Issue link: https://nnumagazine.uberflip.com/i/238877
notion of contracting out for several hospital departments and services as a way to control costs and provide better care. The Queensland Nurses Union (QNU) was staging a protest the day I arrived in Brisbane to push back against this sort of chipping away at the public infrastructure of Australia's public hospitals that inevitably leads to budgetary pressures on the remaining public services and calls to cut staff, including bedside nurses. For example, the global consulting firm, KPMG, issued a very detailed report supporting the construction and contracting out of many hospital services that surely contained information the public had a right to know about relating to services, staffing, and health interests, yet much of the reporting document has redacted content. That hidden content was being seen only by some public officials and the corporate interests seeking to profit from the new hospital. The reasons given for redacting information were that the information was commercial or financial in nature and related to a competitive procurement process. In other areas of the country, like the Northern Beaches communities between Sydney and Brisbane, public hospitals are in danger of being closed down and private hospital corporations are moving in to try to squeeze out any potential for new public facilities. Often the players behind these corporate privatization schemes (the Australians use the word "scheme" much more appropriately than we Americans do) are often the same global health industry giants we know all too well in the United States, like the Hospital Corporation of America (HCA) and the Adventist System, just to name a couple of the players. In December, the QNU scored a major victory when their state government reversed itself on public hospital privatization, announcing that the new Sunshine Coast University Hospital will be run by the state health system, Queensland Health, using Queensland Health clinical staff. DECEMBER 2013 QNU secretary, Beth Mohle, said overwhelming evidence shows that privatized public hospitals are either more expensive to run, lead to reduced services, or eventually require the introduction of patient fees as private operators skim a profit margin off the contract payment. But it still took a lot of hard work and lobbying by nurses to make the government and public understand this. In May 2013, the QNU launched a statewide campaign against the privatization of Queensland's public hospital and community health system. The campaign included a $300,000 radio advertising campaign in May, community rallies and other events, and a major petition. While I was in Australia, we attended another public meeting in Wollongong, New South Wales, during which angry community members expressed their frustration and anger about the push to privatize more of their community's healthcare access. In a poll published by the "Save Our Ports Committee," privatizing Wollongong Hospital was widely opposed with 92 percent of people thinking it was a bad idea, and nearly 88 percent thought the region's ports would be better run by the government. "Private organizations, whether they're for profit or not for profit, have a core obligation, as most corporate organizations do, to provide a return to their shareholders and investors," said Brett Holmes, general secretary of NSWNMA, to a local paper. "That's what the system would be focused on." While I shared plenty of horror stories from the United States on my trip, one of the Australian nurse leaders who so graciously hosted my visit wanted me to share a success story about their system when I returned here. Judith Kiejda, RN is the assistant general secretary of the NSWNMA and she fights to keep the public health system vibrant and strong. Judith worked tirelessly for months to help plan the association's conference in Sydney during which I gave my presentation to hundreds of their members and other interested attendees. But as the program kicked off, Judith got really sick. She caught the respiratory bug that had been circulating over these past months, and she was nearly unable to drag herself out of bed. After the final day of the conference, she was so ill that she called for a physician to make a house call to her home on a Friday evening. A doctor came to the house, examined her, gave her the antibiotics she needed, and there was no charge. The care Judith received was all part of the public health system that covers every Australian. "I want people to know, you can still count on the public system," said Kiejda. "I was too sick to wait any longer, and all I had to do was make one phone call and stay in my bed while I waited for the doctor to arrive." Just a few days later, Judith was with me as we were part of a panel educating about the perils of privatizing the health system. She felt much better. Did I see koala and kangaroos in Australia? Of course. Did I enjoy a cup of full flat white (coffee with cream) and marvel at the sensible inclusion of baked beans with breakfast? Yes. I even found a delicious chocolate biscuit called a "Tim Tam" that I fell in love with. There is so much about Australia that Americans like me know a little bit about and an awful lot more that we need to learn from them. What I hope my Australian hosts learned from me was that the fight to make our healthcare systems function for nurses and their patients is the same fight that we wage against private interests for whom profits are prioritized above all else. Until we remove the profit motive, it will be a constant struggle to win high-quality and safe healthcare for patients everywhere. Donna Smith is executive director of Healthcare for All Colorado. W W W. N A T I O N A L N U R S E S U N I T E D . O R G N AT I O N A L N U R S E 15