Solving the crisis in our hospitals

In other words, instead of lowering hospitalisations and costs, the international evidence shows that better co-ordinated primary care uncovers new cases requiring hospital treatment.

Both sides of politics are formulating hospital and primary care policies in an information vacuum. A second round of co-ordinated care trials commenced in 2002 and concluded in 2005. The Commonwealth Department of Health and Ageing has not made the evaluation report publicly available. It is “currently being prepared for publication”, but a publication date is yet to be scheduled.

Meanwhile, the national evaluation report on the first round trials isn't even posted on the DOHA website.

So much for evidence-based “preventative” medicine. Nevertheless, Professor John Dwyer of the Australian Health Care Reform Alliance told The Australian in October that countries like New Zealand had “markedly reduced the demand on hospital services by investing in better primary care”.

In 2004, the Care Plus program was introduced in New Zealand, which entitled chronically-ill patients to reduced-cost nurse and doctor visits and access to care planning, quarterly checks, and self-management support.

The findings of independent evaluation of the program once more contradict the premise of the “prevention” mantra. The evaluation found that “hospital admissions for those enrolled in Care Plus rose 40 per cent in the following year”.

There is nothing wrong with this, per se - the health system should take care of the sickest and most vulnerable in the community.

But if instead of keeping more elderly and chronically ill people out of hospital, stronger primary care identifies new cases that require hospitalisation, both Coalition and Labor health policies will exacerbate - not solve - the hospital crisis.