Corporate Health Care
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The Corporatisation of Health and Aged Care in Australia This page is the root page for the Australian section. It was completely rewritten in 2006 and now provides a broad overview of the corporatisation of health and aged care in Australia. There are links to pages which address different sections of the health system in Australia. (Created June 2004. Completely rewritten Sept 2006 last entry 8/08)         Australia         Australia         Australia         Australia         Australia         Australia         Australia         Australia         Australia         Australia         Australia         Australia         Australia         Australia         Australia         Australia         Australia         Australia         Australia                 Australia         Australia         Australia         Australia         Australia         Australia        Australia         Australia         Australia         Australia         Australia         Australia        Australia         Australia         Australia         Australia         Australia         Australia        Australia         Australia         Australia         Australia         Australia         Australia        Australia         Australia         Australia         Australia         Australia         Australia        Australia         Australia         Australia         Australia         Australia         Australia        Australia         Australia         Australia         Australia         Australia         Australia        Australia         Australia         Australia         Australia         Australia         Australia        Australia         Australia         Australia         Australia         Australia         Australia        Australia         Australia         Australia         Australia         Australia         Australia        Australia         Australia         Australia         Australia         Australia         Australia        Australia         Australia         Australia         Australia

Warnings and Policy Statements I travelled to the USA in 1993 to obtain documents about National Medical Enterprises (now called Tenet healthcare). These documents provided a profound insight into how the market operated in health care. I soon realised that the problems were not isolated to this company but were systemic to the corporate marketplace. I have tried to make this point and warn Australia of the dangers since then. Others have also done so. Governments have had an ideological health care agenda which has caused them to disregarded all warnings. Extracts from "Remission Impossible" : Ron Williams (1992) Ron Williams studied the US Medical System and then politics and economic thinking in Australia. He was among the first to understand the overall threat. His dire warnings about the pending US corporatisation of our health system fell on deaf ears and his book was hardly read. The Hon Michael Wooldridge : Speech to the Australian Medical Association - May 1996 Although the labour government had moved strongly towards privatisation in the early 1990s it was Dr. Michael Wooldrige, minister for health, in the Coalition government elected in 1996 who staked his future on the commodification and competitive corporatisation of health care. His aggressive responses to criticism and his willingness to scheme were his undoing and led to his ultimate resignation. This is his speech to the Australian Medical Association explaining his policies. Dr. Weedon welcomes Dr. Wooldridge - May 1996 Dr. Weedon, president of the Australian AMA made his dissenting views very clear when he introduced Dr. Wooldridge prior to his policy speech. This is his introduction.   Corporatisation in Australia Over the years I have written a number of reviews looking broadly at different aspects of the corporatisation of health care in Australia. Some have been put on this web site. As they were written at different times and for different purposes there is some overlap. Corporate Medicine in Australia I wrote this review in late 1997. It analyses the application of economic rationalist ideas to health care comparing what had happened in the USA with what was happening in Australia. Because values, trust and integrity are more critical in health and aged care than any other sector of society health is at the eye of a wider social battle between community values and economic ideology. Like it or not those who work in health care have been drafted into this war. Their future depends on it and so perhaps does the prospect of a society in which economic self-interest is harnessed by the values and norms of a civil society of reflective interacting individuals. The Dominance of the US market and US marketplace Ideas This page was written some time in early 2000 after the chairman of Australia's National Competition Council (NCC), Graeme Samuel's speech to the world bank calling for urgent global health care reform using economic levers. This page discredits the claims that we are different to the USA and that these things could not happen here. THE GREAT DIVIDE IN PERCEPTIONS about the CORPORATE MARKETPLACE This page looks at market failure in the USA. It examnes the great divide between the perceptions of market advocates when contrasted with the way health professionals, patients and most citizens perceive and experence the market system in health care. It goes on to list the red flags which should alert citizens and regulators in Australia to the possibility of dysfunction. I wrote this page in 2004 when Primary Health induced the University of Wollongong to take a page off the web site. Privatisation and the public hospital system This page written in 2002 to analyse the privatisation of public hospitals and colocation traced the application of market theory and corporatisation leading up to these processes. See same page under the privatisation section below. Regulation in Australia This page also written in early 2000 examines the way in which regulations, which protect citizens from unsuitable, even criminal corporate health care corporations, have been undermined in the corporate interest in Australia. It tells the story of multiple regulatory failures and the unsuccessful struggle to get regulators to regulate. The Corporatisation of Health Care in Australia This page written later in 2000 describes the Australian government's multiple attempts to introduce a corporate health care market into Australia. The strategies used and the depths to which they sank to accomplish this are described.  DEFICIENCIES IN FIRB A criticism of the deficiencies and loopholes in the FIRB process written early 1998 after the deficiencies had been exploited to bring Sun Healthcare into Australia. The problems created for state regulators and the refusal of federal governments to do anything about it are reviewed. WELCOMING MULTINATIONALS IN AUSTRALIA : Some considerations This late 2000 page examines some issues surrounding overseas ownership of health care in Australia and some of the social processes and problems. It needs some editing! Politics, Markets, Health and Democracy This 2004 web page explores the links and relationships between political ideology, politicians, the marketplace, ideas about democracy, and health care. It describes and contrasts the role of these factors in the USA and in Australia. The Scan Scam This is summarised on the Scan Scam page. There is more detail on the Mayne page dealing with conflicts of interest. Radiology was one of the areas of medical practice turned into a corporate business by government policy. Doctors were turned into businessmen acting for their companies, yet the minister of health, Dr. Wooldridge treated them like disinterested doctors who would put responsibility to the community first - something he had destroyed. The scandal involved Dr. Wooldridge, Mayne Nickless' Barry Catchlove (the chairman of the HIC), and the radiologists in the purchase of costly scanners. It cost Catchlove his post and Wooldridge his political credibility. The doctors whom they blamed were largely exonerated. See also -- The web pages "Corporate Medicine: I told you so" and "Corporate Medicine - Hospital licences" in the section about Columbia/HCA below. They deal with the control of US style corporate practices in Australia. Funding and Rationing in Australia This page written in early 2000 is a flight of fancy. It looks at Australia's funding system and for the purpose of the argument accepts that in spite of our claimed wealth the rationing of expensive care is inevitable. It considers the likely consequences of "rationing for corporate profit" then creates an idealised future where citizens decide on health care funding and where scarce resources are stretched fairly for maximum benefit rather than shareholders wallets. The Market, Contracts and the Bush When Graham Samuel, chairman of our National Competition Council (NCC), in a speech to the world bank early in 2000 urgently pressed the bank and developing nations to adopt a complex competitive market based health care model I was apoplectic and gave birth to a litter of criticisms most of which appeared on this web site. A large part of my working life in medicine had been spent in Africa. To highlight the absurdity of this for Australian readers I looked at the potential for such a competitive corporate marketplace for the dispersed bush residents of Australia and for its Aboriginal communities. Even Australia's most extreme economic ideologists had not suggested anything so ridiculous for them! Published Papers Building on Values: The Future of Health Care in Canada (pdf file) This paper by Wendy Armstrong (from Canada) and myself examines the report of the Romanow Royal Commission into health care in Canada and draws implications for Australia. It was published in the March 2003 edition of the Health Issues Journal. A pdf version of th paper is here. Hazards in the Corporatisation of Health Care (pdf file) A paper of mine "Hazards in the Corporatisation of Health Care" was published in the Autumn 2004 edition of "New Doctor" <http://www.drs.org.au/>.. It is about corporate medicine in Australia and the Citigroup led purchase of Mayne hospitals. Belief Versus Reality in Reforming Health Care (pdf file) A paper "Belief Versus Reality in Reforming Health Care"contrasting for-profit with not-for-profit health care and the implications for Australia was published in the August 2005 edition of "Health Issues". Unpublished Australia's Experience with Health Reform : Are there lessons for Canadians? (pdf file) In 2004 I was asked to speak to an invited group at a meeting organised by the Consumers' Association of Canada (Alberta Chapter) and the Seniors' Action and Liaison Team (SALT). I prepared this as a background paper. The tittle was not really appropriate as the thrust of my argument was as much on the USA as on Australia. What I was trying to do was to link the dysfunction in health care to the prevailing ideology in the western world today and to suggest that health care was where the first steps could be taken towards a more balanced society.   