Investing for efficiency.

The French Revolution set out to abolish hospitals but in fact strengthened them, made them the core of medicine and improved their effectiveness. Mortality rates more than halved between 1789 and 1850. This reduction was bought about by improvement and investment in old hospitals, appropriate separation of institutions and new administrative organisations. Our modern hospitals and institutions started with the French Revolution and have been going through similar cycles of neglect and abolition or concern and investment. This paper will look at the effects of investments, neglect and "pork- barrelling " by successive governments which has led to inappropriate locations of hospitals, sub-standard facilities, inefficient location of facilities within hospitals, outdated equipment, insufficient maintenance and dangers to public health and human safety. Operating costs, consequences of inefficient layout, buildings and sites within a number of Australian hospitals are then analysed. It is then suggested that orderly capital funding on a triennium basis be established in a similar way to university capital funding.