So one of the Australian National health care standards is having adequate governance structures in hospital to support quality and safety of healthcare. Notably, however, public hospitals are more likely to appear on the cover of the newspaper for the state of their finances rather than quality of safety.

My hospital network has had its’ financial position downgraded by the Ministry of Health as unexpectedly it is in deficit – or at least more deficit than anticipated. So the consultants have been brought in to assist in saving dollars and recovering the financial position.

What bothers me is there is no governance standard for budgets and finance in our public hospitals. Now whilst I acknowledge that in a public health system we will never actually go out of business there is no reason why we shouldn’t have financial standards that resemble of those of corporations, but perhaps without the legal ramifications. The NGO I work with needs to comply with the Corporation Act and not trade as an insolvent entity. This concept can’t really apply to public hospitals but they should be accountable for their financial management.

Despite this the financial management of hospitals and the governance of this management seems to be ad hoc and left to the local sites. My experience of this is that all finance & budgeting is hospitals is forensic rather than planned and projected.

Hospital staff need to demand good governance practices for hospital budgets and ideally these standards should be harmonized between hospitals. I should be able to turn up to an administrative meeting and see a balance sheet that I understand and can react to in a timely and appropriate manner. As it stand we chase our tails.