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 delivery and the ageing of many tertiary teaching hospitals, has led governments 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 Vincent's hospitals in Sydney and Melbourne--provides some interesting insights into the challenges of resource allocation facing policymakers within the healthcare sector. Both hospitals were long-established, much-loved fixtures on inner-city sites with powerful connections to government and business. In Sydney, where the attempt was part of a larger plan to reallocate resources to the western suburbs, the announcement was met with 10 days of intense media coverage and scrutiny by lobby groups and the general public. By contrast, in Melbourne, no such announcement was made and the low-key reporting of support and opposition to the move occurred over two months. Both attempts failed. No matter how the debate is handled, radical changes involving long-established hospitals, powerful provider groups and loyal communities are very difficult to accomplish.