Qld public health "not cost effective" says Audit Office
QUEENSLAND public hospital patients are waiting unnecessarily to get tested or receive treatment and taxpayers are paying too much because high-value medical equipment is not being used efficiently.
The Queensland Audit Office report into efficient and effective use of high-value medical equipment, which was tabled in Parliament on Thursday, found local hospital and health services were often paying too much to purchase items and not using them to their capacity.
It criticises both Queensland Health and the state's hospital and health services for the way medical equipment worth more than $1 million is purchased, replaced and operated - such as CT scanners and MRI machines.
"The health system cannot demonstrate that its investments in these high-cost assets are yielding the expected benefits and are the most cost-effective way of delivering health services," the report said.
"This audit identified significant concerns about future funding for high value medical equipment replacements."
The rapid growth in the amount of high-value medical equipment in Queensland hospitals has contributed to a shortfall of $131 million in the 2016-18 years, in terms of replacement cost for machines. The methodology used to calculate replacement costs has not changed since 2008.
"As such, current funding arrangements will not meet the ever-increasing costs of replacing the fleet commissioned since that time (2008)," the report said.
Queensland Health was found not to be enforcing its own policies requiring hospital and health services to develop business cases when purchasing replacement equipment.
"More often than not, when it comes to purchasing equipment, HHSs are not selecting the value-for-money option identified by the department," the report said.
"This means that the health system cannot demonstrate it is making cost-effective decisions about the substantial investment of public funds in these assets."
The QAO also discovered many machines were not being used to capacity because of poor planning.
"By managing the use of high-value medical equipment across hospitals rather than only within the hospital in which the equipment is located, the health system could more efficiently use equipment capacity to reduce patient wait lists," the report said.
"For example, there is unused CT scanner capacity in metro hospitals, and patients waiting for those services at nearby hospitals within the same HHS."
The QAO criticised the health system for managing high value medical equipment "in an uncoordinated way, using a patchwork of various asset management systems and approaches."
"There isn't a single source of reliable information with a complete and accurate picture of high value medical equipment statewide," the report found.
Auditors made eight recommendations in total, with three directed at Queensland Health and a further five targeted towards Hospital and Health Services.
One of the key recommendations was to undertake a comprehensive stocktake of high value medical equipment across the health system. Another was for Hospital and Health Services to develop guidelines for high value medical equipment including their life cycle and replacement costs.
The Government has accepted the QAO's recommendations.
Health Department director-general Michael Walsh said he supported the audit report's recommendations but other considerations needed to be taken into account.
He said patients' clinical plans were crucial to how equipment was used, providing equity to access for people in regional centres and the significant expansion of health facilities and equipment over the past decade needed to be factored in when reading the report's findings.
"It's better that patients from Rockhampton be able to use this equipment in Rockhampton rather than having to fly down to Brisbane to do it," Mr Walsh said.
"(The Department aims) to provide as much equity of access that we can achieve.
"(And) a patients' clinical care (program) is a major factor in how high value medical equipment gets used."
Mr Walsh said equipment which was not used regularly had a longer life cycle and did not need to get replaced as often.
Health Minister Cameron Dick's office has been contacted for comment.