THE CORPORATE INVASION OF AUSTRALIAN HEALTH CARE BY MULTINATIONALS FROM THE USA AND ELSEWHERE That Ron Williams dire predictions have not come true may be largely due to the megacorps serious misconduct in the USA. Australian authorities and their political masters were repeatedly embarrassed when concerned citizens drew the major breeches of Australia's probity requirements to their attention and publicised corporate misconduct in Australia. Links to the many pages describing their US conduct are given on the US section of the site map. I give here only links to the central pages of the companies attempting to enter Australia, and to those sections dealing specifically with their time in Australia. Tenet Healthcare & National Medical Enterprises I first became aware of corporate misconduct when I started making inquiries about National Medical Enterprises' (NME but later renamed Tenet Healthcare) operations in Singapore where I had an unpleasant experience. I decided to take action. When NME entered Australia in December 1991 it was in the midst of a US scandal . It departed Australia in 1996 under a cloud after paying about $1 billion in fraud settlements in the USA. Australia's Response to Tenet/NME - the story in Australia, told in a paper I published in 1996 Australia - a lack of frankness and candour - in a submission I made to Tenet's ethics committee The Senate Statement - a statement made in the Australian senate describing Tenet/NME's departure and my role in this Tenet/NME dispute - a summary of my dispute with NME and subsequent actions Taking on National Medical Enterprises (NME) - A more detailed account of my battle with Tenet/NME written primarily for those interested in whistle blowing and its perils. The Yeldham scandal - the story of the judge who was at risk of improper influence in 1993 when he assessed NME's compliance with NSW probity regulations. He overruled state authorities and allowed NME to operate in NSW. When he was exposed in 1996 he committed suicide. REWARDS OF DEVIANCE : What will Happen? - Extract from my 1993 submission to Justice Yeldom in which I predict that because of the market and political pressures approval would be given in spite of NME's conduct. Vista Healthcare - In 1997 some of Tenet/NME's international staff set up the international health care advisory group Vista Healthcare in Singapore. They advised other health care companies wishing to expand internationally. They quite possibly used their experience of our system to advise others who entered Australia. (e.g.. Sun Healthcare). Unbeknown to me they bought a hospital in Australia. They were acquired by BUPA. Personal Experiences 1988-92 and Unnecessary Cardiac Procedures in 2002 - My early impressions of NME's Singapore hospital and the later allegations of unnecessary cardiac procedures in a California hospital in the second US scandal. The senior hospital administrator in Singapore became CEO of the Australian company in 1991. In 2002 he held a senior position in California where unnecessary surgery allegedly occurred. His documents were subpoenaed by a senate committee of inquiry. Might this have happened in Australia if Tenet Healthcare had stayed? Generale de Sante Internationale (GSI) GSI, the largest European hospital owner was one of the bidders for Tenet's Australian hospitals in 1995. I played a role with others in unearthing problems in their UK operations and publicising them. They dropped out of the bidding Parkway Holdings, a Singapore and Malaysian group also bid for Tenet's hospitals, and was later tipped as a purchaser of Mayne Nickless. The Tan family businesses and other Malaysian groups had an interest in Alpha Healthcare and also in Gribble's Pathology. Columbia/HCA (now renamed HCA) In February 1997 Columbia/HCA, the largest hospital megacorp in the world announced plans to invest $1 billion in Australia. A scandal was breaking in the USA at the time. Together with others I gathered information and lodged objections with the Foreign Investment and Review Board (FIRB). When the FBI raided its hospitals in March 1997Columbia/HCA withdrew from Australia. This was the first step in the US $1.7 fraud scandal which engulfed the company. Pages describing this can be accessed from the US part of the site map. "Implications of the entry of Columbia/HCA into Australia", the document describing their conduct at that time and attacking their entry into Australia was completed in March 1997 only the day before Columbia withdrew from Australia. Pages from it can still be accessed from Columbia/HCA's central page but it is dated. One section of this Corporate Medicine in Australia comments on the situation here in 1997 and a page entitled Mayne Nickless in Australia describes Mayne's similar business practices. Corporate Medicine - I told you so -- By July 1997 there was much more information and the company admitted to the business practices and the internal pressures which led to the fraud. I used this information to boost my credibility in Australia, to draw parallels with Australian business and reaffirm the points I had been making. Corporate Medicine - Hospital licenses -- In August 1997 Queensland was revising its hospital licensing regulations. I took the opportunity presented by Columbia/HCA's admissions to reinforce my 1996 objections to Mayne Nickless business practices by urging that these practices be prohibited in the new hospital regulations. I did not anticipate success! Managed care - Aetna, was involved in some activity in New Zealand. The Australian AMA were energetically battling managed care in Australia and had the matter in hand. I did not get too involved in the internal politics. Kaiser was snooping around South Australia. There is some information about Aetna and Kaiser on the managed care pages I wrote in 2003. There is more about Kaiser on the 1997 "I told you so" page above and on a 1997 page of press clippings. AXA This French multinational insurer took control of Mutual health insurers in the southern states and privatised them. It joined with Mayne and the minister for health in attempting to introduce managed care style contracts in Australia. Hospitals succombed but doctors refused. Its Austraiian health insurance operations were later acquired by BUPA Sun Healthcare Sun Healthcare was a US aged care and step down care giant which had enjoyed meteoric growth in the USA. When it entered Australia in 1997 there were already serious concerns about fraud and about standards of care in its facilities. It bought into Alpha Healthcare in Australia and also a bought a number of hospitals from Moran Healthcare. The deceptive manner in which it was brought into Australia, and Dr. Wooldridge's role were of particular interest. Once again I collected information, lodged objections and pressed the issues. The main pages relevant to Australia can be accessed from Alpha Healthcare below. Sun sold its Australian holdings after it entered bankruptcy in the USA in 1999 - and in Australia. Political Blindness When Sun Healthcare entered Australia in 1997 I wrote a short piece pointing out that in each instance politicians had been supplied with vast amounts of information about multinationals entering Australia. No one could claim ignorance, yet despite repeated embarrassment they continued to bring in US multinationals. Laboratory Companies - SmithKline Beecham operated laboratories in the USA and Australia. In 1999 it sold all its laboratories to Quest Diagnostics. Quest was the laboratory arm of Corning which had recently been spun off as a separate company. Both SmithKline and Corning were central culprits in the fraud exposed by operation labscam in the 1990s. Hundreds of millions of dollars in fines were paid. An objection to Quest's entry to run laboratories in Australia was ignored. HEALTHSOUTH entered Australia in 1997. It had enjoyed unprecedented success and dominated rehabilitation in the USA. It appeared to have an unblemished track record. Success in the competitive health care corporate marketplace is simply not achieved in this way. I was suspicious but could do nothing. In 2003 it was revealed that its success was built on a US $4 billion fraud which commenced soon after it was founded in 1986. The Australian subsidiary participated in one part of this fraud. Australian authorities have been kept fully informed since the scandal broke over a year ago but have taken no action to constrain the company or to warm the public. Pharmacology giants - Most of the multinational pharmaceutical giants operate in Australia. Many have been involved in extensive fraud in the USA and internationally. In the pursuit of profits the industry has adopted a number of socially and humanitarian distasteful business practices. In Australia they have made every effort to undermine the successful PBS system and to push drug prices up using international trade agreements. Vista Healthcare and its National Medical Enterprises (NME) Heritage Vista Healthcare was formed in Singapore in 1996 by Chase Manhattan bank and the core of Tenet/NME's international division. It expanded rapidly across Asia. These people who had been pressured out of Australia in 1995, because of their conduct, very quietly bought back into Australian hospitals in 1999. BUPA bought Vista in 2001.(written in 2000 updated 2005) Citigroup After Sun Healthcare and the scan scam Dr. Wooldridge departed and there was a period of embarrassed freedom from healthcare multinationals. However when Mayne Nickless' hospitals were in trouble they sold internationally again in preference to a local consortium. Mayne hospitals were sold in 2003 to a group of venture capitalists led by CVC Asia Pacific. That this was a part of Citigroup was concealed from doctors and the Australian public but not internationally. A correspondent informed me. Citigroup was at the time embroiled as a central culprit in the massive Wall Street fraud scandals. Citigroup's US misconduct can be accessed from the US section of the site map. (written 2004)  Mayne Health becomes Affinity Health - This page describes the purchase of Mayne hospitals to form Affinity Health, the nature of venture capitalism, management buyouts, and the possible implications for health care in these hospitals. The Companies Buying Mayne Health - This page describes the way in which the Australian press connived in hiding CVC Asia Pacific's relationship to Citigroup and also Citigroup's conduct from the market, the public and the medical profession. It goes on to examine each of the companies involved in the buyout and their links to larger groups. Only Citigroup have any experience in health care and that is extensive and profitable in the USA. An article "Hazards in the Corporatisation of Health Care" which I wrote was published in New Doctor in March 2004 <available at http://www.drs.org.au/>. It summarises Australia's disturbing record with multinationals and describes the Citigroup purchase. TRADE AGREEMENTS AND AUSTRALIA It is clear that governments have adopted a policy of to corporatise health in Australia but have not had the political courage to express this publicly. US groups supported by their government have sought to include health in world trade agreements and also in 2004 in bilateral trade agreements between Australia and the USA. In October 1999 the Australkain Doctor's Fund and the National Association of Practising Psychiatrists responded to pressures on the WTO process with press releases "NO NEED FOR AUSTRALIA TO JOIN INTERNATIONAL AGREEMENT ON HEALTH CARE SERVICES" and "What International Health Care Agreement Will Do For Sufferers Of Mental Illness".   Australian Hospital Companies Enthusiasm for market medicine gripped Australia in the 1980's but there were early failures, followed by recovery in the early 1990s. Most of the 1990s were a difficult period. The market expected to reap large profits as a consequence of the strong support given to private insurance and privatised care by the coalition of liberal and national when it was elected in 1996. This did not eventuate until 2000 and during the 1990s only some companies made money. Australian Hospital Companies This web page discusses the background and the factors influencing the development of the competitive corporate hospital market in Australia. It briefly describes the story of the majority of companies that have operated hospitals for profit in Australia and links to pages decribing each in greater detail. It examines the consequence of progressive consolidation of the market until only two large and very powerful corporations remained (Written 10/2005)         Australian   Hospital   Companies     For the larger companies Mayne Health, Alpha Healthcare, Healthscope, and Ramsay Health Care see separate panels lower down. The American Influence : HCA and AMI The two US hospital multinationals, HCA and AMI operated in Australia between 1978 and 1991. While neither was successful they had a profound influence on political and business thinking. They laid the foundations for the corporatisation of health care in Australia. (Written 10/2005 Last entry ) Ian McGoldrick & Companies : Consolidated Health Care (CHC), Health and Life Care (HLC), Superclinics, Supercare, & more Following a string of failed surgical proceedures in the 1980s controversial Dr Ian McGoldrick was barred from practising medicine although this did not stop him from doing so. He was associated with two hospital companies during the 1980's that were each briefly the largest in Australia. He contributed to the demise of both and was involved in a string of other questionable