Coronavirus: private hospitals come to the rescue

Private hospitals will be contracted into a national health system under an unprecedented deal struck with federal and state governments.

Federal Health Minister Greg Hunt. Picture Gary Ramage

Private hospitals will be contracted into a brand new national health system under a deal struck with federal and state governments to boost the hos­pital workforce by more than 100,000 health workers and guarantee access to hundreds of intensive care beds.

The commonwealth government is pouring $1.3bn into underwriting the nation’s 657 private hospitals during the COVID-19 crisis in a deal that would see ­taxpayers pay them to open up their 35,000 private beds to public hospital patients and give them ­access to tens of thousands of nurses and doctors.

The federal government has struck a deal with state governments to share the cost on a 50-50 basis. The states will, in turn, strike service agreements with the ­owners of the private hospitals to open up their facilities.

Under the state deals, public hospitals will have access to the entire capacity of the private health system as the COVID-19 pandemic puts unprecedented pressure on medical services and intensive care units.

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The deal was announced as the number of COVID-19 cases in Australia reached 4557 as of 4pm on Tuesday (AEDT), including 18 deaths. The figure represents an increase of 312 cases, or 7 per cent, over the past 24 hours but the rate of increase has slowed this week compared with last week.

Private hospitals will be on call to care for any patient, including coronavirus patients, as public hospitals reach full capacity. They will be contracted by the states on a pay-per-service basis, under which private hospitals will be ­extensions of the public system.

Federal Health Minister Greg Hunt described the move as a ­“reconstruction” of the nation’s health system.

“The hospitals have committed to be fully flexible in a way that is beyond conception,” Mr Hunt said on Tuesday. “What this agreement does is dramatically expand the ­capacity of the hospital system.

“It is about integrating two ­national systems — our public and private hospital systems — in a once-in-a-century redesign of our hospital services,” he said.

Under an agreement reached between the federal and state ­governments, the commonwealth will pay half the cost of the services provided by private hospitals, with the states paying the rest.

Number of new coronavirus cases over seven days per million people.

The commonwealth will then tip in a $1.3bn “viability guarantee” to offset the revenue the private hospitals will lose from the cancellation of elective surgery. The ­viability guarantee is uncapped and could end up exceeding the ­initial $1.3bn committed.

Medical Colleges and the Australian Medical Association will negotiate the fees that will be paid to private hospital doctors under the state deals.

The chief executive of the Private Hospitals Association of Australia, Michael Roff, said the deal would not only provide a massive boost to the nation’s hospital ­capacity, it also guaranteed the ­viability of private hospitals amid the cancellation of most elective surgery procedures.

“What this is about is the ­private hospital sector stepping up to the plate and doing whatever is ­required to help the country get through this pandemic and ensure that we have one health system devoted to that response,” Mr Roff said. “This is definitely not business as usual. It is unprecedented.”

The partnership, which would bring more than 100,000 health professionals, 34,000 beds and 2200 ventilators into the public system, will help Australia reach a target of 7500 ventilators available for coronavirus patients.

Deputy Chief Medical Officer Nick Coatsworth said there were 2200 ventilated intensive care beds in Australia, and the partnership with private hospitals would expand that capacity to 4400.

“At the moment, we are using just over 20 of those for patients suffering from COVID-19,” Dr Coatsworth said.

“With immediate expansion, repurposing of other ventilator machines, including anaesthetic machines and use of the private sector, we can expand to 4400. Our target capacity for ventil­ated intensive care beds in Australia currently stands at 7500. We are working around the clock to procure ventilators.

“Locally, we will have 500 ­intensive care ventilators fabricated by ResMed, backed up by 5000 non-invasive ventilators, with full delivery expected by the end of April.”

Doctors at Cabrini Hospital in Melbourne — one of the private hospitals due to imminently sign a deal for services with the Victorian government — are thrilled to be part of a national pandemic response.

Cabrini Hospital’s director of emergency medicine, Michael Ben-Meir, told The Australian he was “proud to say there was never any doubt in anyone’s mind if we’d look after corona­virus patients here”.

“It was always part of our duty, and I think the deal is great news,” Dr Ben-Meir said.

“We have an enormous amount of skill and capability in the private sector, both in intensive care and in respiratory care. We are very keen to support the community at large, and to support our public colleagues.”

Dr Ben-Meir said the hospital had asked staff to work extra hours in anticipation of the extra demand, and had also begun recruiting new staff externally.

The hospital, which ordinarily has 12 intensive care beds, is able to expand by converting operating theatres to 60 beds.

“Some patients will die from this,” he said.

“We’re emergency care workers, we’re not strangers to disease and to people passing away. That’s part of our core speciality.

“If we get to a worst-case scenario like the government is describing and we’re having to make some really tough decisions based on a lack of resources, that is a situation where not many doctors in this country have been in.

“I’m hopeful that won’t come about.”

It is understood that the deal due to be signed between the Victorian government and seven private hospital providers will serve as a national model to be adopted by other states.

The chief executive of Catholic Health Australia, Pat Garcia, said the Victorian government had negotiated to pay the net costs of private hospitals.