Show us the outcomes, measure them publicly, and hold the system accountable for delivering them.
Dear Minister, don’t just tell us how much is being invested. Tell us what success looks like, how it will be measured, and when we can expect to see results.
I welcome the announcement of an additional $10.3 billion investment into the NSW health system. More funding is needed. Reducing surgical waitlists is needed. Recruiting more staff is needed. Improving access to care is needed.
Nobody working on the frontline would argue otherwise.
But there is one question every taxpayer, patient and clinician should be asking: What outcomes will this money actually buy?
The media release tells us how much money will be spent. It tells us how many additional staff may be recruited.
What it does not tell us is how success will be measured.
How far will regional surgical waiting lists fall? By how much, and by when? Will any rural maternity services be restored or strengthened? If so, how many? Will procedural capacity increase in places such as Broken Hill, Orange, Wagga Wagga, Lismore, Tamworth and other regional centres? Will more people receive care closer to home? How many additional theatre sessions will rural hospitals deliver? What are the targets?
These are the metrics that matter.
The reality is that every few years NSW Health seems to announce another surgical waitlist rescue package – another funding injection, another backlog reduction strategy.
Why?
If the system is being funded appropriately and sustainably, why do the backlogs keep returning?
In my view, the problem is deeper than workforce alone. Two issues stand out.
First, demand continues to grow faster than the level of activity being funded.
Second, hospitals are often funded at a level below the real cost of delivering care.
The result is a system that predictably creates backlogs. Local Health Districts know that, eventually, a rescue package will arrive. The cycle repeats: more money enters the system, the backlog falls temporarily, demand rises again, and the backlog returns.
Also in today’s edition:
- NDIS legislation risks ‘stripping back’ human rights, says commissioner
- Software gaps threaten share by default rollout, providers warn
- State’s hospital doctors to take first industrial action in almost 25 years
- DoHDA’s potential constitution breaches rise to 15, ANAO warns
- Aged care providers defend anti-VAD stance
- Two new senate inquiries announced
Another bailout follows.
This is not just a funding problem. It is a system design problem.
Unless we address efficiency, accountability and return on investment, no amount of additional funding will solve it.
The concern is even greater for rural, regional and remote communities.
Roughly a quarter of NSW residents live outside metropolitan centres. Will a quarter of this new investment reach them? Will outcomes be measured separately for rural communities? Or will most of the benefit be absorbed by major metropolitan services, while rural patients continue travelling hundreds of kilometres for care?
Rural people deserve transparency. Rural people deserve equity. Rural people deserve outcomes.
In my opinion, the public does need more than another announcement about how much money is being spent. The public needs to know what difference that money will make.
Tell us:
- Which waiting lists will be reduced, and by how much;
- What targets will be set and by when they will be achieved;
- How many additional surgeries will occur in regional hospitals;
- How many rural maternity services will be strengthened;
- How access will improve for rural communities;
- How these outcomes will be publicly tracked against clear targets.
Because accountability is not measured in billions of dollars. Accountability is measured in outcomes.
Minister, our communities are tired of reviews, plans, strategies and announcements.
We want results. We want better value from every health dollar. And we want bureaucracies held accountable not for how much they spend, but for what they achieve.
Related
More money alone will not save the health system. Better outcomes will. The people of NSW deserve nothing less.
As a GP in rural NSW, I have seen firsthand your enthusiasm for better care. I also acknowledge that your government has done a significant amount of work in this area. I write this as a clinician on the ground, not as a representative of any advocacy organisation.
My request is simple: show us the outcomes, measure them publicly, and hold the system accountable for delivering them.
Associate Professor Alam Yoosuff is a rural generalist GP, chair of the Murrumbidgee PHN, and a board director for the Murrumbidgee LHD. He is a clinical academic at the University of Notre Dame.
This article was first published on Professor Yoosuff’s substack. Read the original here.