In NSW,the annual health spend is $38 billion – more than one-third of the state’s budget. The truth is,no one knows where it’s all going or how it’s being spent. Health workers who keep the system moving – such as paramedics,therapists,radiologists,cleaners and nurses – know it’s not going to salaries. They have been operating under a pay cap for the last decade. Indeed,research by Professor David Peetz shows the average health worker will be several thousand dollars out of pocket due to the wages policy. In 2022-23,for example,a second-year paramedic will see their annual income shrink by $2402.61.
This underinvestment in staff has fostered an attraction-and-retention crisis. In the 10 years to March 2020 the number of vacancies in the NSW health sector doubled from around 3000 to 6000,but by July 2022 they nearly doubled again to almost 12,000 vacancies.
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Every day health and hospital workers are going backwards,and we are on the precipice of a mass resignation. Yet,there is little transparency about the income of non-salaried doctors and specialists. What we do know is concerning. Locum doctors,for example,now charge up to $5000 per day,or $35,000 per week before expenses and accommodation. NSW spent $997 million on visiting medical officer costs in 2020-21,which was four times more than Victoria and 10 times more than Queensland.
There is also ample evidence of cost shifting in the system. A recent freedom of information request revealed about one-in-10 hospital beds in the Illawarra is occupied by an aged care resident. Anecdotally,we know there are similar challenges with disability care.
The unedifying squabbles between private health insurers and device manufacturers over who gets a bigger slice of the pie is another prime example of a complete lack of focus on how the public benefits.
There is no question Australia and NSW enjoy a world-class health system. But to stay healthy we need more than a cursory check-up. We need a full-body examination of where and how our health dollar is being spent.
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