Scott Prasser | ACT government will resist royal commission calls

In addition, other independent sources have highlighted the ACT's poor performance in relation to waiting times for surgery, emergency visits and spending levels. And there are other complaints about the high costs of visiting a doctor, workplace culture and even loss of accreditation by some key territory health bodies.

A royal commission is a statutory inquiry which under the ACT's Royal Commission Act 1991 and as in other jurisdictions, has coercive powers of investigation to call witnesses including ministers and health officials, procure files, hold public hearings and make recommendations.

These are not enforceable but are potent in forcing a government to adopt them often lock, stock and barrel.

And let's be clear - only executive government can appoint a royal commission.

They are not established by parliament, as Kevin Rudd found in 2020 when his petition with thousands of signatures to the Commonwealth Parliament for a royal commission into the Murdoch press was immediately and appropriately dismissed by the then government. Royal commissions are instruments of executive government, though independent by virtue of their statutory powers, external membership, and open processes.

As the ACT government would be the target of such a royal commission it is understandably not enthusiastic about appointing one. It would be an inquiry into its competence and performance in health, potentially exposing its failures, releasing files and giving public air to a wide range of critics.

Exacerbating this reluctance is that the ACT government has in effect been in office for 21 years. It is therefore responsible for all that is both right and wrong with the current health system. It can hardly blame the previous administration.

A further factor is that ACT elections are set for October next year and so a royal commission which could easily last twelve months and would report, with all its potentially damaging findings, in the lead up to the polls.

In other words, appointing a royal commission is a risky business for any government, as many others have previously found. Indeed, even with narrow terms of reference, careful selection of members, and tight deadlines, royal commissions often probe deeper and discover more than expected, causing governments to fall.

In such circumstances the ACT government argues that a royal commission is unnecessary as they already have strategies and new priority areas in place, it would be costly and that a royal commission is an inquisitorial instrument more attuned to seeking the "truth" about some allegation, and thus unsuitable to review a complex health system and to make policy recommendations.

Such a view ignores how royal commissions across Australia have reviewed, with some effect, not just scandals, but broad areas of policy ranging from old age pensions, postal services, health, taxation, national insurance, television, public service, Aboriginal land rights, and human relationships.

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Moreover, even those established to respond to allegations of wrongdoing like the recent royal commissions into banking and the later aged care while unearthing scandals also reset the policy direction, administrative arrangements and resolved competing truths about issues. Indeed, the aged care royal commission proposed, somewhat controversially, new spending and staffing levels which governments have been reluctant to ignore.

While there are legitimate concerns about royal commission costs that all depends on their membership and processes. Costs can be contained. That is up to the appointing government to resolve.

In the end, appointing a royal commission is decided only by executive government whose actions are ultimately driven by politics - in other words is it more politically damaging to have an inquiry than to resist one. That decision is affected by the overall standing of the government and its confidence to withstand public concern, media agitation, and the seriousness of the issues

So, in this case don't hold your breath for a royal commission into ACT's health system, but further exposure of mistakes, can cause government to change its mind. It does happen.