Privatisation: a major policy shift underway without debate

An agenda of privatising public health services is now apparent in New South Wales.

“In a recent meeting with the NSWNMA the Minister for Disability Services denied that the privatisation of ADHC was privatisation. It was, he said, a transfer of services to the private sector.”

First, we had the privatisation of the new Northern Beaches hospital, followed by the announcement that pilot mental health services were to be given to private companies and the non-government sector. Now we are told Ageing, Disability and Home Care (ADHC) is to be privatised and palliative care services hocked off to private consortiums (see page 19).This is a major shift in public health policy being undertaken by the O’Farrell Government, without any public debate or consultation.Nurses and midwives and the community are entitled to ask: what is the case for doing so? Where is the evidence that this will lead to better public health provision and better patient care?

In fact, there is plenty of evidence that says this is a disastrous path to go down. The privatised and highly competitive US health care system is a test case in market failure. It swallows up a massive 17% of US GDP. Despite this massive commitment of money, huge numbers of Americans are without health cover and fall through the cracks. Of that health expenditure, 31% is spent on administration costs – a ridiculous waste of resources.

Britain is an even more relevant cautionary tale. Historically it has a universal public health system similar to our own. Both Britain’s National Health System and Australia’s Medicare are iconic institutions, held in high regard by the public and representing the best values of our societies.

Since the Conservative Party came to office in Britain there has been an agenda of increased privatisation. A former head of the NHS, Sir David Nicholson, described the “medicine” of increased privatisation and the morphing of patients into customers as “toxic”.

Section 75 of Britain’s Health and Social Care Act codifies this march to privatisation. It stipulates that services must be tendered out. Now 49% of services are open to the private sector. Management consultant McKinsey has predicted that the British private sector health market will be worth £200 billion British pounds by 2030.

In Australia, the Liberal Party has been coy about talking openly about privatising public health care. Privatisation is not popular in this country. Remarkably in a recent meeting with NSWNMA representatives, the NSW Minister for Disability Services denied that the privatisation of ADHC was indeed a privatisation. It was, he said, a transfer of services to the private sector. A masterclass in semantics!

The privatisation of ADHC is one of the largest in the history of NSW. In tandem we have learnt that the National Disability Insurance Scheme (NDIS) is to be a wholly privatised affair in NSW.

None of this has ever been put to the public or to the staff or the disabled and their families. In fact, it is a major policy decision delivered as a fait accompli when the bulk of policy development around the NDIS is yet to be started.

It is open to any one to question if these decisions are based on ideology rather than sound public policy.

It is consistent with the modus operandi of the O’Farrell Government – that with its massive majority it can bulldoze through an ideological agenda without effective public debate or consultation.

Late night sittings of the Legislative Council, where votes are traded by cross bench parties, does not replace informed public consultation and a genuine testing of ideas and recommendations.