Ben Harvey: Past Budget decisions help explain why Sir Charles Gairdner Hospital is such a mess

Crisis is the most overused word in the English language, especially when in the hands of a journalist. We reporters throw those six letters around like confetti. In our insular, hysterical world nothing is ever just a “problem”. We are professional catastrophisers. That said, Sir Charles Gairdner Hospital is emerging as a legitimate crisis for the Cook Government. It might not be a clinical crisis (yet) but Charlies is a bonafide political calamity. It takes a fair bit to shock a population accustomed to ambulance ramping, bed blocking, cancelled surgeries and stretched waiting lists but the litany of maintenance problems besetting Charlies gave us all pause for thought. For the first time since the Aboriginal Cultural Heritage Act debacle, the State Opposition had the Cook Government on the ropes. “A world-class health workforce in a Third World system,” was Basil Zempilas’ zinger of the week. It’s not Third World, of course. Have a walk through an emergency department in Myanmar and you’ll see no resemblance to the ED at Charlies. But it’s bad. This current drama is a hangover from decisions made a full eight years ago. Glance at the past week’s headlines and you’ll appreciate that this isn’t a “I have got a bit of a headache” hangover; it’s a “wake up with a Mike Tyson face tattoo” kind of hangover. The chickens that have now come home to roost were set wandering soon after the election of Mark McGowan in 2017. This was a time when the WA economy was in the toilet and State Budgets were drowning in red ink. “The worst set of books since the Great Depression,” Sneakers warned us ominously after taking office. As the new mayor of Shanty Town, Mark needed to find some savings fast. The swollen health budget was a prime target for a nip and tuck so the new Government commissioned a report into hospital spending. The Sustainable Health Review (that’s a title straight out of Utopia, isn’t it?) noted that the health portfolio was eating up an ever-greater proportion of the total State budget. It was 18 per cent in 1993 but 30 per cent in 2016. If someone didn’t pump the brakes, health was on track to account for $2 of every $5 spent by the WA Government. The toecutters at Treasury had also noted that it cost a bit over $6300 to treat a patient in a WA hospital compared with $4700 in Victoria. There was clearly a lot of fat in the system, policy wonks who had never worked inside a hospital concluded. McGowan became the Ebenezer Scrooge of health. To put his miserliness in context, consider these stats. In Colin Barnett’s first year of office in 2008, health grew by 12 per cent. It had averaged growth of 9 per cent a year for the preceding decade. In McGowan’s first year in office, growth was 2 per cent. A year later, it dropped to 1.4 per cent. The ever-increasing cost of medical equipment means you need to increase spending by at least 5 per cent a year just to stand still, so these were serious cuts. The Australian Nursing Federation and Australian Medical Association went bananas, saying patient lives were at risk (also affiliation fees, because less health money means fewer doctors and nurses paying their membership dues) but McGowan wasn’t for turning. It took a child’s death for him to loosen the purse strings. The public outcry after Aishwarya Aswath died at Perth Children’s Hospital in April 2021 could not be ignored. Labor started throwing money at the problem but by that time the damage had been done. Anyone who owns a house knows that if you scrimp on maintenance you’re going to pay eventually. It’s taken a while, but the chooks have made it home. Last week it was Health Infrastructure Minister John Carey’s turn to take a big old bite of the health s*** sandwich. The Health Infrastructure portfolio was created specifically to oversee the construction of the new women’s and children’s hospital, so in between mouthfuls John was probably wondering why he was having to answer questions about Legionnaires’ Disease. But answer the questions he did, albeit sounding like Homer Simpson chasing that runaway roast pig (“it’s just a little dirty, it’s still good, it’s still good!”). Tony Blair’s spin doctor, Alastair Campbell, believed that if a politician could weather a political storm for 11 days, then they would survive and move on. The “Hospital of Horrors” headline which kicked off this crisis was printed on August 12. Let’s see whether John can hold his breath for another four days.