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    Rob Lake

    lovely, i’d like to register, attendance, contributions to debate, committees and contributions, declarations, donations, speeches and questions.

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    Check out the My Birth website – this website was built by myself and another mum.

    The Government would not build this website so we had to do it ourselves.

    The My Birth website makes perinatal statistical data accessible to Australian women to help them understand their choices during labour and birth. By making the data more publicly accessible, we hope it will also encourage more transparency and discussion about maternity services and the current rates of intervention.

    We have taken the relevant data from the publicly available perinatal data reports from across Australia and created a database which people can search using their post code or by state to see the maternity services in their local area and the intervention rates for those maternity services.

    Our Federal Government is making pivotal decisions about how every Australian child will be born in the future. We need to look at the data to help make the best decisions possible. Ideally we would like to see all Australian maternity service providers making their statistics public and transparent, including obstetricians. As many of these services are funded by the taxpayer with millions of dollars of public money each year we feel this information should be easily accessible and freely available to the public.

    If Australian parents have the right to know the performance statistics of where their child will be educated, then they must also have the right to know the statistics of where that child is born, and what alternatives are available to them.

    Michelle Meares – My Birth

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    Interesting that Gavin presents just a week after an article was published in The Age (28 January 2010) “Plan for national hospital monitor” suggesting that bureaucrats were engaged in a $4 billion proposal to monitor and scrutinise Australia’s hospitals with the Federal Minister declining to comment.

    For those of us who perhaps have been around too long the evidence on performance and outcomes is obvious and well known. Inner city teaching hospitals consume the greater proportion of resources, outer urban city hospitals generally have much less resources for the same population, but much needier communities and by the time we get to rural and Aboriginal communities the equation is bleaker.The resource allocation also generally reflects health status and outcomes(or lack of). Perhaps this is the same issue for the where any indicator of dollars invested per child and how that is allocated geographically and its relevance to effectiveness is strangely absent!

    In both Schools and in hospitals in most States they are directly funded, managed and services are delivered by State bureaucracies. So, in reality the ‘Commonwealth State body’ to be created to oversee hospitals will be examining its own performance. Hospitals can only operate within and to the extent of State allocated funds and have little local authority or capacity to manage in their own right.

    The evolution of large State controlled health systems has occurred with little public debate or evaluation of effectiveness. The approach is not consistent with the historical, political or cultural context of health care in Australia. Increasingly these highly systemic approaches have failed if formal public Inquiries are taken as a measure of failure. Generally health professionals and communities have been disengaged from any governance or decision making about what communities need and want in terms of health care.

    Until a re-engagement of communities and health professionals in governance of their health system is re-established and management and organisational scale is returned to proportions that allow diversity, engagement and innovation in health care organisation and delivery we will continue on an ineffective path to further tight centralised bureaucratic control.

    I would love the alleged $4 Billion to develop this watchdog to be better used by committed communities and health professionals to demonstrate how they could reshape and make more effective the health care of our communities. The debate on hospitals and performance ahead of effectiveness, that is the outcomes of care, is highjacking the health care debate and I am not looking forward to sitting in awe and amazement of charts and graphs about what is already substantially known. Maybe some of the outcome measures might assist but also need to identify resource use. Lets keep some of the $4 billion for effective health care reform and let communities and committed health professionals demonstrate what they are capable of achieving.

    Dr. David Briggs is Co-ordinator of Health Management Programs at the University of New England and Editor of the Asia Pacific Journal of Health Management.

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    Mary Osborn

    Myhospital, myschool and myjob. Myjob like myhospital is supported by MyJulia. Fair choices for a fair days work. You can go on the web site and compare your jod work agreements with other similar job agreements. You can ask people to join your myjob face book and compare levels, discuss bargaining agreements and how to negotiate ways to meet expectations.


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