TL/DR –
A nurse working in a cancer clinic has been told her clinic will close for several weeks when she takes leave, due to a lack of funds. The author argues that it is not just lack of funds, but mismanagement, that is causing problems in the healthcare sector, as shown in a report on the failings of one healthcare organization. The report concludes that while funding matters, it does not guarantee good management, governance, or communication, suggesting that the problems in modern medicine are not always about money.
What happens when a vital cancer clinic nurse stops working?
Imagine a day in the life of a cancer clinic nurse, advising one patient to consume more fluids, sending another an electronic prescription, and consoling a third. These simple interventions can prevent a costly emergency hospital visit. Now imagine, the clinic closes for several weeks due to a lack of funding. It’s hard to believe that with such high costs associated with cancer treatment, there’s no money to sustain a nurse who saves the healthcare system exponentially more.
The ‘no money’ cliché in healthcare
Too often, shortfalls in healthcare are chalked up to “no money”, a mantra that clinicians have grown accustomed to. But as a damning report into one healthcare organisation’s failings reveals, mismanagement is often a more significant problem than funding.
Case study: Cohealth’s community health organisation
Cohealth, one of Australia’s largest community health organisations, serves disadvantaged patients, including those facing mental illness, homelessness, and substance abuse. Despite its $120m annual budget, it made a shocking announcement last year: it was closing three GP clinics due to lack of funding. This decision, causing great distress for over 12,000 patients, led to an inquiry into whether inadequate Medicare funding was the real culprit behind the clinic closures.
Unveiling healthcare delivery failures
The subsequent expert report revealed a sad tale of healthcare delivery failures. Poor practice oversight and high corporate costs were identified as the main reasons for financial loss. Cohealth’s systemic issues, hidden for a decade and kept from the board, were largely ignored. Staff ideas were brushed aside, and vague revenue targets were set. This led to considerable organisational and power distance, ultimately impacting patients the most.
Valuing clinicians’ observations
The report highlighted that while funding is important, it can’t buy responsive management, good governance, culture, communication, or integrity. It emphasised the importance of engaging clinicians and valuing their observations rather than viewing them as threats. The insights of healthcare workers are a societal asset, and their marginalisation results in disengagement and reduced productivity, ultimately affecting patient-centred care.
Lessons learnt
Cohealth has since accepted all the report’s recommendations and acknowledged the need for strengthened governance, leadership, and communication. Other healthcare organisations, where over $100bn of taxes are spent annually, can learn valuable lessons from this case. It serves as a stark reminder that healthcare failures are not always about money, but often about management, governance, and the proper engagement of clinicians.
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