Australian hospital staff have to raise money for patients’ basic needs

Patients attending Footscray Hospital emergency department, in the western suburbs of Melbourne, have received letters from the Western Health Foundation requesting donations. While fund-raising has become standard in all the chronically-underfunded public hospitals, this letter was not seeking resources for medical equipment but for the hospital’s own impoverished patients.

Signed by Western Health chief executive Russell Harrison, the letter points to the intolerable conditions experienced by many patients of the Western Health hospitals. Increasingly, nurses, doctors and health workers are paying for these patients’ basic life needs.

Harrison’s letter, in appealing for the Greatest Need Project, provides a glimpse of the escalating inequality in Australia. It states: “As a patient of Western Health, you will understand more than most, that in addition to battling illness or injury, many of our patients experience great hardship.” Harrison relates harrowing stories where hospital staff members have assisted patients financially.

In one case, a midwife intervened to arrange crisis accommodation for a mother and her newborn daughter after discovering they were homeless following the loss of their house due to mortgage default. The midwife also purchased a baby capsule for the car to which the mother and baby were being discharged.

In a further case, nurses organised for a washing machine to be delivered to a 92-year-old’s home after they discovered the reason for her continuous infections was that she was laundering her reusable continence aids in a bucket.

Another patient was presenting to hospital with pneumonia every winter because he could not afford to fix his broken plumbing. He was showering with an outdoor hose in the dead of winter. Staff offered to pay for the plumbing.

These cases are only a small sample of the desperate situation facing tens of thousands of people throughout Melbourne and other Australian cities and towns. The Greatest Needs Project website estimates that up to “10 percent of our patients experience severe hardship, and as many as 10,000 patients a year struggle to meet their most basic needs.

“Some of our patients experience disadvantage so extreme that they cannot meet their most basic needs. Many go without what most of us take for granted—household essentials, utilities and, in some cases, even items that help alleviate the discomforts associated with a chronic or terminal illness.”

Footscray Hospital is one of three acute and sub-acute hospitals managed by Western Health, along with Williamstown and Sunshine Hospitals, servicing a major working-class region of the Victorian state capital.

Suburbs such as Braybrook, St. Albans, Kings Park, Sunshine West, North Sunshine and Ardeer have unemployment rates between 12.5 and 15.2 percent, more than double the official national average. The median weekly personal income in the area hovers around $424, much less than the national figure of $662.

With house rents over $350 per week, housing stress—where rent payments are equal to or greater than 30 percent of household income—affects as many as 18.9 percent of residents.

The relationship between low income, low levels of education, under-employment and unemployment, and poor health outcomes is well established globally, and borne out by the conditions in this region.

In these suburbs, the incidence and mortality rate from cancer is the highest in the Melbourne metropolitan area. They also have higher rates of children who are developmentally vulnerable and are among the ten highest incidence areas in Australia for asthma and respiratory-related hospital admissions for 3–19 year olds.

What Harrison’s letter does not address is how this situation has developed and who is responsible for it.

Western Health established the Western Health Foundation in 2011 to operate as a charitable public company to raise the shortfall in hospital funding due to the years of unrelenting budget cuts to health services by state and federal governments, both Liberal-National and Labor. To plug this gaping hole, armies of volunteers are deployed to raise donations from ordinary working people to pay for the hospitals’ essential needs and research that governments refuse to fund.

Two of the foundation’s board members, former Victorian state Labor Party minister Bronwyn Pike and former federal Labor minister Ralph Willis, served in governments that were responsible for slashing social spending. Alongside them in the boardroom are millionaires Bob Scarborough, who made his fortune breeding thoroughbred horses, and Susan Alberti, CEO of the Dansu construction group.

During the 13-year rule of the Hawke and Keating governments, in which Willis served as a senior minister, Labor imposed structural reforms that deregulated financial markets and suppressed both wages and public expenditure through Price and Incomes Accords with the trade union bureaucracy. This multi-pronged economic assault resulted in the greatest wealth transfer from the working class to the financial and corporate elite in Australian history. The share of wages in national income plummeted from a peak of 62.5 percent in 1975 to under 54 percent three decades later.

Under the Accords, hundreds of thousands of jobs were destroyed in manufacturing and other industries deemed not profitable enough, and public health and other social programs began to be cut. Between 1983 and 2003 at least 60 public hospitals were either closed or amalgamated and 20,000 acute beds closed. Billions of dollars were diverted from the public health system to subsidise private health insurance premiums under successive Labor and Coalition governments, as part of a creeping privatisation of health care.

In Victoria, beginning in 1992, a state Liberal government sacked around 50,000 public sector employees, closed 350 public schools and 17 hospitals, and privatised much of the transport and electricity networks. These measures were entrenched and deepened under the 1999–2011 Bracks and Brumby Labor governments, in which Bronwyn Pike held the health and education portfolios, among others.

The fact that health workers are paying for the needs of their patients highlights the culpability of the governments that have created these conditions and the trade union leadership that has suppressed opposition to the health cuts. It mirrors the situation facing teachers and educators, many of whom are personally paying for pens, pencils, text books, writing pads and, at times, food for their students.

The generosity and compassion of the Western Health workers, highlighted in the Greatest Need letter, comes as no surprise to the patients and families of these hospitals and others throughout the country. It is in sharp contrast to the role of governments, whose policies have gouged funding from health, education and welfare payments to pay for increased military spending and tax cuts for corporations and the wealthy elite.

The more than $21,000 raised to date from patients, staff and volunteers could have been funded many times over by foregoing tax breaks to corporations and redirecting military spending to social programs and services. Western Health’s letter raises none of these issues. Instead, the very people who rely on its hospitals are being solicited to provide the means to assist their fellow patients.