A Sydney Morning Herald article has detailed a new method of making important decisions that affect the community in the health sector – let the citizens make the choices:
The concept is simple. Select jurors at random from the electoral roll and present to them vital statistics for their area: the health of the population, the budget of the area health service, and the difficult choices that need to be made each year about the provision of services.
For Woodhouse, decisions came easily once he had the facts. “We have got 17 hospitals, some costing $1.5 million to run for the year, and they have very few patients. As a taxpayer my antenna went up when I heard that.”
The tiny Augusta Hospital, south of Bunbury, has only enough staff to care for 12 patients at a time. “The question arises: is that facility justified?” Woodhouse asks. “Should you not centralise it, move those staff to another place and run a community health centre there that will be able to treat a lot more people instead?”
Of course, not everyone in the community agrees with this policy, (Woodhouse says “I had people from the public ringing up and asking me what kind of qualifications I had that enabled me to make these decisions.”) but it is undeniably a creative approach.
This new policy of placing important strategical decisions in the hands of a randomly chosen jury of citizens implies that together, citizens will come to the best decision, based not on their qualifications or experience, but common sense.
A key issue in the NSW health system is the existence of small local hospitals that are under-funded and under-staffed, and which not only remain open, but even continue to fund emergency wards. These hospitals are often the result of election promises, and so are not likely to use funds as effectively as other solutions might.
The jury of citizens follows the same approach as that of law – where justice will supposedly prevail. But should the same idea be applied to the NSW health system? If indeed, common sense can lead citizens to the ‘right’ decision after being presented with all the facts, then why do our political leaders have such a problem attempting the same task? The obvious answer is political pressure. However, is it not pressure from the citizens in the first place for expensive and ineffective solutions like poorly funded small emergency wards, that lead politicians to make promises that are unproductive? So why would a jury of the same people that have been creating this pressure, come to an alternate conclusion?
The only apparent difference between the citizens on the jury and those casting their ballot, is the energy put into making them understand the complexities of the situation. Perhaps if the whole community had ready access to such information, the election promises we hear would be different, because the demands would have changed.
