June 27, 2022

PPP

Privatisation means dirtier hospitals

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Governments have to clean up the mess left by private contractors.

The People’s Inquiry into Privatisation received details of “numerous” public hospitals that had been wholly or partly privatised, only to be returned to public control.

They were handed back to governments after “catastrophic contracting failures endangered service provision to the public”, the inquiry said.

The inquiry report cited examples from all states including Port Macquarie Base Hospital (NSW), La Trobe Valley hospitals (Victoria), Modbury Hospital (South Australia), Robina Hospital (Queensland), Mersey and North West Regional hospitals (Tasmania) and Fiona Stanley, Perth Children’s and Midland hospitals (Western Australia).

The report said privatisation seriously affected hospital cleaning services – a crucial element in disease control and patient safety.

It found that new contracting arrangements under privatisation required cleaners to work at a faster rate, to the detriment of public safety.

Cleaners also suffered reduced job security, making it difficult for them to speak out about employment and hospital hygiene issues.

A submission by the Uniting Church’s Justice and International Mission cited evidence from the UK where the contracting of cleaning services has largely been abandoned due to failures relating to staff retention, training and engagement that produced serious infection control issues.

Even more work for nurses

The inquiry report cited Sydney’s Royal North Shore Hospital (RNSH) where cleaning services were contracted out through a “public– private partnership” (PPP) but had to be returned to public control due to ongoing problems.

The report said that in 2008, the NSW government announced that in order to redevelop RNSH, a PPP would be entered into with a consortium called Infrashore, which would build the new facility and provide ‘soft services’ and maintenance services until 2036. After this time, the hospital building would be handed over to NSW Health.

A confidential submission to the inquiry outlined some of the problems including disputes over the quality of service provided after cleaning and portering staff numbers were cut by 20 per cent.

“Patient care was being delayed by a lack of porters and the nurses were picking up extra work. Delays with cleaning beds after a patient was discharged at one point reached six hours – causing a huge backlog of patients in the emergency department.

“This had a debilitating impact on an already struggling service and the RNSH branch of the NSWNMA resorted to writing to Jillian Skinner MP, NSW Health Minister, begging her to intervene.”

Earlier this year it was announced that consortium member ISS lost the contract for soft services and Healthshare (part of NSW Health) was to take over for 18 months.

“This was to bring the service up to the level required at which point it will then go out to private industry to tender for the ongoing contract,” the inquiry reported.

It noted that the retail arm of the PPP had clashed with the hospital volunteers who run a shop with all profits donated to the hospital.

“Not only was the volunteer shop relegated to a low traffic area, a rival convenience store was opened close to the entrance, taking a lot of the volunteer shop’s business.”

12,000 say ‘Don’t sell Shellharbour hospital’

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The Illawarra community has shown it is determined to keep Shellharbour Hospital in public ownership.

A petition signed by more than 12,000 Illawarra residents opposing the privatisation of Shellharbour Hospital prompted vigorous debate in the NSW parliament last month.

Labor MPs said the petition showed the depth of community feeling and demanded the government rule out any privatisation plan.

Even the Liberal Party’s MP for Kiama, Gareth Ward, demanded the government make a quick decision on the issue.

Shellharbour is one of five regional hospitals originally listed for privatisation under a “public–private partnership” (PPP) late last year.

The government has since abandoned PPPs at Wyong, Bowral and Goulburn hospitals but Shellharbour and Maitland hospitals remain up for grabs.

The parliamentary debate on the Shellharbour Hospital petition was watched by hospital staff and community supporters who travelled to Sydney by bus.

They included emergency department nurse Silvana Dimovski, who finished a busy nightshift before boarding the bus after less than two hour’s sleep, the Illawarra Mercury newspaper reported.

“The community is rallying behind us – I hear it at the shops, on the street, and on the wards,’’ she told the paper.

‘’I’m fighting for my patients to have quality care, for the community’s right to have equitable access to their hospital. And I’m fighting for my colleagues and I to have job security, to not lose our current salaries and entitlements.’’

Cracks in the Coalition

Inside parliament, MP Gareth Ward, the government’s Parliamentary Secretary for the Illawarra and South Coast, caused a stir when he demanded an answer from Health Minister Brad Hazzard on the hospital’s future.

“Hurry up and get this thing done,” he told the minister.

“Whatever decision you make, I want to see the facts, I want to see the evidence, and I think it’s high time that this debate was brought to a close.

“We all want to know all of the information; it’s time to make a decision. I ask you to do that, Minister.”

On the Labor side, Shellharbour MP Anna Watson said residents had “made their feelings undeniably clear”.

“We have evidence from every corner of the community… we all stand together and collectively reject this government’s privatisation agenda.”

Member for Wollongong Paul Scully said it was “time the government listened” to what the Illawarra had to say and “back-flipped” on their decision.

Keira MP Ryan Park said the region was known for its “fighting spirit” and “over 12,000 people have made it very clear that this is a hospital that should remain in public hands.”

