International Construction Law Review
CURRENT ISSUES IN HOSPITAL PPPs IN AUSTRALIA
ANDREW CHEW
Special Counsel, Mallesons Stephen Jaques 1
DAVID STORR
Partner, Mallesons Stephen Jaques
BARRY CASEY
Partner, Mallesons Stephen Jaques
1. INTRODUCTION
The Australian public hospital system faces various challenges, none of which is particularly unique to this country. Australians are living longer, and their expectations for health services are increasing. The population, which is already heavily concentrated on the Eastern seaboard, has become more coastal (and less rural) based. Retirees have been moving in large numbers to the sunshine belt of Queensland and northern New South Wales. At the same time, much of Australia’s public health infrastructure is aging, is located in low-growth areas, and is not well suited to current clinical practices. Large old hospitals cluster around the inner city areas, while many country towns have dated facilities, and the mortgage belt, dormitory suburbs and sunshine coast retiree areas all need new facilities to meet the growth in demand for services.
These changes have required extensive planning for new and relocated health facilities over the last 15 years, at a time when the prevailing public sector wisdom is to reduce the level of public sector borrowing.
The planning task has been complicated by the fact that, under Aus-tralia’s federal system of government, the public hospital system in Australia is primarily funded by grants to the state governments from the central (Commonwealth) government, but the system is administered by the various state and territory governments. There is an ongoing inter-govern-ment debate over investment in health care and public hospital funding arrangements.2
The Commonwealth Government’s Medicare system provides a universal basic health cover through the public hospital system. Some people supplement this with private insurance coverage from a nongovernment health insurer, which gives them access to a range of private hospitals and medical services.
Pt 3]
Current Issues in Hospital PPPs in Australia
291