AFTER YEARS of work to transform a grim and unaccredited D.C. General Hospital into a respectable, well-managed urban medical center, the independent citizens' commission that has been guiding this recovery has just been given the back of city hall's hand. Instead of welcoming the group's thoughtful report, Mayor Barry and Polly Shackleton, who heads the D.C. Council's committee on human services, have dismissed it in cavalier fashion, indicating they see no justification for any additional subsidy at this time. As a result--and who can blame him?--commission chairman Gilbert Hahn Jr. has resigned.
It is the nasty tone of the Barry/Shackleton responses that is especially troubling. Mrs. Shackleton notes that neither her committee nor the mayor "has ever been convinced" that D.C. General had a projected deficit of $31 million, as the commission reported in January. The commission's request for a budget for two fiscal years instead of "one fiscal year at a time" is "obfuscation of the first order," she says. Come on.
Mrs. Shackleton points disapprovingly to certain measures cited in the commission's report but not recommended for immediate adoption, such as contracting out various medical and administrative services and converting the hospital's salaried physicans to a fee-for-service system.
These are promising ideas, as we have said before. But the report cites an accounting firm's warning that such changes take time to put into effect and to yield savings. Changing the physicians to a direct- billing system needs "at least one and one-half years" for proper study, said the firm; "deficit reduction savings probably cannot be realized before fiscal year 1985." Other changes, says the report, may entail negotiations with unions and significant shifts in services. It recommends that the hospital address these issues now, rather than make changes without proper preparation. For example, management by a private firm is a good idea, it says, but "it is doubtful that a firm would accept a management contract" without special exemptions from D.C. government personnel regulations.
If it is as easy as Mrs. Shackleton seems to think to make these changes, perhaps her committee and the mayor should recommend that all services of the city government be performed on a fee-for-service basis, effective this fiscal year. Instead of taking on all those new deputy mayors, Mr. Barry could sign up an urban management firm.
D.C. General is too important to the city and-- thanks to Gilbert Hahn--it has made too much progress in recent years to be made a political football.