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Media Analysis On The Privatization Of Public Hospitals

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Question:

Discuss about the Media Analysis on the Privatization of Public Hospitals.

 

Answer:

Introduction

Australia has had a very long tradition that involves the provision of various health services by the private providers to private patients at a fee. There are also the provision of health services to public patients by a non-profit charitable or religious institutions. Up to the late 1970s, most of the numerous private hospitals aimed at making profits were small and mostly owned and run by various medical practitioners. However, there has been a development over the recent years in which there has been an increase in the expansion of the operation of the private hospitals aimed at making profits as many corporations have entered the market. There have been other changes in the private health sector due to the development of new technologies and more complex procedures which are undertaken in most of the private hospitals and the population ages. The private sector in Australia offers services to some of the patients in public hospitals under a contract with the government. The public sector also provides clinical and non-clinical services to different public hospitals. Therefore, these interconnections have blurred the boundaries that should be there from the private health sector and the public health sector (Brown & Barnett, 2004 p427). The government has privatized various public hospitals, for instance, Port Macquarie Base Hospital to provide affordable health services to the general public (Fox, 2013 p103). The press release to be analyzed in this article is from the NSW Nurses and Midwifery Association that is against the privatization of five major public hospitals which include Maitland, Bowral, Wyong, Shellharbour and Goulburn hospitals. The NSW Nurses and Midwifery Association argues that privatization of these hospitals will have adverse effects on the nurses, general public, and the government. The issues raised range from loss of employment, reduced safe patient care, lack of accountability, mismanagement of public funds among other problems (Nswnma.asn.au, 2015).

 

Discussion

The media article states the struggles that are there from the NSW Nurses and Midwives Association and the Australian government. The New South Wales Nurses and Midwives Association is a union that represents the industrial interests of all nurses in New South Wales (Nswnma.asn.au, 2015). The association is so important in Australia since there is workforce shortage and these nurses are exploited (Sullivan, Lock & Homer, 2011 p331). The article reveals that the NSW Nurses and Midwives Association is protesting the privatization of five public hospitals again. The association believes that privatization of these five hospitals will lead to numerous problems that will affect the whole society. The media article views the many adverse effects of privatization in various perspectives. The article highlights on the effects privatization will have on the nurses, the government, and the patients. Public-Private partnerships have been found to significantly affect the health staff negatively since when the public hospitals are privatized, the staff that was employed in the public hospitals finds no employment in the newly privatized hospitals. The private sector uses their set of health workers. Hence there are no positions for the old staff at the new hospitals. The article also states that the nurses will have little alternatives since the private sector is rigid and does not readily conform to changes. The media release also states that the Minister for Health, Jillian Skinner says that the only persons that will be offered employment in the newly privatized hospitals are the permanent staff if only a similar job to that they held in the public hospitals is available (The Sydney Morning Herald, 2017). These sentiments, therefore, means that the casual staff has few and limited rights.

 

Effects on the Nurses

The NSW Nurses and Midwives Association is fighting the privatization of the five public hospitals because its members are in the darkness in regards to their future working conditions and even the entitlements. The article argues that the nurses will be entitled to only a two-year employment guarantee after privatization and their contract can be terminated after the two year period. Privatization of the five major public hospitals also will leave the nurses and midwives with no opportunity to negotiate since the private investors are expected to be tougher in formulation and execution of their policies since they are strictly into business and their main aim is to make higher profits. The association is not happy with the privatization process as its members who are professional nurses and midwives are made to wait on the sideline as their prospects and projections are discussed and analyzed without consultations with them. The media release shows that the NSW Nurses and Midwives Association is not pleased with the privatization of the five public hospitals as they were not consulted nor were they given any warning on these new developments. The association believes that they should have been informed earlier so that they could table the interests of the people that they represent. The media release shows that the NSW Nurses and Midwives Association is opposed to the ignorance of the government and the private health sector on the rights of the health workers and the community. The association is the introduction of the regulation that was involved in the termination of the redundancy entitlements of various public servants who are transferred from government employment to the non-government private sector (Nswnma.asn.au, 2015).

