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the last four or five years, without any change, and everything will be all right. We do not believe in that kind of deception of the people of Canberra. We are prepared to embark upon a process that will not make us popular in the short term but, at the end of the day, will deliver benefits that all Canberrans will receive, and I think that is something worth fighting for.

MS HORODNY (4.23): This report is indicative of the way this Government and most governments around Australia evaluate outcomes on quantitative national benchmarks. It is also a good example of how governments, and the previous Government was no exception, focus the majority of the Territory's health resources in the hospital system. This report offers a largely quantitative analysis of certain areas of the hospital and its administration. Through this benchmarking exercise, Booz Allen and Hamilton illustrate areas where our services differ from national benchmarks in terms of the way we use resources in the hospital system and also identify so-called opportunities to examine these differentials in more detail. There are some big questions raised by this kind of methodology. Should we conceptualise the problem of health care in economic terms? Should we match resources against outcomes in a way that leads to a rational, quantitative outcome?

Mrs Carnell claims that this is the most detailed look at our health system ever conducted. After the number of reports into our health care system, you would want to be able to claim that. Unfortunately, most of the resources and focus in our health system is still on hospitals, the acute end of health care. In other words, we have a system that concentrates its resources on sickness rather than on keeping people healthy. The Greens believe that more resources should be spent in preventative health areas such as local health clinics and in areas that seek to care for those in greatest need in our community such as dementia care and respite care. This report is essentially about the hospital and administration of health and, although it does stress once again the need for better outcomes in terms of continuity of care, most of the claimed savings are going to be put back into big ticket items in the hospital. The opportunity costs of doing too little to prevent ill health are not factored into the Booz Allen analysis at all.

This study is, for the most part, quantitative. It includes very little methodology, and it fails to discuss quality of care in a comprehensive fashion or provide models for quality of care in other States as a measuring tool. Quantitative national benchmarks may or may not be relevant to the health situation in the ACT. In the areas of nutrition and occupational therapy, for example, the report notes that the ACT offers more service per patient but fails to provide significant analysis on the type of service that is offered or the outcomes of this service.

Mrs Carnell has also said that she plans to restructure the health administration along a purchaser-provider model. Once again, there has not been much detail, except that she will split the hospital and community health into two separate statutory authorities. What mechanisms will be put in place to ensure continuity between policy and planning, the hospital and community health? Clearly, in order to achieve the goal of a healthier ACT community, efficiency gains within the system are one aspect of many issues that must be addressed. While we believe that there are areas within the health service that need significant reform, we will not support actions that lead to a reduction in the quality of care. While we support the need to make significant changes to the health care system,

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