If the Healthscope journey is to teach us anything, it's that buying and selling our nation's essential healthcare infrastructure should not be a rubber-stamp process.
We’re nearing the end of what has been one of the biggest hospital sell-offs in Australia’s history, and once the ink dries and the funds clear on the Healthscope deal, what then will we have to show for it?
Rehashing the past seems laborious at this point. Healthscope and Brookfield’s issues are well covered.
But reflecting at this juncture, it’s a case in point how private equity can misjudge the complexity of managing one of Australia’s most essential pieces of healthcare infrastructure. And patients, doctors and nurses are the ones who face the uncertainty created.
Thankfully, there is no doubt whether we will still have a hospital group at the end of this. It is whether we will have a better one.
To date, this process has centred on dollars and cents. Who’s the highest bidder? What will the carve-up look like? Who’s pitching in? Yet to enter the conversation is how the new owners will improve healthcare quality and experience for patients.
That perspective can no longer be treated as secondary.
Last August we revealed that during Brookfield’s ownership, patient responses consistently placed Healthscope below other private hospital groups in certain specialities based on patient reported experience data reviewed as part of Voice of the Patient.
And still now, the week when the deal finally closes, patient responses suggest persistent areas for improvement across our largest national private hospital groups – not just Healthscope.
Importantly, these findings do not indicate poor clinical care. Hospitals are among the most complex, high-stakes organisations we ask anyone to run. They are where clinical, commercial and human imperatives meet daily, and do not always agree.
Rather, these findings highlight the complexity of running world-class facilities, the standards patients hold them to, and the importance of basing success on patient experience and outcomes. The upside from these insights, which many hospital groups are desperate to leverage, is seeing and hearing clearly the patient perspective, and driving change.
Crucially then, if the Healthscope journey is to teach us anything, it’s that buying and selling our nation’s essential healthcare infrastructure should not be a rubber-stamp process.
Highest price alone cannot be the only factor that is considered. Patient centricity – through a clinical and value lens – is the single common factor that keeps almost every branch of healthcare delivery focused, effective and efficient. It must be considered as part of the process.
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All stakeholders, be it patients, doctors or staff would therefore like to think that the owners put quality above all else and bring some stability to these crucial healthcare facilities.
It is worth noting, however, there has been limited broader consultation with AHSA about the future of these hospitals and where opportunities exist to enhance patient and provider experiences and outcomes.
Given the scale of capital involved, you’d expect meaningful engagement with major funding groups about continuity, value, quality and contractual certainty.
The federal minister for health, relevant departments and licensing bodies have an important public-interest role in ensuring prospective owners are assessed not only on financial capacity, but on their ability to be responsible long-term custodians of essential hospital assets.
Likewise, industry and the patients’ voices deserve some say in how we improve services for all.
One can only hope the powers that be are assessing prospective owners against these value and patient-centric measures. And that whoever acquires these facilities can explain how they will prioritise and improve value, quality and experience for patients.
This process remains a chance to review what fit-for-purpose hospital ownership looks like in Australia. Rather than a game of highest price wins, major healthcare infrastructure decisions must always be balanced against quality, patient centricity and stability.
There’s too much at stake, and no time or patience for history to repeat itself.
Andrew Sando is the CEO of the Australian Health Service Alliance, one of the country’s largest group health services purchasing agents representing member-owned/not-for-profit health funds. He is heavily involved in funding negotiations with private hospital operators, nationwide.