 

Effects on the Patient

Under the perspective of the patient, the article suggests that the patients will also be negatively affected. There will be reduced safe patient care due to the reduction of the quality of services offered in the private sector since the private investors try to minimize costs and maximize profits and are not much concerned about the welfare of the patients. Due to cost cutting, the private sector may not be able to provide quality health care via patient safety interventions and approaches. The private sector is interested in the revenues that the patient offer hence the best interests of the patients may not be at heart. The private hospitals can hold a patient even though they know they will not be able to improve his condition instead of referring him to other facilities that can handle his situation because they want to take his money. Privatization requires cultural and institutional change (Connell, 2010 p25). The patient may also not be treated due to lack of funds unless in public hospitals where the patients are treated for free or at a lower cost. The media release also reveals that the community has been kept in the dark as the government and the private sector have not involved the community in the decision-making process. The community needed to be part of decision-making since these changes affect them directly. The NSW Nurses and Midwives Association is aware of these problems that may face the patients if the five major hospitals are privatized. The privatization of these public hospitals will upset the nurse to patient ratios as the private health sector tries to minimize costs and maximize profits through employing few nurses to deal with the growing population (Nswnma.asn.au, 2015). The association is determined to pass this information to the general public so that they can join them in the fight again privatization of the five public hospitals.

Effects on the Government

From the government point of view, the media article states that the privatization of the five public hospitals will lead to the loss of the government ministered accountability since the private operators are involved in the management of government money (Acerete, Stafford & Stapleton, 2012 p311). The private operators’ misuses the state resources and fully exploits them to serve their immediate purpose as they are only interested in profit making. The abuse of the government resources to maximize profit is because the private operators have a duty to the various stakeholders who are mostly after making money and profits. The private operators always promise affordable services to entice the government in privatizing public hospitals but most of the time their plans fails, and they go back to the government asking for more funds due to the underestimation of the demand. The government is usually forced to pay up, or it is made to take back the control of the hospitals and pay huge compensations to the private companies (Regan, Smith & Love, 2011 p365). The media article reveals that the privatized hospital models have had a history of a high rate of failure in Australia. The example given is that of Port Macquarie Base Hospital which failed after privatization.

Interrelations between Various Parties

The article indicates that there are various ways in which the public health sector and the private health sector interrelates. The primary relationship method is through privatization of the public hospitals as well as the private provision of numerous services for public patients. The Australian government has made many arrangements which combine both the private and the public sectors in management, ownership, service delivery as well as financing of the hospitals. The privatization of public hospitals by the Australian government is mainly due to the financial constraints experienced by the government which usually limits the capacity to make new investments or expand the facilities that are found in the public hospitals (Domberger & Rimmer, 2008 p445). There is a perception also that there will be cost sharing which leads to the improvements in the quality of health care via the private sector involvement. The other links are through outsourcing of clinical and also non-clinical services in the public hospitals, and purchase of services from the public sector by the private hospitals. Although there is the outsourcing of non-clinical services by the private contractors, privatization does not guarantee employment of non-clinical staff. These services include laundry, catering, maintenance, car park, cleaning, and security. The NSW Nurses and Midwives Association claims that the subordinate staff will lose their employment as the private contractors may reshuffle the employs and terminate some employments as a means of cutting cost and increasing profits (Nswnma.asn.au, 2015).

 

Benefits of Privatization

However the media article is mainly focused on the downside of the privatization of public hospitals by use of colored language, some advantages are attributed to the privatization of public hospitals. Privatization enables the reduction of duplication of services between the public and private sectors allowing the government to take advantage of the excess private capacity to meet the unmet public sector demands (Hodge & Greve, 2007 p547). The government can get private financing hence being able to achieve public policy goal (Sekhri, Feachem & Ni, 2011 p1498). There is also increase in the flexibility in the service provision allowing the issue of unmet health demand in the public sector to get a sufficient attention as well as increased choice for patients and better quality services (Braithwaite, Travaglia & Corbett, 2011 p133). The privatization enables the sharing of infrastructure costs since there is the high cost of health capital as well as risk transfer which leads to enhanced efficiency (Siddiquee, 2011 p129). These advantages are the probable cause of the need to privatize the five public hospitals by the Australian government.

Methods used by the Media

The media release portrays the ideological viewpoint of the NSW Nurses and Midwives Association which argues that the Baird Government is not concerned with the welfare of its people as it is making policies and deals with the private health sector that do not represent the needs of the community or upholds the rights of the workers. The media uses many approaches to convince the general public the plights that await them if these hospitals are privatized. The media tries to air the various adverse outcomes in different perspectives as well as uses the evidence of Port Macquarie Base Hospital that failed after privatization. The author of this media article, the General Secretary of NSWNMA, Brett Holmes is an expert in the nursing field hence uses the media article to vividly discuss the many challenges that will face the health sector if the five hospitals are privatized (Nswnma.asn.au, 2015).The media article uses emotive language as it cites various instances where the rights of the nurses have been violated and the suffering associated with those violations.