corporate endeavours. Everything he touched turned to tears for those his charisma won over. (Written 10/2005 Last entry ) Markalnga Trust & Australian Medical Enterprises (AME) Markalinga Trust was founded by a group of investors and listed on the market in 1985. It overspent and was in trouble by 1991. The fraud plagued US company, National Medical Enterprises (NME), bought a controlling holding and it became Australian Medical Enterprises (AME). As the scandal in the USA unfolded NME's probity was challenged by concerned citizens. NME was forced out of Australia in 1996 after a complex saga in which authorities were repeatedly embarrassed. (Written 10/2005 Last entry ) James Hardie & Health Care Corporation James Hardie the large Australian multinational at the centre of the Asbestosis scandal became enthusiastic about profits from health in the 1980s investing in American Medical International, founding Health Care Corporation (HCC) and investing in health in the USA. It did not prosper and struggled to get out of health care selling HCC into Alpha Healthcare and then struggling to get out of Alpha without losing too much money. (Written 10/2005 Last entry ) Australian Hospital Care This page describes the steady rise of Australian Hospital Care (AHC) between 1979 and 1998 to become the second largest for profit hospital owner in Australia. Eighteen months after a very successful float in 1996 market pressures imposed their rigour on a company that believed the illusions of the ideology but did not understand its nature. Losses and miscalculations left it in a parlous state. It quickly succumbed to a takeover in 2000. (Written 6/2005 Last entry 9/2005) Moran Health Care : Hospitals Moran Health Care is currently a private for profit operator of nursing homes. It has also invested enthusiastically in hospitals and was a strong advocate for private care with political connections. Doug Moran is best known for his failed Taj Mahal style medical parks targeting wealthy foreigners, but he had many other business interests in Australia and internationally. (Written 10/2005 Last entry 10/2007) Two other pages "The Nursing Home Empire" and "The Moran Family Story" are listed under the aged care section below Benchmark Group This page examines Benchmark, a private for profit hospital company owned and run by one man. It wanted to list on the stock market but never did electing instead to sell itself in 2004. It is an Australian example of a subgroup in the for profit system. Unlike publicly listed companies hospitals in this category sometimes work well but they are also at greater risk of abuse. (Written 5/2005 Last entry 10/2005) Nova Health This page examines the upbeat claims made by this company Nova Health when it floated in 2002. The page documents its collapse, resuscitation and finally takeover by Healthscope in 2005. (Written 5/2005 Last entry ) Insurers Owning Hospitals During the 1980s and 1990s many medical insurers owned and operated hospitals. When a managed care system based on competition between hospitals for contracts with insurers was introduced this created an impossible conflict of interest. By the end of the 1990s they had all sold their hospitals. (Written 10/2005 Last entry )  Hospitals of Australia HOA) Hospitals of Australia Trust was floated in 1986 and Mayne Nickless bought a 29% interest. Mayne increased its interest, took over management and in 1992 bought out other share holders forming HCoA. HOA had prospered and grown (Written 10/2005 Last entry ) Affinity Health When a group of venture capitalists led by CVC Asia Pacific, part of the fraud prone Citigroup, purchased Mayne's hospitals these were renamed Affinity Health. Eighteen months later the bulk of the hospitals were sold to Ramsay Health Care. Affinity kept 20 hospitals and still runs them in 2005. (Written 1/2004 Last entry 8/2005) OTHER SMALL HOSPITAL GROUPS A number of smaller groups have operated over the years and this page looks at some of them. Only one or two still operate and the most successful is a doctor led group called Independent Private Hospitals of Australia. Tom Wenkart and Macquarie Health Tom Wenkart, a colleague of Goldridge and the infamous Edelsten founded Macquarie Health, a complex set of companies built around a large pathology business but including hospitals, medical clinics and a medical technology business. Like the other two doctors he indulged in unacceptable practices, ran into trouble with the tax office and became bankrupt.. For the larger companies Mayne Health, Alpha Healthcare, Healthscope, and Ramsay Health Care see below  Mayne Nickless Access Page and its subsidiary Health Care of Australia (HCoA) which became Mayne Health Until 2003 Mayne was by far the largest corporate owner of hospitals in Australia. It has been iat the centre of almost every health care controversy in Australia with the possible exception of the attempt to Americanise our healtrh system. Its conduct illustrates corporate behaviour - particularly behaviour under pressure. This page provides links to the Mayne pages. It summarises the Mayne story describing how this wealthy trucking giant switched to hospitals when exposure of its unsavoury collusive practices and trucking fraud rendered trucking no longer profitable. The story is told of its struggle to make a profit from hospitals and the ultimate revolt of doctors against its practices. It eventually sold its hospitals to a consortium led by a Citigroup subsidiary and turned itself into a mainly pharmaceutical company. It continued to perform poorly and in November 2005 broke up into a local company Simbion and an international company Mayne Pharma. Citigroup is a US multinational financial conglomerate with a dreadful track record for deceiving its customers. (Written 1997 Last entry 11/2005)   M a y n e H e a l t h Mayne Nickless 1886 to 1994 - The Early years Mayne's story prior to the plea to collusive practices and fraud in 1994. The development of a culture of ruthlessness, fraud and dishonesty and the origin of its approach to health care. (Written Nov 2001 Last entry Aug 2004) References : Mayne Nickless 1886 to 1995 - references and extracts The Collusion and Price Fixing Scandal Mayne's behaviour leading up to the 1994 prosecution for collusive practices in trucking, its guilty plea, its fine, and its aggressive response. (Written Nov 2001 Last entry Mar 2002) References : The Collusion and Price Fixing Scandal The Dalziel and Catchlove Years 1995 to 2000 The decision to sell off trucking and other businesses and switch to health care as the company's main business and theatre for growth. The promise of profits which never materialised culminating in Catchlove and Dalziel's departures in 2000 (Written Nov 2001 Last entry Aug 2004) Dalziel and Catchlove - References December 1995 to August 2000- references and extracts Mayne Nickless in Australia - Part of the March 1997 criticism of Columbia/HCA's entry to Australia where I briefly review Mayne's conduct. (Web page now removed) Governmant Appointments and Conflicts of interest - Conflicts of interest involving Mayne staff. Catchlove's relationship with Dr. Wooldridge, his appointment to chair the HIC and the involvement of both in the scan scam which finally discredited Wooldridge and ended his political career. (Written Jan 2002 Last entry Mar 2002) Conflicts of interest References - references and extracts Colocations and Privatisations in Australian States - Mayne was one of the strongest advocates and supporters of privatisation of public hospitals and of the colocation on public hospital campuses. It was involved in NSW, in West Australia, in Queensland, and in Tasmania Mayne Nickless press reports - In 1998 Mayne working with the multinational insurer AXA and Dr. Wooldridge attempted to entice doctors into managed care contracts which would have given them a hold over doctors. Doctors refused and so were able to walk away when Smedley later cut back on care. I circulated a series of articles in order to help dissuade doctors. (Written 1998 Last entry Oct 1998) Peter Smedley - The new Doctor on the Block An analysis of Smedley, the corporate Mr. Fixit, and his business practices - what he brought to Mayne when he came from Colonial to replace Dalziel in 2000. (Written Nov 2001 Last entry Aug 2004) Peter Smedley, Mayne's new MD : References and Abstracts The Smedley years June 2000 to Dec 2001 The page describes the hope and surge in share prices as Smedley embarked on a program of marketplace restructuring, cost cutting, and rapid expansion by takeovers of hospital and drug companies. Doctors in contrast felt that care was being compromised and walked away from the hospitals causing financial collapse and Smedley's demise in 2002. (Written Nov 2001 Last entry Aug 2004) References : The Smedley years June 2000 to Dec 2001 - references and extracts The Mayne Health Care Story The page describes Mayne's foray into hospitals, its relationship with doctors and the issue of patient care versus profit. (Written Mar 2002 Last entry Aug 2004) MAYNE CRASHES : 2002 and 2003 This page describes how Smedley's character and policies brought Mayne to its knees and the role which the medical profession played in this. Mayne has now been broken up and seems to be continuing to fragment. (Written Aug 2004) Mayne Health becomes Affinity Health The purchase of Mayne hospitals by a group of Venture Capitalist led by CVC Asia Pacific, a subsidiary of Citigroup, in a management buyout - an examination of this process and its implications. It records the sale of Affinity hospitals in 2005 (Written Jan 2004 Last entry Oct 2005) Affinity Health Hospital Licenses This web page documents the difficulties Affinity Health had in securing licences for its hospitals in NSW and the implications of this for the takeover of the nursing home operator DCA in 2006. (Written Sep 2006 Last entry Mar 2007) The Companies Buying Mayne Health An examination of what happened when these venture capitalists purchased Mayne hospitals and the hiding of information. A review of these companies and their past activities. . (Written Jan 2004 Last entry Aug 2004) Mayne Finally Breaks Up This web page documents Mayne's inept management and steady decline during 2004 and 2005, and its break up into local and international companies in November 2005. It also documents the end of the tarnished Mayne name as a local operator although it still tarnishes the international operation. This new international drug company is seen as a likely takeover target. (Written Nov 2005) Mayne Diagnostics and General Practice This web page briefly tells the story of Mayne's radiology, diagnostic laboratory and general practice businesses which generally underperformed competitors. (Written Nov 2005) Efforts to Restrict Mayne Nickless A brief description of my own attempts over the years to curb Mayne Nickless and its practices. The two older pages below have been removed from the web site. Email me if you want a copy. (Written Mar 2002 Last entry Oct 2005) Submission Mayne Nickless 1996 : The Use of Incentive Bonuses in Medicine - When Mayne Nickless adopted aggressive business practices and large incentives to managers I lodged objections to hospital licenses in all states on the basis that these practices were inappropriate (lacked probity) in health care. I showed how they had been largely responsible for the problems in the USA.. DOCUMENTS IN SUPPORT of submission against incentives in health care - A brief summary of the many documents submitted in support of my contention.   