The moving of St Vincent's: a tale in two cities

In Australia, demographic changes have seen the population of large cities move away from the inner city. This, combined with changes in healthcare de livery and the ageing of many tertiary teaching hospitals, has led governme nts to attempt to close, relocate or redefine the role of some institutions . Tracing the media coverage of two such events - the attempts to move St Vin cent's hospitals in Sydney and Melbourne - provides some interesting insigh ts into the challenges of resource allocation facing policymakers within th e healthcare sector. Both hospitals were long-established, much-loved fixtures on inner-city sit es with powerful connections to government and business. In Sydney, where the attempt was part of a larger plan to reallocate resour ces to the western suburbs, the announcement was met with 10 days of intens e media coverage and scrutiny by lobby groups and the general public. By contrast, in Melbourne, no such announcement was made and the low-key re porting of support and opposition to the move occurred over two months. Bot h attempts failed. No matter how the debate is handled, radical changes inv olving long-established hospitals, powerful provider groups and loyal commu nities are very difficult to accomplish.