The reader of the media release is a watcher who the NSW Nurses and Midwives Association tries to explain to the problems that the Australian health sector is about to face if those hospitals are privatized. The perspective of the private contractors is left out although it is important. The private contractors are a source of revenue to the government hence their point of view is important. The article convinces me fully on the adverse effects of privatization especially the failure of Port Macquarie Base Hospital which makes the claims of the association seem real. Different people will react differently especially those that benefit from the privatization, for example, the private investors. They will rubbish the claims of the press release. The question that lingers in my mind as I read this media release is where the government advisers are? This is because the government is making a mistake that it has made once again of privatizing public hospitals which are doomed to fail.

Conclusion

The media release by New South Wales Nurses and Midwives Association is an argument against the privatization of five public hospitals. The arguments are balanced among the perspectives of the government, nurses and the general public. The article uses emotive language as well as retaining the formal tone of the recognized nurses association. The article explains that the patients will suffer as there is the risk of reduced safe patient care while the nurses have job insecurities if the hospitals are privatized. The government also will suffer financially as the private hospitals will keep asking for incentives or worse compensation (Nswnma.asn.au, 2015). The Association urges the government to change the policies and stop the privatization process.

Recommendations

The government needs to hold talks with the NSW Nurses and Midwifery Association on the better plans to improve patient care without privatization of these five hospitals. The involved stakeholders need to be all involved in the decision making since these changes affects all the parties.

 

References 

Acerete, B., Stafford, A. and Stapleton, P., 2012. New development: New global health care PPP developments—a critique of the success story. Public Money & Management, 32(4), pp.311-314.

Braithwaite, J., Travaglia, J.F. and Corbett, A., 2011. Can questions of the privatization and corporatization, and the autonomy and accountability of public hospitals, ever be resolved?. Health Care Analysis, 19(2), pp.133-153.

Brown, L. and Barnett, J.R., 2004. Is the corporate transformation of hospitals creating a new hybrid health care space? A case study of the impact of co-location of public and private hospitals in Australia. Social Science & Medicine, 58(2), pp.427-444.

Connell, R., 2010. Understanding neoliberalism. Neoliberalism and everyday life, 23.

Connell, R., Fawcett, B. and Meagher, G., 2009. Neoliberalism, new public management and the human service professions: Introduction to the special issue. Journal of Sociology, 45(4), pp.331-338.

Domberger, S. and Rimmer, S., 2008. Competitive tendering and contracting in the public sector: A survey. International journal of the economics of business, 1(3), pp.439-453.

Fox, K.J. ed., 2013. Efficiency in the public sector (Vol. 1). Springer Science & Business Media.

Hodge, G.A. and Greve, C., 2007. Public–private partnerships: an international performance review. Public administration review, 67(3), pp.545-558.

Nswnma.asn.au, (2015). NSW Nurses and Midwifery Association. [Online] Available at: https://www.nswnma.asn.au/ [Accessed 12 May.2017]

Nswnma.asn.au, (2015). NSW Nurses and Midwifery Association. [Online] Available at: https://www.nswnma.asn.au/public-hospital-privatisation-a-sad-day-for-nsw/ [Accessed 12 May.2017]

Parliament of Australia, (n.d). Chapter 6-The interference between private and public hospitals. [Online] Available at: https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/Completed_inquiries/1999-02/pubhosp/report/c06/ [Accessed 12 May.2017]

Regan, M., Smith, J. and Love, P., 2011. Infrastructure procurement: learning from private–public partnership experiences ‘down under’. Environment and planning C: Government and policy, 29(2), pp.363-378.

Sekhri, N., Feachem, R. and Ni, A., 2011. Public-private integrated partnerships demonstrate the potential to improve health care access, quality, and efficiency. Health affairs, 30(8), pp.1498-1507.

Siddiquee, N.A., 2011. Rhetoric and reality of public–private partnerships: Learning points from the Australian experience. Asian Journal of Political Science, 19(2), pp.129-148.

Sullivan, K., Lock, L. and Homer, C.S., 2011. Factors that contribute to midwives staying in midwifery: a study in one area health service in New South Wales, Australia. Midwifery, 27(3), pp.331-335

The Sydney morning herald, (2017). Five NSW hospitals to be privatized under ‘Surprise’ plan. [Online] Available at: https://www.smh.com.au/nsw/five-nsw-hospitals-to-be-privatised-under-surprise-plan-20160915-grh6mq.html/ [Accessed 12 May.2017]

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