Antes de que venga la hora

There were several layers of formal reporting relating to elective surgery, starting with individual hospitals and extending to national waiting time data.

The first step in the reporting cycle was for individual public hospitals to extract data from their systems and report to their state-level health department. Next state-level health departments aggregated data from the hospitals in their jurisdiction and sent it to the Australian Institute of Health and Welfare (AIHW) up until July 2011. After

then it was sent to the National Health Performance Authority (NHPA). Some jurisdictions also published their own performance reports publically. For larger states these public reports were prepared for regions within the state as well as for the state as a whole.

The central organisation (AIHW or NHPA) calculated the performance indicators for each state from the state-level data. Under the agreement establishing the NHPA the results of these calculations were then sent back to the states for verification and amendment or explanation of special circumstances where necessary. Data and performance indicators for individual hospitals were published on the MyHospitals website (National Health Performance Authority 2016) and formal performance reports submitted to COAG (COAG Reform Council 2011).

Some of the key indicators were:

• Median waiting times

o by urgency and specialisation for a hospital

o aggregated by urgency and specialisation for a state/territory o all specialisations aggregated by urgency for a state/territory

• Number of people on waiting list:

o by urgency and specialisation for a hospital

o aggregated by urgency and specialisation for a state/territory o all specialisations aggregated by urgency for a state/territory

• Number of people receiving surgery

o by urgency and specialisation for a hospital

o aggregated by urgency and specialisation for a state/territory o all specialisations aggregated by urgency for a state/territory o all urgency categories combined for a state/territory

o aggregated by urgency category for Australia as a whole o all urgency categories combined for Australia as a whole

• Percentage of patients seen within clinically recommended time

o by urgency category for a state/territory

o all urgency categories combined for a state/territory o aggregated by urgency category for Australia as a whole o all urgency categories combined for Australia as a whole

94 The performance reports to COAG formed the basis for the negotiation between the Commonwealth and the states/territories of reward funding under the National Health Reform Agreement (see Chapter 3.2.4 on page 70).

This chapter described the collection and synthesis of source material relating to the political, funding and administrative background to the use of elective surgery waiting times as performance indicators for the Australian public hospital system. It presented the material as two descriptions: one based around the overall political and funding context and one focussing on administrative procedures and data collection. In the context of the Australian public hospital system, elective surgery waiting times are used as performance measures in agreements between the Federal government and the states and territories. In an effort to improve the public hospital system in general and the provision of elective surgery in particular, states and territories were set targets relating to elective surgery with reward funding available to those

jurisdictions which met the targets. The next chapter will cover the methods used to collect and analyse elective surgery-related newspaper articles from The Canberra Times for the period 1 January 2010 to 31 December 2011.

4

Newspaper analysis methods

This chapter describes the methods used to collect and analyse material relating to elective surgery published in a daily newspaper. For collecting material from the newspaper I used techniques relating to the study of contemporary history outlined in Chapter 3.1 on page 55. To uncover patterns in the articles and later in the instances of elective surgery waiting time being used as a performance indicator I used

techniques from Richard Boatzis’s Transforming Qualitative Data: Thematic Analysis and Code Development (Boyatzis 1998). I chose Boyatzis’s techniques because they allow for an iterative approach to coding which allowed me to continually refine my codes as I learned more about the data. A consequence of this iterative approach is that there has been some blurring of the boundaries between method, results and analysis for this part of my research.

4.1

Overview

Public hospital services in general and the provision of elective surgery in particular are reported in the news media as matters of public interest. For closer analysis I chose the ACT’s local newspaper, The Canberra Times as a widely read and readily accessible source of reporting and commentary. According to the website of its publishing company, Fairfax Media (Fairfax Media 2013) The Canberra Times has a circulation of 28,614 as at 2013. This is down from the 2011 figure of 31,521 for weekday editions (Media Spy 2013). It is the only ACT-based daily newspaper and it is a broadsheet containing a mix of local, national and international news. Since the ACT is the seat of the Australian Commonwealth Government, with a high

percentage of its population working in government-related jobs, The Canberra Times has a strong focus on political aspects of the news.