Croakey has been wondering what the trend towards MyWebsites – like MyHospitals, MySchool, MySuper etc – says about where Australia is heading. Is there more to us than me, myself and mine?
Would we feel differently about the health system if we now had a website called OurHospitals?
Meanwhile, health economist Professor Gavin Mooney says the narrow focus of initiatives like MyHospitals risks obscuring the larger role of hospitals as social institutions.
Gavin Mooney writes:
There is much to be admired in efforts to measure hospital performance and in what MyHospitals is seemingly trying to do. But care is needed, especially in a world where quantification is everything and where what is not quantified does not exist.
It is possible to ridicule the efforts on MyHospitals. Now that I know that waiting times for elective surgery are better at the Royal Brisbane than here in Perth, then maybe I should have gone to Brisbane to wait for my surgery. It might have been expensive hanging around Brisbane waiting but at least if I had had that information I could have made the choice whether to wait here or wait there (assuming Queensland Health were OK about all of this).
But then I wasn’t needing surgery 6 months ago when these figures were valid, so why would I have gone to Brisbane?
But there is a more fundamental issue here and that is this: what do we as a society want from a hospital?
What is the good of a hospital from a societal perspective? Funnily enough, I don’t think anyone really knows because no one seems to ask the question!
I was involved recently in setting up and conducting a small survey on ‘the good’ wanted of Women’s and Children’s Hospitals in Australia and New Zealand. The survey was not of the public or citizens but of some staff in these hospitals. Certainly those surveyed did want their hospitals to deliver health improvements but they also wanted the hospitals to do and to be all sorts of ‘soft’ things like being family supportive and family friendly; they wanted their institutions to be caring – the sorts of things that are difficult to measure. And yet may matter. And fortunately difficult is not impossible.
I am not at all surprised that staff want their hospitals to do this sort of good. I would bet if we asked the patients and the citizens what they want, they too would want their hospitals to be compassionate, caring institutions.
The Health Minister, Nicola Roxon, tells us what we want from our hospitals. Well in practice what she tells us is that what we want is what is available to be measured from existing stats. This is a case of (in the words of one of the leading Canadian health economists, Bob Evans) moving the target to hit the bullet
How about asking us, the Australian citizens? They are our hospitals. They are social institutions.
Please Nicola, now you have the site up, why not ask us what we want from OurHospitals?
Then, whatever that is, see how best to measure that.
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For other recent Croakey posts on MyHospitals
Hear hear! Hospitals, like schools, are special places for communities, as evidenced by the furore when services are reduced or a hospital is closed down. Hospitals which work well are firmly embedded in their community, and deliver outpatient services and outreach programs, not just emergency care and elective surgery. A hospital is usually one of the largest employers in a community, and can become a focus for local effort and pride. Everyone who works in a hospital, whether they be a cleaner or the director of medicine, has a reason for working in the health sector and derives personal meaning and identity from their attachment to a social institution. Providing some community services on hospital campuses allows them to stay grounded, to be a place that people visit when they are both sick and well.