Support for Shellharbour’s nurses and residents has also come from communities that earlier forced the government to back down on hospital privatisation.

In Bowral, local shire councillor Graham McLaughlin said the government had backed down on issues when it faced a major community backlash.

“I’m hoping the people of Shellharbour can get a win like we’ve had up here,” he said.

Wyong MP David Harris said his community’s defeat of hospital privatisation had “resonated right through the whole community and that’s what we have to capture in Maitland, Shellharbour and Port Kembla – not because we’ve had a victory, but because it’s the right thing to do.”

 

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Keeping Bowral and District Hospital PUBLIC!

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The NSW Nurses and Midwives’ Association (NSWNMA) has today welcomed reports the Berejiklian Government has capitulated on the privatisation of Bowral and District Hospital.

General Secretary of the NSWNMA, Brett Holmes, said the decision was a testament to ten long months of campaigning together with members of the community group, Public Health First, local health workers and their supporters.

“Another day, another victory for the people. This is a sensible outcome for Bowral Hospital and will ensure the redeveloped facility remains in public hands, as it should be,” Mr Holmes said.

“We congratulate NSW Health Minister Brad Hazzard for listening to our concerns and not just pressing ahead with the public-private partnership model that was left behind by his predecessor.

“Our members had been extremely concerned, not only about their own job security under a public-private partnership arrangement, but also over the lack of guaranteed safe patient care and accountability of taxpayers’ money.

“There is abundant evidence indicating public-private partnerships in health don’t work. They are an expensive ill-fitting exercise for the health sector that often end up costing the government, and therefore taxpayers, much more than anticipated.

“Local nurses, midwives, doctors and other health workers from Bowral and the surrounding area raised these issues since the proposal was first announced last September and it’s very pleasing to see their hard work and dedication to oppose this plan has been rewarded with the best result.

“Now the Berejiklian Government has walked away from plans to privatise Bowral Hospital, it must bring forward the remaining funds required to deliver a better public health service for the people of Bowral.”

Mr Holmes also called on the Health Minister to immediately extend the same courtesy to the communities of Shellharbour and Maitland and scrap their hospital privatisation plans.

“Yesterday, Wyong Hospital redevelopment was secured in public hands and today we learned Bowral will be kept public – it is vital the Health Minister does the right thing and delivers a publicly built and operated new hospital in Maitland and also Shellharbour,” said Mr Holmes.

The NSWNMA has reiterated it will continue to campaign all political parties until all proposed public hospital privatisations in NSW are scrapped.

Download this media release: Keeping Bowral and District Hospital PUBLIC

Regions reject hospital privatisations

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Packed public meetings show health care privatisation is a hot topic in regional communities.

People were angry – they just disagree 100 per cent with the idea of privatisation.”

That’s how nurse Laura Valenzuela summed up the mood of a public meeting called to discuss the proposed privatisation of Shellharbour Hospital on the NSW south coast.

About 300 people packed the Shellharbour Club to hear speakers including representatives of the NSWNMA, state MPs and local councillors.

The Liberal member for Kiama, Gareth Ward, sidestepped a questioner who asked him: “If it’s clear that this community does not want a PPP (public-private partnership) will you support the wishes of your community?”

“I don’t know what’s going to come out of this process,” he replied, to the obvious anger of the meeting.

Shellharbour mayor Marianne Saliba told Mr Ward: “Why did the state government put this hospital out for a tender process in the first place? You are trying deliberately to destroy this city.”

Shellharbour is one of five regional public hospitals to be converted to PPPs under a NSW Coalition government program announced in late 2016.

The then Health Minister, Jillian Skinner, invited expressions of interest from private and not-for- profit operators to build and run Maitland, Wyong, Goulburn and Shellharbour hospitals and to operate Bowral Hospital.

At the time of the announcement General Secretary of the NSWNMA, Brett Holmes, said the “appalling” decision meant the government was effectively gifting the hospitals to private companies.

He warned patient care and patient safety would now be subordinate to the profit motive of private operators, pushing the health system further towards the American model.

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Quality and cost of private care questioned at Shellharbour

At the Shellharbour meeting, Glenn Hayes, president of the Illawarra mental health branch of the NSWNMA disputed the government’s claim that privatisation would not affect standards of care.

“I don’t know how this can occur. No private provider in NSW provides ratios for patient care,” he pointed out.

There was no answer to Shellharbour Hospital nurse Nadia Rodriguez’s question about how much access public patients would get under a PPP model. “I would like to know how many beds are going to be allocated to private patients and how many to public patients, knowing that the majority of people in the Illawarra do not have private health insurance,” she asked.

Shellharbour nurses were supported at the meeting by NSWNMA branch members from nearby hospitals.

Nilda Miranda, a member of the Port Kembla hospital branch said: “I’ve seen what privatisation can do to a country. I’ve seen people handing over not their credit card but a cheque at the front of the clinic. And if they can’t provide that they get no services.”

