Premiers and chief ministers talked turkey on Wednesday morning as crunch time approaches on negotiations with Canberra on a new five-year public hospital funding deal.
Federal Health Minister Mark Butler promised to cover 42.5 per cent of public hospital running costs by 2030 and 45 per cent by 2035, in a deal struck in late 2023.
At Wednesday's meeting, state and territory leaders agreed the pledge must be honoured.
Labor NSW Premier Chris Minns said the share of federal funding would be closer to 37 per cent under the Albanese Labor government's latest offer, calling it a "massive decline".Â
"Right across Australia, Queensland, Western Australia, South Australia, the Northern Territory, different states, different political parties run those states," he told reporters.
"We can't all be wrong.
"It seems to me that the federal government is implying that all of the states have got it all wrong at exactly the same time."
States cannot cut public hospital activity to suit the federal government's bottom line, Tasmanian Liberal Premier Jeremy Rockliff said.
Victorian counterpart Jacinta Allan struck a slightly more conciliatory tone, declaring negotiations had been "robust" but "constructive".
She said states and territories were "so up and about" on the topic due to "huge pressure" on their health and hospital systems.
"We have been working incredibly hard but without the support that's been needed," the Victorian Labor leader said.
There are 1100 elderly people in NSW hospitals that should be discharged but have got nowhere to go, Mr Minns said.
"The federal government's got a lot of far deeper pockets than the states do," he said.
"But we're responsible for service delivery, and we need a new deal because what's been offered here is just not good enough."
Mr Butler, whose office has been contacted for comment, previously said he hoped the agreement would be finalised by the end of 2025 and take effect from July 2026.
The feuding comes as a Grattan Institute report highlighted realistic budgets, funding reform and better system management could pay for an extra 160,000 hospital visits each year.
The study warned the country's approach to funding hospitals was "broken" due to "bogus budgets", with Australian governments wasting $1.2 billion a year on avoidable spending.
It found that while public hospital spending had increased by 50 per cent over the past decade, hospitals remain under the strains of ambulance ramping, extensive surgery wait times and widespread staff burnout.
Demand will only grow and governments will need to spend more, although smarter spending could be the key, the report found.
"Australia's hospitals are approaching breaking point," the institute's health program director Peter Breadon said.
Public hospitals could look to global examples, he said, such as doctors in England who use AI notetakers to reduce time spent on paperwork.
One in three patients who receive hip or knee replacements in Canada go home the same day, Mr Breadon noted.
If hospitals don't curb "ballooning" costs, governments could impose austerity measures, as seen in the UK.
"The danger is we make the same mistakes as the UK, which resorted to brutal austerity to rein in costs, with devastating impacts for patients," Mr Breadon said.
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