The number of doctors in Tasmanian public hospitals fell by 120 on a full-time equivalent basis ‒ or 12.6% ‒ in the year following the state government’s 2011 health budget cuts.

This is a key finding of a new analysis of national hospital data by independent health policy analyst Martyn Goddard. Using statistics from the Australian Institute of Health and Welfare, it compares the state of Tasmania’s public hospitals in 2010-11 with 2011-12, covering the period before and after the budget cuts.

‘On almost all measures, the capacity of the system to deliver care to Tasmanians has declined, often seriously,’ Goddard said.

‘The effects of the cuts are evident not only in elective surgery but across the system. Few areas in any of our major hospitals are likely to have been unaffected.

‘Doctor numbers fell because reducing the use of locums has not been fully balanced with staff recruitment; some staff doctors who have resigned have not been replaced; and, most importantly, specialists have been allowed to set up part-time private practices because the hospitals cannot afford to pay their full salaries.

‘All of these categories are composed mostly of senior, fully qualified clinicians who are no longer available to work full-time ‒ or at all ‒ in our public hospitals. Increasingly, the load of work and responsibility for running the system has been put onto junior doctors ‒ registrars and interns. It’s unfair to them and potentially dangerous to patients.

‘The full-time equivalent number of nurses fell statewide by 65. This understates the impact on nurses, because large amounts of overtime and double-shifts boosts the full-time figure.

We know from hospital data that in the southern region alone, which includes the Royal Hobart Hospital, the number of nurses by head-count went down by 115.

‘The number of clerks and administrators actually rose marginally over the period, by 15.

‘The basic economic efficiency of Tasmanian hospitals, measured by the cost of the average service weighted for complexity, remained stable over the period. But it will need to come down by about 20% if Tasmania is to match the new National Efficient Price, on which federal funding is based. If this does not happen, the state budget will be further hit by as much as half a billion dollars over a four-year budgetary period.

‘By tolerating this level of inefficiency, the state government is also wasting hundreds of millions of dollars of its own share of hospital funding. If the system was better run, all of these savings could be spent on treating the huge backlog of patients who need care they cannot get.

‘On the main measure of a hospital system’s ability to care adequately for the people it serves, Tasmania is by far the worst in the nation and fell further behind in the period after the cuts. The number of overnight separations (services) per 1000 population fell in Tasmania from 92.2 to 89.7, while rising nationally from 112 to 116.2.

‘Tasmania’s system of purchasing drugs and supplies remains the most expensive in the nation.’

Download analysis of the effects of Budget cuts:


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