ALPHA HEALTHCARE Overview and Analysis This page gives an outline of Alpha and Sun Healthcare's activities in Australia. Alpha was a company with a prime interest in profit. It turned to health care in 1988 after failing for 20 years in other areas. Sun Healthcare used Alpha as its joint venture vehicle to enter Australia. The page also gives my comments and assessment of what happened to Alpha. I speculate about what may or may not have been happening behind the scenes and what the involvement of politicians was in bringing Sun into Australia. (Written 9/2002 Last entry )   ALPHA HEALTHCARE'S STORY : Significant Events This is a detailed itemised account of Alpha's history starting in 1969 and ending in 2001 Alpha Healthcare : References and extracts This page gives sources for information about Alpha with some extracts. ALpha Shareholders' Battle (2001 to 2004) This page written in 2001 gives an account of Alpha's shareholders battle to get authorities to address their perception that they had been unfairly treated. It returns in 2005 and reviews possible misconceptions and the ultimate failure of their efforts. It looks for lessons in their experience. A DISSENTING VIEW OF HEALTH AND AGED CARE CORPORATISATION : CONFRONTING SUN HEALTHCARE IN AUSTRALIA 1997-2001 - see the material on combatting corporate health care below. Sun Healthcare : Access to web pages Pages describing Sun's conduct in the USA link from this page or can be accessed from the map section dealing with aged care in the USA. Sun Healthcare enters Australia :: Overview A summary and overview to the following pages written soon after Sun Healthcare entered Australia and after I received FOI documents. US Hospital Giant Sun Healthcare buys into Australia's Alpha Healthcare and Moran Health Care Group (November 1997) An argument against corporate medicine and Sun Healthcare's entry into Australia criticising the manner in which they were brought in and the political agenda. A framework for evaluation. OVERVIEW OF DOCUMENTS SUPPLIED AS AN AID TO EVALUATING SUN HEALTHCARE'S ENTRY INTO AUSTRALIA (November 1997) List of documents and comments on each to accompany the argument above. CRITICISM ::Alpha Healthcare - response to FIRB (letter dated 5 August 1997) A criticism of Alpha's last letter to FIRB indicating that it would use Sun's expertise to enter aged care in Australia DEFICIENCIES IN FIRB A criticism of the FIRB process and its regulations describing the way they were misused to bring Sun into Australia   Healthscope This web page gives a brief overview of Healthscopes near collapse and its recovery to become a very successful growth company. It examines the costs to others of its policies and practices. It provides links to pages which explore its story and the consequences more closely. (Written 6/2005 Last entry )   Healthscope     Healthscope  THE HEALTHSCOPE STORY : The Road to Market Wisdom This web page documents Healthscope's naive beliefs when it entered the marketplace in 1994. It records its near collapse and then its reinvigoration as a ruthless and very successful profit focussed entity with an obsession about growth. (Written 5/2005 Last entry 9/2006) People and Culture This page complements the other Healthscope pages by giving more information about corporate thinking, management, and relationships with doctors, nurses, politicians and others. South Australia Privatisation : The Modbury Privatisation This web page examines the Privatisation of Modbury Public Hospital in Adelaide, South Australia. The contract to run the hospital was awarded to Healthscope. It was a financial disaster. Healthscope's attempts to restructure and cut costs are examined and the consequences for services and care are explored. Mosman Hospital Purchase : The market at work This page documents the unsuccessful attempt by the Mosman Community and its doctors to stop Healthscope from removing surgical services from what had been their community hospital for 70 years. The Mersey Hospital Story This page examines the background to the Mersey public hospital and the Burnie public hospital privatisations in Tasmania. It then explores what happened in the community and the hospital when Healthscope, a company with a very strong commercial focus bought the contract to run the loss making Mersey public hospital. Tasmania : Privatisations and Co-locations This page examines the privatisation of public hospitals and the co-location of private hospitals on public campuses in Tasmania by Mayne Health, Australian Hospital Care and Healthscope. Healthscope and Consolidation : The PACMAN This web page looks at the background to the PACMAN label and then tells the story of Healthscope's PACMAN approach to not-for-profit hospitals. It uses the management contract Healthscope reached with the struggling not-for-profit Adelaide Community Healthcare Alliance (ACHA) to illustrate the similarity with PACMEN in the USA. The Western Community Hospital This page examines the struggle of the local community to save their community hospital when the Adelaide Community Healthcare Alliance's (ACHA) bankers wanted to close it, and Healthscope did not want to manage it. It highlights the contrasting culture of the not-for-profit community service and the for-profit service as illustrated by Healthscope. The Battle with BUPA (Insurer) Healthscope had been gearing up to use its leverage to confront the insurers. In 2003 it challenged BUPA. In the bitter conflict which followed the patients were pressured and their interests compromised as they were used to pressure the opposition. Healthscope got a bloody nose and everyone paid a price. This page describes what happened. Ramsay Health Care Main Page The page gives an overview of the rise of the company from one hospital in 1964 to Australia's largest and totally dominant hospital owner in 2005. It links to pages which explore facets of the company's history and its business strategies in greater depth. (Written 8/2005 Last entry )   Ramsay   Health   Care Ramsay Healthcare : Early Years This page describes Ramsay Health Care's story from its origin in 1964, through its first temporary listing on the share market in the 1987, to the collapse of its founder Paul Ramsay's entire global empire in 1989 and then its recovery during the early 1990s. Paul Ramsay : International Projects This page describes Paul Ramsay's international operations concentrating on his health care operations in psychiatry, managed care, and disturbed adolescents in the USA. It looks at reports suggesting overcharging of Medicaid and of a grand jury investigation into the mistreatment and sexual exploitation of adolescent girls under Ramsay's care. Ramsay Health Care : The Privatisation Years (1994 to 1999) This page describes Ramsay Health Care's enthusiasm for and financial success in the privatisation of veteran's affairs hospitals, its caution in the privatisation of public hospitals, and its strategy for colocated hospitals. Ramsay Health Care : Survival and Growth (1994 to 2005) This page describes Ramsay's strategy for survival through the difficult 1990s and then its rapid growth and expansion after government used taxpayers money to subsidise the private health care system. Ramsay Buys Affinity Health to Become a Giant (2005) This page describes Ramsay's failure to buy Mayne's hospitals in 2003, and their successful bid for the same hospitals from Affinity Health in 2005. This makes Ramsay dominant in the hospital marketplace. Ramsay's Hard Edge Behind the benign public face and good relations with staff is a hard headed business organisation. It has to be to survive. This page examines that hard edge. Ramsay Health Care : The People Paul Ramsay is an enigmatic controlling figure who keeps out of the public eye. Patrick Grier is his front man in Ramsay Health Care. The operation of the business and its culture are a product of these two men. This web page looks at what we know about them. Ramsay Health Care : Business Policies and Practices Ramsay Health Care's business practices and policies are radically different to the economic rationalist recipe for success and are frequently contrasted with Mayne Health. They have been spectacularly successful for the company and have not resulted in any of the controversial failures of the corporate marketplace. This page examines them.     The Privatisation of Australia's Hospitals This page gives a short overview of the contents of the two main pages about the privatisation of Australia's public hospital system and colocation of private hospitals. It links to them.     Privatisation     Privatisation     Privatisation and the public hospital system During the first half of the 1990's strongly right wing coalition governments controlled Australian states and a federal labour government was compliant with state economic policies. Ideology resulted in the enthusiastic privatisation of public hospitals across Australia. Private hospitals were colocated on public hospital campuses. By the second half of the 1990's privatisation of public hospitals had proved a failure and colocated hospitals were not profitable. Political power both federally and in the states had been reversed. State labour governments abandoned these policies. The federal government directed its efforts to tempting and coercing citizens out of the public system into private hospitals, working closely with the corporate for profit sector in this. This page describes and analyses these developments.   Colocations and Privatisations in Australian States This outlines the problems which occurred with privatisation in each in each Australian state, linking to pages studying each state in more detail. New South Wales - Describes the controversies, conflicts and ongoing crises in Australia's first privatisation, the Port Macquarie Public Hospital (Mayne Health). Victoria - Privatisation was adopted most enthusiastically by the coalition government in Victoria. It went from disaster to disillusion to abandonment. The page describes the political background and the story. The La Trobe Privatisation -- The first contact in Victoria went to Australian Hospital Care (AHC - since acquired by Mayne) for the La Trobe hospital. It ended in a mess and the government had to take it back. The Mildura public hospital -- A probity review raised concerns about the contractor, Alpha Healthcare's major shareholder, the US company Sun Healthcare. The deal collapsed. and was awarded to Ramsay Healthcare. The Austin and Repatriation Privatisation -- This teaching hospital privatisation was the biggest in Victoria. It ran into intense opposition following the La Trobe debacle. The labour government abandoned the project in 1999. References and extracts - for the Austin Repatriation The Berwick Privatisation -- another privatisation which was abandoned The Knox Privatisation -- another planned privatisation abandoned South Australia --This web page examines the Privatisation of Modbury Public Hospital in Adelaide, South Australia. The contract to run the hospital was awarded to Healthscope. It was a financial disaster. Healthscope's attempts to restructure and cut costs are examined and the consequences for services and care are explored. West Australia -- The privatisation of Joondalup public hospital by Mayne Health was once again dogged by controversy and allegations. Queensland -- The National party government and the press showed enthusiasm for privatisation and for Mayne Health. Opposition was mounted and the failures of the for corporate system were canvassed to selection committees. Mayne ultimately shared the privatisations with not for profit groups. Tasmania --This page examines the privatisation of public hospitals and the co-location of private hospitals on public campuses in Tasmania by Mayne Health, Australian Hospital Care and Healthscope. The Mersey Hospital Story -- This page examines the background to the Mersey public hospital and the Burnie public hospital privatisations in Tasmania. It then explores what happened in the community and the hospital when Healthscope, a company with a very strong commercial focus bought the contract to run the loss making Mersey public hospital. Renal Dialysis in the USA and Australia : Overview This web page summarises the conduct of the global and local corporations providing kidney dialysis in the fraud prone US system. Many have reached large criminal and/or civil fraud settlements with government. Fresenius paid the largest US settlement in this sector and Gambro Healthcare (now Diaverum) was a recurrent offender. Three of these companies have recently started providing dialysis services in Australia. They have been welcomed and supported by politicians who have contracted the care of public patients to them. All Australian state health licensing regulations have probity clauses restricting the sort of organisationa that can operate in this country. Questions are raised about the granting of licenses to these companies. (Written 8/08 Last entry) The links to web pages and description of the activities of the companies in the USA are on the US site map. Australia Welcomes Dialysis Multinationals Dialysis provided for the benefit of shareholders is a recent development in