Wollongong Hospital nurse Naomi Hayes said privatisation of Shellharbour Hospital would hurt Wollongong Hospital too.

“Everyone is concerned about what’s going to happen if Shellharbour Hospital is privatised. What’s going to happen to the services and the care? Everyone is concerned for the community.

“Wollongong is already under pressure because of the growth in the area. The main thing is, don’t give up the fight.”

The meeting finished with an overwhelming vote against privatisation.

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Bowral told PPPs “fail repeatedly”

Earlier, at the Bowral Memorial Hall, 200 people heard Dr Geoff Murray, Clinical Director of Rehabilitation Services for the Illawarra Shoalhaven Local Health District, described how the PPP model of care had “failed repeatedly”.

“Port Macquarie Hospital, La Trobe in Victoria, St Vincent’s Robina – all of these had to be bought back by their governments,” he said.

“We must make it clear to the NSW government that handing over public hospitals to private corporations is totally unacceptable.”

Bowral Hospital nurse Margaret Samuel said the meeting showed that residents were “concerned about what the PPP actually means, what services are going to be lost or added and how is the $50million for redevelopment of Bowral Hospital going to provide for a proper redevelopment.”

“A lot of the questions weren’t answered. Maybe that’s because they don’t have the answers yet, I’m not sure.”

One community member asked Liberal MPs: “How can we the public believe you will made an unbiased consideration when we know that Ramsay made considerable donations to help you get elected?”

200 people attend Maitland forum

In Maitland, the local newspaper the Mercury hosted a public forum that drew around 200 people anxious to hear details of the government’s plan for the local hospital.

The CEO of Hunter New England LHD, Michael di Rienzo, told them: “We are awaiting a decision from government to determine if we will proceed past the expression of interest phase and into a request for a proposal.”

Michael Lawler, a member of the John Hunter Hospital branch of the NSWNMA, said that response was disappointing.

“They have already had four to six years and they really can’t give us any more information and any guarantee about when the hospital will be built and when it will take its first numbers.”

Another John Hunter branch member, Clare Bolton, said evidence showed that “privatisation – complete or partial – of public services does not provide more efficient services, does not provide safer patient care, and certainly does not provide a better outcome for the staff that work in those services.”

“I asked the panel whether or not they could guarantee that there would be no negative impact on service provision to the community, safety of patient care or degradation of staff employment terms and conditions.

“There was no guarantee there would be maintenance of nurse-to-patient ratios or maintenance of skill mix ratios within the wards and clinical services.”

Farce upon farce

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A privatised hospital still being built is already delivering top outcomes in the surreal world of the NSW Parliamentary Secretary for Planning, Scot MacDonald.

A classic clip from the television political sitcom “Yes, Minister” turns on the minister’s visit to a brand-new hospital.

Minister Jim Hacker is appalled to discover the hospital is “open” and fully staffed but has no patients.

“It’s a very good thing in some ways. Prolongs its life, cuts down running costs,” explains the administrator, Mrs Rogers.

When Hacker threatens to close the hospital unless it gets some patients Mrs Rogers counters: “But minister, it’s one of the best run hospitals in the country.”

For “Mrs Rogers” substitute Scot MacDonald, Parliamentary Secretary for Planning, the Central Coast and the Hunter in the NSW Liberal government.

MacDonald was on stage at the Wyong Leagues Club on a recent Thursday night.

The occasion was a community forum on his government’s plan to privatise Wyong Hospital as a “public–private partnership” (PPP).

A member of the audience asked him: “Can you give us an example of where this PPP has worked?”

“My understanding is Northern Beaches is working well,” MacDonald replied.

Unlike the fictional hospital in “Yes, Minister”, the Northern Beaches PPP is still being built and will not open until 2018.

Beyond the laughs, anger

Amid laughter from the audience MacDonald added: “It is still being developed. You asked for an example. I’m offering that to you as an example.”

As Wyong nurse Craig Gross commented, “You can’t use something that isn’t operating, that isn’t proven, as a shining example of what a PPP is.”

Craig said the meeting showed that “People are angry that this is a community built, community funded hospital that the government is now looking at privatising. People don’t feel that’s right. We will keep on campaigning. Nobody wants this.”

A member of the NSWNMA’s Central Coast mental health branch, Graeme Miller, said the forum revealed the government did not want to give the community a choice.

“The question was directly asked – why not let the community vote on what is happening with the  hospital? And they would not answer it,” he said.

Collette Brennan, a member of the union’s Wyong hospital branch, said community members came to the meeting seeking answers.

“We didn’t really get any good answers. They fumbled around a lot and tried to avoid answering the questions,” Collette said.

She urged people opposed to privatisation to attend protests and write to the government.

Wyong nurse Jacinda Farrell was dubious of government claims that a PPP would make no difference to the way public patients are treated.

“We’ve been told that public patients will be treated as per normal with no hidden costs or extra fees. I guess that is yet to be seen,” she said.■