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we are opposed to the idea of imposing through the budget process change that is decided by expensive outside consultants and adopted by the Government as policy before any debate on those recommendations has occurred within the Assembly or within the community.

We believe that paying Booz Allen and Hamilton $1m for this report and an implementation strategy is a gross waste of taxpayers’ money. The Department of Health currently employs a gaggle of senior managers. Are they not up to implementing such a report and, if not, why not? The Greens believe that we should work towards the best outcomes for staff and patients through qualitative research, consultation, and the established EBA process. When and if staff go, who will suffer? Will it be the people at the bottom end of the salary spectrum or will it be the doctors, senior managers and executives who take the cuts? How much money is consumed by those at the top end of the salary spectrum in Health and those at the bottom end? Cuts per se do not necessarily create efficiency or more effective service delivery. The Booz Allen and Hamilton report is too much about accounting and not enough about quality. The Greens believe that $1m is too much money to spend on a report that to date has not examined any of the qualitative indicators that determine what type of health system we really have.

MRS CARNELL (Chief Minister and Minister for Health and Community Care) (4.28): I agree with everybody. Mr Connolly is absolutely correct in that we did endorse Andersen, and we continue to endorse Andersen. In fact, the Andersen report brought down under Mr Connolly, which he claimed was his blueprint to reform health, actually has three phases: Phases 1, 2 and 3. Phase 1 was the part Mr Connolly did. About phase 2, interestingly, the report states:

An operations improvement process incorporating bottom-up identification of cost reduction opportunities, process redesign and implementation planning is recommended.

That is exactly what we have just done. It goes on to say, as all reports in health do:

We have identified that WVH’s total cost per occupied bed day exceeds a representative group of NSW and Victorian teaching hospitals by some $26.5m.

Of the total cost above the sample mean, they go on to identify VMOs - an area where we have already made savings - nursing, allied health professionals and so on, as the areas where, in macro terms, savings could be made. The report then says:

Beginning with these estimates as targets, an operations improvement process has been recommended to confirm the savings goals, to identify substantial efficiencies in the delivery of services and achieve significant savings in 1994-95 and succeeding years.

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