Australia. It has been associated with a move from hospital to community setting. The same companies that have paid massive fraud settlements and whose care has been inferior to not for profit entities in the USA have been welcomed here. They have been given licenses by state authorities and contracted to care for public patients. Australian legislation requires that the providers of these services be "fit and proper" persons. Companies reaching criminal settlements could not possibly qualify. They should not be operating here. This information is and has been readily available on the most basic of internet searches. It is not possible for politicians and government officials to be ignorant of this unless it was a deliberate decision not to look. In spite of their international track record available indicators suggest that these companies have performed well here and have been good corporate citizens. There is no data on the quality of care provided in Australia. (Written 8/08 Last entry)   Corporatisation of Diagnostic Services :: Pathology and Radiology This web page is the introductory overview of the corporatisation of diagnostic services in Australia. Part 1 explores the history, the processes, the forces at work, and the problems that developed during the corporatisation of patholgy and radiology between 1980 and 2006. It looks for signs of practices simlar to those in the USA. Part 2 lists the main companies that have supplied these services during this period and summarises the history of each one. Links are provided to other pages which examine the conduct of these companies in much greater detail (Written 2/06 Last entry) Diagnostic Services  :: Pathology and Radiology Sonic Healthcare (and its general practice partners Foundation Healthcare, LifeCare and IPN) This web page examines the meteoric growth of Sonic Healthcare to dominate diagnostic services in Australia and then expand into New Zealand, Asia, Europe, and America. It supplied dagnostic laboratory and radiology services. It examines its relationship with general practice corporations and its difficulties in this. The grouping above ultimately became a whlly owned subsidiary of Sonic Healthcare. The page looks for any sign of dysfunctional behaviour and questions some of Sonic's practices. (Written 6/02 Last entry 1/06) SONIC HEALTHCARE : Chronological Account and References This page gives a year by year outline of Sonic's progress and a list of references. (Written 6/02 Last entry 1/06) Mayne Diagnostics and General Practice This web page briefly tells the story of Mayne's radiology, diagnostic laboratory and general practice businesses which generally underperformed competitors. (Written 11/05 Last entry 1/06) It is one of many pages exploring Mayne Health's record GRIBBLES GROUP This web page examines the history of the Gribbles Group, primarily a second tier provider of laboratory services from 1936. It traces its growth during the late 1980s, the 1990s and early 2000s, it records its global expansion, and finally examines its collapse and sale in 2004. During that period the company and its controversial CEO aggressively fought a continuous running legal battle with the tax office, with the health regulators who accused it of illegal and unethical practices, and with financiers and those who were owed money. There were complex corporate arrangements, and financial dealings which skated the edges of legal conduct and required regulatory investigation or ended in court. (Written 1/06 Last entry) Healthscope's purchase of Gribbles Group This links to an account of Healthscope's purchase of the almost bankrupt Gribbles Pathology on the much longer Healthscope Story page. (Written 5/05 Last entry 1/06) Tom Wenkart and Macquarie Health Tom Wenkart, a colleague of Goldridge and the infamous Edelsten founded Macquarie Health, a complex set of companies built around a large pathology business but including hospitals, medical clinics and a medical technology business. Like the other two doctors he indulged in controversial practices, ran into trouble with the tax office and became bankrupt. (Written 11/05 Last entry) Medical Imaging Australia (MIA) This page documents the formation of MIA in 2000 by a group of radiologists, its rapid growth, its global expansion, its financal difficulties and it takeover by DCA's I-Med in 2004. Primarily an imaging enterprise it dabbled in pathology and got burnt. (Written 1/06 Last entry) DCA Group : Nursing Homes and Radiology This web page explore the dramatic growth of DCA Group in the ownership of Nursing Homes and of Radiology practices. The web page reviews DCA's growth and policies in the light of the US experience of similar growth companies with similar policies in health and aged care. A 2006 profit downgrade and adverse findings at a nursing home were an indication that some problems were developing. In September 2006 DCA sold itself to a group of Citigroup Venture Capitalists. (Written 1/06 Last entry Sep 2006) General Practice groups A number of pathology companies owned or formed relationships with general practice companies (see above). In addition to this many general practice corporations also owned some pathology and radiology practices to capitalise on the referral of their GPs. By far the most successful of these is Primary Health which has 4% of the pathology marketplace. Others with pathology or radiology holdings were Endeavour Healthcare, Revesco/MCS/Gribbles and a new unlisted group NMIG. Information and links are in the General Practice section below.     The Corporatisation of General Practice This page examines the vulnerability of General Practitioners and describes the processes driving the corporatisation of General Practice. It comments on each participant in this marketplace and then links to pages examining them. It documents the decline of corporate involvement between 2002 and 2004 then its resurgence with a new aggressiveness in 2007 and 2008.   The Wild West colonises General Practice At least five of the large companies involved in GP corporatisations were products of West Australian entrepreneurs. This is a state which at the time was not renowned for integrity in corporate affairs or government. Foundation Healthcare Foundation, once called Formulab is a company with a history of deception. It switched to health care and floated in 2000. It fanned the illusion of profitable returns from corporatised General Practice buying up practices at inflated rates. The page tracks its course through this bubble to its merger with LifeCare which was in even more trouble. The new company called Independent Practitioner Network (IPN) did not prosper. After a hostile takeover attempt Sonic protected its referral base by buying all of Foundation. Foundation Healthcare Outline and References - Foundation's history in outline and a list of references. Lifecare LifeCare was Boyd's venture into various mainstream and not so mainstream "therapies", into sports medicine and into dentistry. It failed to prosper and in June 2002 it merged with Foundation Healthcare. LifeCare Chronological Account and References LifeCare's history in outline and a list of references. Sonic Healthcare (and its partners Foundation Healthcare and LifeCare) This large pathology and radiology company had a close relationship with Foundation Healthcare aand LifeCare which merged to form Independent Practitioner Network (IPN). Sonic ultimately purchased all of IPN. Many facets of this relationship, the battles and the final takeover are described and analysed on the Sonic web page. Endeavour Healthcare This is another company which emerged with a lot of fanfare and powerful backers like Kerry Packer. When the promise was not met there were corporate resignations. It was finally sold to IPN and Sonic Healthcare. National Medical and Imaging Group (NMIG) This is a group formed by some of those from Endeavour Healthcare after is was sold. They rcently bought the MCS business (see below) from Gribbles. They are not a listed company and I have no more information. The Revesco Story - From Kiwi Gold to Revesco to Medical Care Services (MCS) to Gribbles This was another company which moved from unsuccessful gold mining to health in Western Australia. Among the first into General Practice it soon diverted to a major focus on pathology. Gribbles, the pathology company listed on the sharemarket by doing a reverse takeover. This did not prosper and was eventually sold to the new group NIMG Primary Health Care : 1st Page 1996 to 2004 This is a GP company established in the Eastern states in the early 1990s. It corporatised in 1998 and expanded. It is the only GP company which had prospered and it has done so spectacularly. In its early years it raised the ire of the HIC and of some doctors. In 2004 Primary objected to the university about my web page written in June 2002, presumably because of my choice of words. The university removed the web page written in 2002 from their server without ever offering me an explanation. I explain on this web page why in 2002 I felt so strongly about Primary's business practices and the press reports describing them. I rewrote the web page wording it more appropriately. Primary is still growing and is very profitable. Primary Healthcare : 2nd Page 2005 to 2009 : Update June 2009  This web page reassesses Primary Health Care 5 years after I last did so. It has continued to be very successful. It has grown rapidly by acquisitions in health technology and a risky takeover of a larger competitor as well as by expansion of its existing businesses. On the one hand its policy is congruent with government policies and it is widely admired in the marketplace. On the other it continues to have an uneasy relationship with establishment doctors and some competitors. The page suggests that underlying the marketplace battles and victories there is a deeper and more profound cultural conflict. This web page examines Primary's success on the marketplace battlefield within a cultural context. This context is underpinned by what we know about the behaviour in other corporate endeavours where similar cultural conflicts lay behind growth strategies and takeover battles. The possible consequences for community and care, as revealed by these previous experiences in the USA and Australia fuel my anxiety. There is however no evidence at this time that Primary has done anything illegal or wrong. It is revealed as a superb strategist and a logical proponent of the culture it embraces. Others including myself are critical of this culture in health care. Superclinics and Supercare Two very controversial doctors, Geoffrey Edelsten and Ian McGoldrick, were among the first into entrepreneural medicine in the late 1970s and the 1980s. Among their many projects was the early intoduction of entreprenueral market practices into general practice. This link is to the section of the larger McGoldrick web page exaimining this. As indicated a number of the large diversified groups did have general practice subsidiaries. These were Sonic Healthcare, Mayne Health (now Symbion Health), Macquarie Health and Gribbles Group. Information and links are given in the diagnostic services section above.   