west

By Chris Gordon, Socialist Equality Party candidate for Parramatta
22 November 2007

A leaked memo from a senior surgeon Mac Wyllie at Mt Druitt Hospital, in Sydney’s west demonstrates yet again the dysfunctional state of the public hospital system.

The memo, which was made public earlier this month, revealed that the surgery network of the Sydney West Area Health Service (SWAHS) had overspent its budget by $18 million, and that hospitals in the region were being called upon to make up the shortfall by cutting services.

Despite the fact that the working class areas of Sydney’s west are heavily dependent on public hospitals for their health needs, hospital beds will be closed and surgery cancelled. At Mt Druitt hospital, the number of overnight beds will be reduced from 30 to 15 and the number of day beds from 16 to 10.

Richard Hanney, a surgeon at Mt Druitt hospital, warned that there “may well be the need for elective surgery to be cancelled because beds will be filled by the emergency patients.”

Other hospitals will also be affected. Associate Professor Geoffrey Brooke-Cowden, director of surgery at Auburn Hospital, told the Sydney Morning Herald that operating room capacity at his hospital would be halved over January. Moreover, the large Westmead Hospital would be “virtually shutting their operating rooms down for six weeks.”

David Dunn, head of surgery at Blacktown Hospital, likewise indicated a “Christmas slowdown” for about a month. He noted that while not always the case, the practice had not been “uncommon” in the past.

The state Labor government immediately went into damage control. NSW Health Minister Reba Meagher declared that nothing unusual was taking place. The reduction in activity, she said, was to allow doctors and nurses to take leave and carry out maintenance. In any case, there was reduced demand over the holiday period.

Seeking to make political mileage out of the issue in the midst of the federal election campaign, the state Liberal party attacked Labor’s threadbare excuses and branded Meagher an incompetent, pointing out that there were over 5,600 people on public hospital waiting lists for elective surgery in Sydney’s west alone.

The Liberal party’s outrage is no less absurd than Meagher’s excuses. “Instead of cutting the bureaucracy, Reba Meagher and Labor always cut frontline services first,” Liberal leader Barry O’Farrell declared. In other words, the alternative to cutting beds is the slashing of jobs in health administration.

Neither Labor nor Liberal suggested an end to the chronic underfunding of Sydney’s public hospitals. On this, the two major parties are absolutely united. Public health care, along with other essential services such as education, housing and welfare, has been run into the ground to fund tax cuts, financial incentives and other benefits for the major corporations and wealthy individuals. For-profit, private hospitals, health funds and nursing home chains are abounding, while public facilities are being gutted.

Mt Druitt Hospital’s Richard Hanney gave voice to the anger of the staff in comments to the local Mt Druitt-St Marys Standard “When the intensive care unit closed, despite massive public protest, the Health Department made a commitment to excellence in elective surgery,” he explained. Branding the latest decision as “a betrayal”, Hanney added: “There’s been a constant exodus of services from Mt Druitt hospital. This left a shell of a hospital. This is yet another major blow.”

The very categories employed by NSW Health reflect the appalling situation facing the thousands of people waiting for “elective surgery”. The recommendation for a category 1 elective patient—with a condition that can deteriorate quickly into an emergency—is that “admission within 30 days is desirable”. For category 2 patients—suffering “pain, dysfunction or disability” but unlikely to become an emergency case—admission within 90 days is recommended.

The situation in Sydney’s west is by no means unique. The leaked memo came in the wake of another major scandal—at Sydney’s Royal North Shore (RNS) hospital, where a woman was forced to miscarry in a public toilet in the emergency department after hours of waiting to be examined. It quickly emerged that other women had suffered the same terrible experience due to the lack of adequate resources.

The constant pressure of budget constraints is eroding staff morale. Increasingly, administrative work is being foisted onto hospital workers. According to one nurse, in an eight hour shift, only 5½ hours are allocated to patient care—“occasions of service”. Patients are moved along “clinical pathways”, determined by insurance companies, to minimise their stay in hospital and remove the backlog. Faced with diminishing resources, staff are repeatedly instructed to “find ways” to do more with less.

It is little wonder that one of the main demands of Victorian nurses during their recent campaign was for better nurse-patient ratios to improve conditions for both patients and staff. While the Victorian Labor government backed away on its demand for a free hand in setting the ratios, the new productivity arrangements—agreed to by the Australian Nurses Federation leadership—will inevitably mean heavier loads.

While health care is a major priority for working people, neither of the major parties is even promising to seriously address the issue. That is because they are both committed to implementing the demands of global capital for the opening up of all aspects of society to private profit. Health care is driven by the free market principle of “user pays”. Those who can’t are forced to rely on a public system that is being stretched to breaking point, or to miss out altogether.

The Socialist Equality Party is campaigning for a complete refashioning of society, so that the first priority will be the social needs of the majority of ordinary people, not the profits of a few. No one should have to wait for months in discomfort, pain and fear for routine surgical and other medical procedures. Access to free, high quality health care and to the extraordinary advances in medical science and technology that have been made over the past century should be a basic right for all.

Only when this socialist perspective becomes the basis for an independent political movement of ordinary working people will the current situation in public health be overcome. I urge all those who agree, to participate in the final days of our 2007 federal election campaign, and to join the fight to build the SEP as the new mass party of the working class.