SERVICE CUTBACKS: THE FUTURE OF GOVERNMENT MEDICINE

Some patients would be forced to catch a school bus to get hospital care under government plans to close beds and reduce services at a New South Wales north coast rural hospital, a doctors' group said today. The Rural Doctors' Association of NSW said it had become aware the state Government planned to close all 14 inpatient beds and end 24-hour emergency services at Campbell Hospital at Coraki, near Lismore. The Government wanted to have the emergency department open only during business hours, the group said.

The association's president Peter McInerney today urged NSW Health Minister Morris Iemma to guarantee existing services would continue at the hospital, 740km north of Sydney. "Closing Coraki Hospital is bad policy and bad politics," Dr McInerney said. "Those living in and around Coraki will be left without local access to ongoing hospital treatment, immediate assistance with emergency births and 24-hour accident and emergency care. "If the hospital closes, some patients who need inpatient services or minor procedures and have no transport of their own may have to travel by school bus to access services in other centres."

Dr McInerney questioned why government funding was available for mothers to have home births in Sydney, but there was no money for 24-hour emergency care in a rural community.

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PAINKILLER HYSTERIA

The blockbuster painkiller Bextra was yanked off the market Thursday, and the government ordered that 19 other popular prescription competitors - from Celebrex to Mobic to high-dose naproxen - carry tough new warnings that they, too, may increase the risk of heart attacks and strokes.

The warnings encompass an entire class of anti-inflammatory medicines called NSAIDs that are the backbone of U.S. pain treatment, not just newer versions of the painkillers initially suspected when the heart concerns made headlines last fall.

The warnings - in black boxes, the strongest the Food and Drug Administration can order - are likely to cause confusion because they won't tell patients and doctors which of these prescription drugs is a safer choice. In addition, the FDA will make over-the-counter NSAIDs, or nonsteroidal anti-inflammatory drugs, such as ibuprofen, naproxen and ketoprofen bear stronger reminders to take only low doses for a few days at a time to avoid the same risks of high-dose, long-term use.

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.

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