Markets and the Aging Bonanza This web page examines the way in which the aging population, and particularly the potential of the baby boomers, to be exploited for profit has influenced the marketplace and government. It looks at the way the provision of care of the aged has been shifted by government policy from a community humanitarian service to an aggressive and competitive marketplace. It documents the intrusion of private for profit entities, of market listed companies and of the banks and financial institutions into the sector. It summarises the impact of these changes on retirement villages, nursing homes, home care, and the various sections of health care. This is the central page in the tree of pages addressing aged care in Australia. There are links to pages which explore these issues and the sectors of the aged care industry in greater and greater depth. (Written 9/06 Last entry)                                     Markets and the Aging Bonanza                                     Markets and the Aging Bonanza                                               Markets and the Aging Bonanza                                         Markets and the Aging Bonanza                                     Markets and the Aging Bonanza                                     Markets and the Aging Bonanza   From Humanitarian Service to Corporate Profitability : The story of the corporatisation of health and aged care in Australia This page explores the changes to welfare funding and institutions as the welfare sector changed from a cooperative humanitarian service to a competitive corporate marketplace. It examines the impact of this change on the professions and the community oganisations that already provided services in this sector. It expresses personal opinions and a point of view. (Written 9/06 Last entry 10/07)  The Not-for Profit Dilemma The difficulties experienced by humanitarian institutions, the personal dilemmas, and the process of adaptation are discussed and then illustrated by an article from The Age. (Written 3/06 Last entry 10/07) BUPA : The British United Provident Association A case study of a "successful" not for profit - For more see below under unlisted companies The Aging Bonanza : Business View in Australia This page examines the way in which the business community has targeted the aging population as a source of profit. The enthusiasm for the upcoming retirement of the baby boomers is described. The breadth of services targeted is documented. Payment systems, values, regulatory failure and probity are discussed. (Written 9/06 Last entry) BPRIVATE EQUITY : Banks and Trusts and Financiers invest in Australian Aged Care Behind the market enthusiasm lie the bankers and financiers who accumulate the funds and invest or lend money to business projects. This enthusiasm is reflected in the surging purchases of aged care operations by the Private Equity arms of these financial institutions. This page examines how they have set up investment vehicles for aged care. These protect their investments from risk by forming property trusts and then leasing the facilities to closely associated capital light operators. National and international investments are described. Also cashing in on the expanding sector are the construction companies. (Written 9/06 Last entry 9/08) Macquarie Bank and Retirement Care Australia which became Regis in 2007 Australia's Macquarie bank has become an aggressive player in the health care marketplace. Its private equity subsidiary Macquarie Capital Alliance Group Ltd (MCAG) has targeted aged care in Australia, New Zealand and Canada buying up retirement villages and nursing home companies. Its vehicle in Australia has been Retirement Care Australia (RCA). A review of available reports provides interesting pointers to the way private equity thinks and operates. Why it is dysfunctional for the system and for care is readily apparent. Macquarie suffered in the economic downturn of 2007-8. It responded by trying to sell some facilities, merging with another large group, spreading the risk through a new investment vehicle and delisting MCAG from the share market. (Written 9/08 Last entry) MFS (now renamed Octaviar) and Domain Aged Care MFS (now renamed Octaviar) is a private equity group that has had a major interest in aged care where it did not do well. It has partnered with a number of other groups in owning retirement villages. A business dispute resulted in the callous attampt to have nearly 400 elderly pensioner residents evicted from their homes. Its nursing home vehicle has been Domain Aged Care. It got badly caught in the economic downturn in 2008 and sold Domain to AMP's Principal Health Care. An examination of the staffing policies, track record for care, and statements made by Domain as well as the attitudes of Principal Healthcare give a useful insight into the way private equity thinks and operates.(Written 9/08 Last entry) Retirement Villages This page traces the history of retirement villages as the focus shifts away from serving the needy to meeting the luxuries demanded by the wealthy. Services provided by the community are being replaced by commercial packages from the marketplace. Links are provided to pages describing the companies involved. (Written 9/06 Last entry)             Retirement Villages Aevum : From Friendly Society to Share Market The 36 year old Hibernian Friendly Society demutualised and then listed on the share market. It operates retirement villages and nursing homes and is expanding rapidly.  (Written 9/06 Last entry) Forrester Kurts Properties (FKP) and Australian Retirement Homes A Queensland construction company that moved into retirement villages. It expanded in Australia and joined with Macquarie Bank to expand into New Zealand. (Written 9/06 Last entry) Community Life Another company which believed it could make money by offering basic services to the poorer section of the community. (Written 9/06 Last entry 10/07) Craigcare An established Western Australian retirement company recently acquired by more commercial interests and expanding into nursing homes. This expansion was accompanied by multiple accreditation failures in nursing homes in 2006. (Written 9/06 Last entry Dec 2006) Gandel Retirement Enterprises This is another construction company which owns and operates nursing homes. It too had adverse publicity about the contracts it entered into with residents. (Written 9/06 Last entry) Milstern Health Care (see under nursing homes below) A nursing home company which also operated retirement villages Mirvac - Fini A West Australian family construction business which moved into retirement villages. It has recently been acquired by Mirvac a large construction company in eastern states. There was an outcry about the contracts residents in retirement homes had signed. (Written 9/06 Last entry) Moran Health Care (see under nursing homes below) A nursing home company which also owned some retirement villages Primelife One of the largest retirement groups in Australia this company was established by a controversial past bankrupt who, litigated aggressively, entered into illegal agreements, consorted with and paid criminals for protection, and tapped the telephones of staff. (Written 9/06 Last entry) Retirement By Design Owned by DCA whose primary businesses are nursing homes and radiology. (Written 9/06 Last entry) Retirement Services Australia This is another construction company with an interest in retirement villages and the luxury market. It was acquired by Macquarie Bank. (Written 9/06 Last entry) St Ives A West Australian private company which has targeted the wealthy and pioneered the building of a retirement village on a university campus. (Written 9/06 Last entry) Tricare : Nursing Homes and Retirement Villages This is a Queensland nursing home and retirement village operator which has developed relationships with banks in order to expand rapidly. There have been two disturbing but unproven allegations about its services. (Written 9/06 Last entry 1/07) Village Life A company which thought it could make money out of those who lived on government pensions. This was more idealistic hope than practical common sense. It did not work. (Written 9/06 Last entry 9/08) See also part owner MFS page (under nursing homes) for the 2007 eviction scandal in Village Life villages Zig Inge This is another operator of luxury retirement villages. It has linked with Macquarie bank to expand its operations. (Written 9/06 Last entry) NURSING HOMES INTRODUCTORY PAGE This page summarises the history of nursing home corporatisation in Australia and compares it with what happened in the USA. It gives an overview of the story of nursing home care in Australia as well as the role of government and the accreditation and complaints mechanism. It looks at the predicament of nurses, of residents and relatives, as well as the ambiguous position of not for profit charitable organisations in this marketplace. It examines the different sorts of operators in the for profit sector. Each sector links to pages which expand and amplify the sections on this page. (Written 9/06 Last entry 7/10)                   NURSING HOMES                             NURSING HOMES                               NURSING HOMES                   NURSING HOMES                               NURSING HOMES                               NURSING HOMES Government and Nursing Homes : Australia It is the Australian government which has turned aged care from a caring professional activity into a profit focussed and competition driven market in which the culture of care in nursing homes is replaced by one of apathy and disinterest. The story of aged care in Australia is best examined by following government policy and practice over the years. This web page gives an overview of what has happened. It links to web pages which explore successive periods and the behaviour of the aged care ministers responsible. (Written 9/06 Last entry) From socialist Labour to free market Coalition : Doug Moran - Judi Moylan - Warwick Smith : 1985 to 1998 The web pages describes the situation that existed under a federal labour government and the radical changes made after the election of the market focussed coalition government in 1996. It documents the community's rejection of what they saw as the most offensive parts of those policies. The government adopted a watered down system but did not abandon its policies and ultimate objectives. (Written 9/06 Last entry) Correspondence about Aged Care 1998/9 This web page contains a selection of my correspondence with federal and state authorities at the beginning of 1999 before the major problems in aged care in Australia were recognised. The thrust of the material was an objection to the US company Sun Healthcare entering the Australian aged care marketplace. Sun Healthcare was soon in trouble and never did so. The interest in this material is in looking back to see the comments about the system made by the minister's departments and my concerns about the practices and policies being introduced into Australia 7 years ago. The failures were predictable, they were predicted and authorities were warned. After multiple scandals they are still in denial. (Written 9/06 Last entry 3/07) Bronwyn Bishop and the Riverside Scandal : 1998 to 2001 This web page documents the first series of scandals which exposed the barrenness of the governments policies and the ineptitude of its ministers. Following the crisis created by the Riverside scandal there were ongoing instances where appalling conditions in nursing homes were exposed. None of this had any impact on government policy and they did little more than tinker with the system. The stage was set for continued deterioration and the truly confronting scandal in 2006. (Written 9/06 Last entry) The Julie Bishop years : 2002 to 2005 This web page documents the steady deterioration of the system during these years as the government continued its drive to corporatise and marketwise the system. There was less publicity but a senate inquiry in 2005 clearly identified the many failures in the system. It had little impact and was ignored until a truly damaging scandal broke in 2006. (Written 9/06 Last entry) The Rape and Sexual Abuse Scandal : Santo Santoro : 2006 By 2006 morale in nursing homes had reached an all time low. Neglect, elder abuse and apathetic staff were prevalent. When government claimed that the rape of multiple patients in a nursing home was an isolated event in a well functioning system the floodgates opened. The government was forced not only to act but to act more effectively. The measures set in place are likely to restrain and contain the worst excesses. They do not address the key issues in policy responsible for what happened. Government used its response as an opportunity to promote its ideology in the nursing home context. This page charts these events. (Written 9/06 Last entry) The Accreditation and Complaint Processes : Australian Nursing Homes The industry friendly accreditation and complaint handling agencies set up by the government in 1997 have failed. This is illustrated by the ongoing problems in care, the recurrent scandals and the increasing seriousness of the problems encountered. This page examines these processes, the reasons why they failed and why the measures to make them effective have not worked and are unlikely to work in the future. (Written 9/06 Last entry) Nurses in the aged care system This web page examines the importance of staffing levels, staffing skills and staff morale, and their interdependency. It