Australian Financial Review http://www.afr.com.au/content/991124/news/news5.html November 24, 1999 Australia's health system is in a critical condition By Julie Macken Australians owe the Minister for Health, Dr Michael Wooldridge, a debt of gratitude for undermining their expectations of the health system, according to leading health-care consultant Mr Brent Walker. "One of the best things Wooldridge has done over the last five years is change the public's expectations of Medicare. Let's face it, they certainly don't expect as much today as they did under Labor," Mr Walker said. As an adviser to Australia's biggest private health funds, Mr Walker, of BW Actuarial Services, applauds the lowering of expectations for the public health system. Mr Russell Schneider, chief executive of the Australian Health Insurance Association, agrees, saying figures released last week showing health fund membership in the September quarter up by 96,557 is in part due to this loss of faith. "Media exposure of the obvious problems in NSW and Victorian hospitals played their part," Mr Schneider said. The word "crisis" has been used by the media and health-care experts to describe the state of the public health system repeatedly over the past five years. But is there really a crisis? And if there is, what does it look like, and what can be done to prevent a critical condition becoming chronic? In 1965 Australia came third amongst OECD countries in expenditure on health. In 1995, we came 16th. Today Australia spends 8.2 per cent of its Gross Domestic Product on health, compared with 14.2 per cent by the United States. Between 1991 and 1998 Australia's provision of health services per person increased by 40 per cent. Over the same period, funding did not increase. As a senior doctor working in one of Sydney's largest public hospitals puts it: "Australia has a brutally efficient health-care system." In health care, efficiency is determined by throughput and outcomes. That is, getting patients in, treated, and out of hospital as quickly as possible. According to Dr Wooldridge: "There is no crisis in the Australian health-care system." There is only "a serious hospital management issue in NSW that could be remedied by adopting the case-mix [hospital funding] system of Victoria". However, as Jeff Kennett discovered during the Frankston by-election, a number of Victorians would not agree with Dr Wooldridge's analysis or praise of the Victorian system. Nor does Professor Peter Baume, head of the School of Community Medicine at the University of NSW. Professor Baume, who has been involved in public health for the last three decades, described the system as "totally hopeless" and "based on a lie". "The lie is that everyone has equal access and an equal right to every form of medicine available. That's not true, but we all pretend it is. That leaves the rationing to be done at the emergency units on an ad hoc basis," he said. Last Tuesday, a senior doctor at Westmead Hospital in Sydney decided he could no longer remain silent about the dangers posed by such a chaotic situation. Professor Richard Kefford, who is chairman of Westmead's division of medicine, said he was told to discharge one of his cancer patients because there were no empty beds for emergency patients. The women was in the middle of her first course of radiotherapy for curable breast cancer, but had developed an overwhelming infection. Professor Kefford said the patient needed to be treated with intravenous antibiotics and to discharge her would breach his duty of care to his patients. "This is a very clear-cut case," Professor Kefford said. "She was an extremely sick women being asked to leave hospital. And this is happening almost every day in hospitals across Sydney. "The only reason I can speak out about it is because I'm a university academic. Even so, we'll pay for this publicity in a big way." Unfortunately, if Westmead Hospital is made to pay for these criticisms of the system, it will be patients who pick up the tab. This material is subject to copyright and any unauthorised use, copying or mirroring is prohibited. ************************************************************************* This posting is provided to the individual members of this group without permission from the copyright owner for purposes of criticism, comment, scholarship and research under the "fair use" provisions of the Federal copyright laws and it may not be distributed further without permission of the copyright owner, except for "fair use." -- Leftlink - Australia's Broad Left Mailing List mailto:[EMAIL PROTECTED] http://www.alexia.net.au/~www/mhutton/index.html Sponsored by Melbourne's New International Bookshop Subscribe: mailto:[EMAIL PROTECTED]?Body=subscribe%20leftlink Unsubscribe: mailto:[EMAIL PROTECTED]?Body=unsubscribe%20leftlink
