Page 1656 - Week 06 - Wednesday, 18 May 1994
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QUESTIONS WITHOUT NOTICE
Health System - Casemix Funding
MRS CARNELL: Madam Speaker, my question without notice is directed to the Minister for Health. The introduction of casemix funding into Victoria's health system has resulted in a reduction of 10 per cent in the overall waiting lists in just nine months. Casemix is also saving Victoria's health budget some 20 per cent in real terms, without service reduction, while the number of patients treated has increased by some 7 per cent. This compares with the traditional multimillion dollar budget blow-out in ACT Health, a 20 per cent increase in waiting lists and a reduction in the number of patients seen. Minister, when will we see casemix funding introduced into the ACT, and what is the hold-up?
MR CONNOLLY: Madam Speaker, in one of my early interviews when the portfolios changed in the Government and I was given Health I made the point that there is no magic wand for issues of public health; that this Government confronts problems that governments across Australia are confronted with. Unfortunately, oppositions tend to want to seize on magic wands, and sometimes governments do too. I think casemix funding is being seized on by the Victorian Minister and people like Mrs Carnell as a magic wand.
I have read with a great deal of interest the statements Mrs Tehan has been making on casemix and some of the papers that have come out of Victoria, which do tend to indicate a quite rosy picture. I have also read editorials in the Medical Journal of Australia and articles from the AMA which cast a very different perspective on casemix.
Mrs Carnell: For obvious reasons.
MR CONNOLLY: Again, there are some very mixed views about casemix. There has been some fairly obvious change in accounting practices in Victoria as well. We have a different system of counting our waiting list. We regard a person as on the waiting list until they are operated on, which seems a fairly logical thing to do. Victoria regards a person as on the waiting list until they are booked in for surgery. So, if they are booked in 12 months ahead, they are not on the waiting list; whereas one would assume that they are waiting.
I read with great interest an Age editorial on Thursday of last week, I think, canvassing one of Mrs Tehan's statements on casemix. There does seem to be some reclassification, and there is clear evidence that some of the hospitals in Victoria have reclassified patients to ensure a dramatic reduction in waiting lists for the highest category by simply reclassifying people to different categories. That being said - that there is not a magic wand - there clearly are some advantages in casemix. It is an attempt to ensure that you are properly measuring outputs. One of the criticisms that have been levelled at this health system, but also at others, is that there can be a tendency if you are focusing on
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