explores the impact of funding restrictions, profit priorities and market myths on altruism and staff motivation with an ultimate impact on the care given. It looks at the role of the nursing unions and at the importance of whistle blowing by nurses. (Written 9/06 Last entry) People farming This satirical piece, written by a nurse working with the elderly in nursing homes satirises the way residents are cared for by describing it as a lucrative battery farming enterprise. (Written 9/06 Last entry) Nursing home residents and their relatives This page examines the plight of nursing home residents and their families in Australia. It gives a few examples of their difficulties. It does not offer specific help to those with problems. For more information and links to resources you should try the Aged Care Crisis web page. They have had direct experience of the system. (Written 9/06 Last entry) FOR PROFIT NURSING HOME COMPANIES In Australia commercial groups comprise only about 25% of the aged care marketplace. There is one large market listed company, a few larger private companies and multiple small commercial operators. The banks own large numbers of nursing homes. With government driving the sector in this direction marketplace thinking has come to dominate the ethos and manner of operation of the entire sector. This web page summarises this situation, looks at patterns of dysfunction, and links to pages describing a selection of these companies. (Written 9/06 Last entry3/07) Listed Companies Milstern Health Care : Yagoona, Ritz and other Nursing Homes, Founded by a very successful self made businesswoman, this company was listed for a few years. Allegations were madeabout its nursing homes and it was claimed that staff levels were cut to boost profits. Claims were made that it was treated leniently and there were allegations about the relationship with the aged care minister and political donations. All of these were denied by the minister and the owner. Retirement Villages and other businesses run by the owners are also examined. (Written 9/06 Last entry 7/10) DCA Group : Nursing Homes and Radiology This web page explore the dramatic growth of DCA Group in the ownership of Nursing Homes and of Radiology practices. The web page reviews DCA's growth and policies in the light of the US experience of similar growth companies with similar policies in health and aged care. A 2006 profit downgrade and adverse findings at a nursing home were an indication that some problems were developing. In September 2006 DCA sold itself to a group of Citigroup Venture Capitalists. (Written 1/06 Last entry 3/07) Amity at Caulfield : Accreditation Agency Assessment An adverse accreditation agency review of one of DCA's nursing home is worrying if it is a predictor of things to come. The company rushed to fix the problems which the press did not report. (Written 9/06 Last entry) Affinity Health Hospital Licenses This web page documents the difficulties Affinity Health had in securing licences for its hospitals in NSW and the implications of this for the takeover of the nursing home operator DCA in 2006. (Written 9/06 Last entry 3/07) Citigroup Buys DCA This web page examines the 2006/7 purchase of DCA by CVC Asia Pacific and CVC Capital Partners, both part of Citigroup. It examines objections lodged and their failure in the light of what is known about Citigroup and its previous investment in Australian health care as well as earlier correspondence with the federal department of aging. Two linked pages contain selected correspondence. (Written 3/07 Last entry 10/07) Ramsay Health Care (see hospitals) A hospital company which entered aged care then departed Aevum (see retirement homes) A listed company running retirement villages and nursing homes BPRIVATE EQUITY : Banks and Trusts and Financiers invest in Australian Aged Care A new development in the drive for profits. See details further above. Unlisted Companies THE BIGGER PRIVATE COMPANIES   BUPA : The British United Provident Association This web page examines the culture and practices of United Kingdom based not for profit BUPA. It focuses on the dilemma which BUPA faces operating very successfully in a marketplace context. It looks at the extent to which it has betrayed its mission in order to achieve marketplace goals and the implication this has for its suitability as a provider of nursing home care in Australia.(Written 10/07 Last entry) Will BUPA seek approved provider status The British not for profit group BUPA has purchased Australia and New Zealand's largest for profit nursing home company. This web page tracks the efforts made to show that promises made by ministers have not been met and that BUPA did not have to front up and seek approved provider status. Any criminal or dangerously aggressive commercially focused entity can still buy nursing homes without scrutiny. The page documents the new labor governments refusal to meet their predecessors undertakings.  It records their continued reliance on regulatory vigour and oversight to control the consequences. These measures have already been unsuccessful. Suggestions are made as to how the community might do something about the problem. (Written 10/07 Last entry 11/08) Healthscope : The Battle with BUPA see under Healthscope Moran Health Care : The Nursing Home Empire Australia's largest nursing home company was founded by Doug Moran in the 1950's. Over the years Moran exerted a profound influence on government policy. Nursing homes were the core of his empire. The company ran into trouble because of a failed international investment and bitter family feuds. Moran is now 81 and the family is fragmented. What is the company's future?. (Written 9/06 Last entry 10/07) The Moran Family Story This page examines Doug Moran's character, his philanthropy, his political influence and the tragic public family feud which engulfed the Morans. (Written 9/06 Last entry Oct 2007) Moran Health Care Hospitals -- see hospital section above Tricare : Nursing Homes and Retirement Villages see above under retirement villages Regis Group Pty Ltd One of the largest of the private companies. It tried to sell itself to DCA but the deal fell through. In 2008 it merged with Macquarie's Retirement Care Australia converting from private ownership to private equity ownership. (Written 9/06 Last entry 9/08) Macquarie Bank and Retirement Care Australia which became Regis in 2007 See details under private equity section earlier MFS (now renamed Octaviar) and Domain Aged Care See details under private equity section earlier Blackstone's attempted takeover of Japara Aged Car : The Approved Provider Process :: This web page examines the attempted takeover in 2011 of Japara, an Australian aged care provider, by Blackstone a large US private equity group about which there was some concern. The deficiencies in the approved provider process were confirmed and it was discovered that the entire process was "in confidence" so that no one would know about the application and supply information   SMALLER PRIVATE COMPANIES IN VICTORIA Illawong Retirement Equity Pty Ltd : The Riverside Scandal The government's nursing home policies imploded with the Riverside nursing home scandal. Examination of this scandal gives a fascinating insight into the market, into Australian regulations, into government processes and into the way ideology, social processes and the people involved in them inexorably progressed what happened into a tragedy for all parties. (Written 9/06 Last entry) Saitta Pty Ltd and Neviskia Pty Ltd : Kenilworth and Belvedere Park Nursing Homes These two related companies operated by someone with a criminal history owned two homes which were a continuing problem. It gives a fascinating insight into the type of people who enter the sector and the failures of the regulatory system. (Written 9/06 Last entry Oct 2007) CIS Holdings : Templestowe Private Nursing Home This is another instance where the department tolerated appalling standards in a Victorian nursing home over many months before it forced the company to sell to someone else. (Written 9/06 Last entry) Eildon Nursing Home This small group had its home rated as the worst of the worst when it failed 39 of the 44 accreditation standards (Written 9/06 Last entry) McKenzie Aged Care Group : Armitage Manor and others A Victorian family company which operated a nursing home where understaffing and appalling standards of care were found. This did not prevent it from being granted more nursing home licenses. (Written 9/06 Last entry) Supported Residential Services (SRS) and Marnotta Pty Ltd : Tangerine Lodge, Ripplebrook Village and Rosedale Manor Two related Victorian companies. There were serious problems in three of their four nursing homes. Both companies entered bankruptcy. (Written 9/06 Last entry) Enhance Aged Care : Chelsea Private Nursing Home This is another company with faceless owners which had major problems in a nursing home and hostel on the same campus. It sold to DCA. (Written 9/06 Last entry) Peel Street Management Services Pty Ltd : Mews Aged Care Facility A leading member of the aged care community was a director of a company which was sanctioned in 2004. The release of details about this were delayed. (Written 9/06 Last entry) Muskjest Pty Ltd : Emerald Glades Nursing Home The situation in the home owned by this group was so bad that staff complained. It was assessed and sanctioned. (Written 9/06 Last entry) Easyplan, Lasalto Pty Ltd and Lestlin Nominees Pty Ltd Three small Victorian companies that have had trouble with their nursing homes. (Written 9/06 Last entry) Ellis Residential Care and Ellfam Nominees : Paynesville Aged Care Facility and George Vowell Centre These two related Victorian family companies have sold some homes to Ramsay and would have sold more. There have been disputes with staff and problems in two homes. One became a national scandal in 2006 when four 90 year olds were sexually abused and raped. (Written 9/06 Last entry) Dampier Bay Pty Ltd : St Lawrence Nursing Home This web page describes a company which was allowed into aged care even though the new owner of a nursing home had no experience and no training. It failed accreditation and went bankrupt. Elderly patients whose home this had been for up to 20 years were ejected and had to relocate, (Written 9/06 Last entry) Hastings Regional Nursing Home Pty Ltd This web page looks at the different understandings of care, the economic pressures, the problems for nurses and whistleblowers, as well as the impact of nursing home size on the service in the home. It is illustrated by looking at this small Victorian family owned nursing home which closed in 2006. (Written 9/06 Last entry) Navatha Nominees and Locksley Manor Pty Ltd : Blackburn Aged Care Facility A functioning community of carers and elderly, one 111 years old, was broken up and scattered when a bitter dispute between the owner and the manager of this nursing home ended with the home being closed. Government saw this as a commercial dispute, which gave it precedence over community. It refused to intervene to protect the residents and staff. (Written 9/06 Last entry) SMALLER PRIVATE COMPANIES IN OTHER STATES Aegis Aged Care Group (see for profit nursing home company page) A large West Australian company with a good track record. (Written 9/06 Last entry) Craigcare (see also retirement villages above) An established Western Australian retirement company recently acquired by more commercial interests and expanding into nursing homes. This expansion was accompanied by multiple accreditation failures in nursing homes in 2006. (Written 9/06 Last entry Dec 2006) Kennedy Health Care Group (see for profit nursing home company page) An established NSW family owned company with a good track record. Thompson Health Care(see for profit nursing home company page) Another moderate sized family business in NSW where there were no adverse reports Alchera Park Nursing Home A Queensland nursing home which had serious problems and where regulators were tardy. (Written 9/06 Last entry) Trans Dominion Holdings and Farad Nominees : Sir Thomas Mitchell Nursing Home These were the owners of a nursing home in NSW which had problems in 2001 and again in 2002 (Written 9/06 Last entry) Gonzales Nominees Pty Ltd : Albury and District Private Nursing Home This company owned a home in Albany which was a chronic offender. It