Politician, Heal Thyself

by Nick Richardson - Herald-Sun

They are beaming down there on the northwest coast of Tasmania.

John Howard flies in, dispenses $45 million in largesse to keep the Mersey Hospital going, and flies out.

The Prime Minister looks like some kind of superhero, and before you know it, other towns and other hospitals throughout rural and regional Australia are lining up.

They will ask Health Minister Tony Abbott for the same kind of handout.

Nothing reveals the profound gap between a local community's perceived need and long-term health policy than this episode.

And nothing reveals more about John Howard's political style, and his determination to keep on using it, than his flying visit to Latrobe on Wednesday.

The immediate response from the Labor premiers was on the money: Howard's funding package in one of the nation's most marginal Liberal seats is all about the politics.

Yes, it is opportunistic, but does anyone on the northwest coast care?

No, they have their hospital back.

The Mersey, as it's known, had undergone profound changes in recent years and under Tasmanian Labor Government reforms it became a centre for elective surgery.

This was part of a long-term health strategy that rationalised services in some areas.

It meant the Mersey's intensive care unit was shut and specialist services moved about 50km away to Burnie Hospital and even Launceston in the north of the state.

This is Howard's shrewd political antenna at work.

He knows that nothing works better on the ground, with the people most directly affected, than snatching a vexed issue off the states and making the Federal Government look as if it has solved the problem.

But therein is the key issue: has he solved the problem or just papered over it until the real long-term issues emerge?

In a decade, will Howard's handout look less like the act of a benevolent uncle and more like reckless spending?

A clue to this is contained in some of the reactions from Tasmanian health professionals, because they are the people who will be left with the consequences.

The chairman of General Practice Tasmania, Dr Patrick O'Sullivan, who is also based on the northwest coast, says independent studies have shown current services at the Mersey are not safe and sustainable.

"For the Prime Minister to step in and ride roughshod over what has been a comprehensive, considered and consultative process is disgraceful," said O'Sullivan.

"We've fought hard for an evidence-based plan rather than a political quick-fix and this intervention will take us back to the past of political interference in sound health planning."

So, the changes to the Mersey were about fostering a long-term health plan for the region, rather than trying to keep open a facility that appeared to have been struggling for a future.

This is just one part of this issue.

But you can bet there are plenty of other regional centres around the country facing similar change in services because of funding issues.

More specifically, they are having difficulty in finding specialists to staff them.

And there is nothing in Howard's intervention that shows any long-term vision to address that problem.

Could it be that in a few years the hospitals at Burnie and Launceston will be suffering the consequences of intervention at the Mersey?

The other broader political concern is what this says about the nature of federal-state relations.

Howard has signalled again that he has no problem with riding over the states to deliver what is a politically saleable outcome to a particular constituency.

This runs counter to Kevin Rudd's Labor, which makes soothing noises about an era of co-operative federalism.

Expect several more of these incursions into the states from Howard during the months before the election.

It will, in that old-fashioned way, win friends and influence locals, but Howard has to be very careful about it.

The long-term reality is that he may poison his legacy by showing a willingness to pursue short-term gains rather than address the bigger problem at the heart of federal-state relations.