Today we have better chances of staying alive in hospitals. But while methods of delivering care have changed, the organisation in which the care is delivered has not. But we also have the same professional cultures that have existed since Florence Nightingale. Doctors are at the top of the hospital hierarchy. Doctors regard patient treatment as a skilled individual performance.
Nurses see patient care as a collective multi-disciplinary task.
Patients are still at the bottom of the hierarchy. The NSW Health Council Report published in March set new directions for the health system. It is a revolutionary document. These are all necessary reforms. But alone they will not achieve better outcomes for patients.