is another example where managers from the accreditation agency overturned assessors advice that accreditation be withdrawn. (Written 9/06 Last entry) Bresant Pty Ltd : St Catherine's Nursing Home The owner of a South Australian nursing home was a local doctor. The home had major problems in 2004 and 2005 (Written 9/06 Last entry Oct 2007) Tolega Pty Ltd and Karoona Pty Ltd : Barton Vale and St David's Nursing Homes A South Australian nursing home was purchased by someone who had been a director of a previously sanctioned home. It was soon in serious trouble. The accreditation agency overruled their own staff's advice that the home be closed. There was concern that previous audits may have missed serious problems. (Written 9/06 Last entry) Peninsula Care Pty Ltd This web page describes the conviction of two hospital owners for Medicare fraud in their nursing homes. In spite of this they continued to own the company and the agency simply allowed their children to be directors. (Written 9/06 Last entry) From humanitarianism to markets : Not for profit nursing homes This web page looks at the not for profit sector in nursing homes. It comments on the shift from a caring humanitarian system towards an impersonal service focused on economics. It gives some examples of failures in care by not for profit entities. (Written 9/06 Last entry Oct 2007) AGED RELATED INQUIRIES 1997-2010 OH NO ! - NOT ANOTHER AGED CARE INQUIRY : BUT THIS TIME IT MIGHT REALLY MATTER This page examines some of the many inquiries and reviews relevant to the aged care sector conducted during the 14 years between 1997 and 2010. That there is still widespread concern about the operation of the sector is clear. In 2010 the Procutivity Commission has been asked to come up with a blueprint for reform. They have asked for oour views and we have until 30 July 2010 to tell them. Updated with links to submissions, links to the Final Report and a Critique of that Report (Written 6/10 Last entry 10/11) REPORT ON FUNDING OF AGED CARE INSTITUTIONS : Senate Community Affairs Committee JUNE 1997 This was the labor controlled senate's critical review of the 1997 aged care bill which turned aged care into a competitive market and opened it tomultinationals. Many of their fears are now seen to have been well founded (Written 6/10) Senate Inquiry Into Nursing : Senate Community Affairs References Committee June 2002 The shortage of nurses has been a major problem since 1997. This was the broadest of the multipl reviews into this problem. (Written 6/10) Managing Residential Aged Care Accreditation : The Aged Care Standards and Accreditation Agency Ltd The Auditor-General Audit Report No.42 2002-03 Performance Audit. This was the first and I think the only audit of the aged care accreditation agency. Although the criticisms were mild it must be seen in the context of the agency's undertakings and its subsequent performance. (Written 6/10) REVIEW OF PRICING ARRANGEMENTS IN RESIDENTIAL AGED CARE : The Productivity Commission WP Hogan 2004 This is the massive review of the economic performance of the aged care sector performed by the Productivity Commission in 2004. It had a profound impact on policy. How valid was it and was the data it used sound? (Written 6/10) FUTURE AGEING : Inquiry into long-term strategies to address the ageing of the Australian population over the next 40 years. March 2005 Canberra. This was a widely focused generally positive government initiated inquiry into aged care. It does not make many criticisms and is generally positive. Some useful points are made. (Written 6/10) Quality and equity in aged care : The senate Community Affairs References Committee June 2005 This was a report from the opposition controlled senate. Critics of the system were given an opportunity to tell the parliament what was really happening out there. The accreditation and complaints systems were heavily criticised.  (Written 6/10) Aged Care Amendment (Security and Protection) Bill 2007 [Provisions] : The Senate Standing Committee on Community Affairs March 2007 This was a review of the bill to increase oversight of the aged care sector following the rape scandal in 2006  (Written 6/10) Private equity investment in Australia : The Senate Standing Committee on Economics August 2007 Private equity investment was sweeping across the world. Health and aged care were targets. Submissions warning of the consequences were ignored (Written 6/10) Evaluation of the impact of accreditation October 2007 This was not an evaluation of the accreditation agency but an inquiry into whether accreditation actually improves the quality of care and quality of life. It tells us a lot about the accreditation process and what the agency does not do (Written 6/10) Aged Care Amendment (2008 Measures No. 2) Bill 2008 [Provisions] : The Senate Standing Committee on Community Affairs November 2008 This was the senate review of the aged care amendment bill 2008. I felt it fell well short of what was required and made a submission. I lodged a test case afterwards (Written 6/10) Residential and Community Aged Care in Australia : The Senate Standing Committee on Finance and Public Administration April 2009 This report examining the costs of aged care degerated into an argument between providers who cried poor and claimed there was a crisis in aged care on the one hand, and the department who claimed that funding was adequate. What was revealed was a lack of data. (Written 6/10) Review of the Aged Care Complaints Investigation Scheme : Assoc Prof Merrilyn Walton October 2009 This 2009 review was very critical of complaint handling by the Department of Health and Ageing. It recommended that complaints be handled by an independent body. (Written 6/10) Review of the residential aged care accreditation process for residential aged care homes : Department of Health and Ageing (DOHA) Report due end June 2010 (Written 6/10) Contribution of the Not-for-Profit Sector : Productivity Commission Research Report January 2010 This is an extensive review of the role played by not-for-profit endeavours in Australia and the difficulties they face. The aged care sector is dominated by not-for-profit providers but differs in that they must compete with for-profit businesses. This makes it more difficult for them. (Written 6/10) Conclusion: A time to change all this : What the reviews reveal about the 1997-2010 era This page looks at the issues that concern many of us in the light of what has happened in the past and what is revealed in the reports of some of the many inquiries, audits and commissioned research projects since 1997. It suggests that we make our views known to the productivity commission inquiry so that they have no doubt about our discomfort at what is happening. (Written 6/10) SUBMISSIONS TO THE PRODUCTIVITY COMMISSION : FINAL REPORT AND CRITIQUE : An outline of the submissions in which I was involved with links to them. A link to the Final Report. Links to a critique of the final report (pdf) as well as a pdf document setting out the basis for this critique. (Written 10/11) Home care in Australia This web page examines developments in home care globally, in the USA and in Australia. It documents the arrival of the largest global home care corporation in the world, the US based Home Instead Senior Care in Australia. It describes the criticisms of this and attempts to force authorities to confront them (Written 9/06 Last entry) Letter to Foreign Investment Review Board : 30 May 2006 The giant home care corporation "Home Instead Senior Care" was welcomed into Australia by our politicians. I lodged an objection with the Foreign Investment and Review Board. I sent copies to politicians. (Written 9/06 Last entry) Letter from my local member of parliament (pdf file) My loca; MP responded supporting the entry of this company into aged care. (Written 9/06 Last entry) Letter to local Member of Parliament 13 June, 2006 My response to a letter from my local MP supporting Home Instead Senior Care (Written 9/06 Last entry) Objection to approved provider status : Home Instead Senior Care I lodged an objection to the granting of approved provider status for Home Instead Senior Care on the basis that the introduction of a large market focused, franchising US multinational into this vulnerable sector was undesirable (Written 9/06 Last entry) Health Care The Breadth of Health Care Corporatisation This web page contains a selection of press extracts revealing the approach to and the breadth of recent corporatisation of health care in Australia. (Written 9/06 Last entry) Australian Hospital Companies -- see major sections above The Privatisation of Australia's Hospitals-- see major sections above Corporatisation of Diagnostic Services :: Pathology and Radiology-- see major sections above The Corporatisation of General Practice-- see major sections above  CRITICISM OF GRAEME SAMUEL'S SPEECH to the World Bank in February 2000 When in spite of the revelations from the USA Graham Samuel, chairman of the National Competition Council (NCC), in a speech to the World Bank urged the urgent adoption of a complex market model essentially little different to the USA system I was incredulous. I wrote a long criticism, some sections of which appear on these web pages. Samuel was made chairman of the NCC by the coalition government and his views very probably are those of this party's think tanks. They subsequently appointed him chair of the ACCC, a body which regulates every sector of Australlian life to ensure that competitive market practices are adopted. The government have never however had the courage to publicly suggest such a system of health care to Australians. Efforts to move in this direction had been strongly resisted. The web pages criticising Samuel's model are listed on the Map of the International Web pages. The Queensland Hospital Scandals : Dr Death This web page gives a brief understanding of the complex, very public and politically charged scandal which engulfed the Queensland public hospital system in 2005. DISSENT COMBATING GLOBAL HEALTH CARE CORPORATIONS AND CORPORATISATION IN AUSTRALIA A number of pages on this web site describe my efforts to keep global megacorps out of Australian health care and to challenge the concept of corporate health care in Australia. These are best accessed from the Initial Map where all the pages are described. Here I list only the main pages. Over a period of years I flooded politicians, regulatory authorities, citizens groups and medical associations with documents and arguments. Many of the letters and reviews I wrote and used to press the issue make the arguments against corporate care and I have included a number of these on the web site. They were written for different people at different times so there is overlap. PERSONAL STORY This page summarises my activities in confronting issues and corporations. It links to pages where more information can be found about these companies and where efforts to expose corporate medicine and confront those who advocate it are described. Hansard Statement Australian Senate A statement in the Australian Senate in 1995 describing my efforts to expel Tenet Healthcare from Australia and the defamation actions they took against me. A DISSENTING VIEW OF HEALTH AND AGED CARE CORPORATISATION : CONFRONTING SUN HEALTHCARE IN AUSTRALIA 1997-2001 This page examines the ideological conflict in health care. It describes the efforts I made, during the years following Columbia/HCA's abrupt departure in March 1997, to confront the conflicts in health care and to force authorities to confront Sun's conduct and contain it. The battle to introduce managed care was in progress and I believed that US managed care corporations would be brought in. The inappropriateness of market ideological solutions for health care was repeatedly emphasised. A selection of the letters and documents I wrote during this period can be accessed from links on this page or from the Initial Web Pages Map.

 

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LINKS TO MAPS
Central Map ..... Initial Map ..... USA Map ..... Australian Map ..... International Map ..... Corporate Practices Map

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This page created June 2004 by Michael Wynne
Modified February 2006, September 2006, January 2007, Oct 2007, Aug 2008

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