THOUSANDS DIE NEEDLESSLY IN AUSTRALIAN PUBLIC HOSPITALS

Thousands of Australians continue to die unnecessarily in public hospitals despite the federal and state governments spending millions of dollars to improve patient safety. Ten years after a groundbreaking study revealed 18,000 people died every year from adverse events, experts involved in the study said safety standards had not changed. "If we did the study again we would find just as many preventable deaths," said Fiona Tito-Wheatland, the former chairwoman of the Professional Indemnity Review who commissioned the 1995 report. "We haven't changed the system fundamentally, so why would the results differ?" Ms Tito-Wheatland and senior hospital staff say the Australian Council for Safety and Quality in Health Care - set up by the federal and state governments in 2000 - was overly bureaucratic. "In 10 years we haven't even collected the national data we need to know what's going wrong," Ms Tito-Wheatland said.

Bill Runciman, head of Royal Adelaide Hospital's department of anaesthesia and intensive care and one of the authors of the 1995 report, said changes that could save lives were not being implemented. He said the use of catheters impregnated with antibiotics could reduce the rate of bloodstream infection - which killed up to 1000 people a year - tenfold. "The catheters are more expensive which is why hospitals won't buy them," he said. "Our hospital uses them but I know of a lot of hospitals that don't."

The council, which received $55million over five years from the federal and state governments, is under review. Council chairman Bruce Barraclough said the council should be replaced with a body that had regulatory powers. However, hospital staff say the council has failed to raise awareness of safety procedures. "We believe that despite the initiatives of both commonwealth and state quality councils, there has been rather limited impact on the practice of healthcare at the grass roots level in public hospitals," said John McNeil, head of Monash University's department of epidemiology and preventive medicine. A Monash University study of public hospitals in four states found medical staff at all levels had "little systematic involvement in quality and safety-related activities".

Health groups claimed the council also failed to improve doctor-patient communication. "Open disclosure hasn't gone very far at all and it's been a disappointment," said Prue Power, head of the Australian Healthcare Association. But Professor Barraclough said the council was committed to open disclosure. "It took about two years to develop a national standard for open disclosure and ministers endorsed it in 2003," he said. "If you are running a health system you need to understand the complexities of doing this, rather than just saying, 'yes this is good thing, let's just do it'."

Former NSW Health Care Complaints Commissioner Merrilyn Walton disagrees, saying: "Patients should always be told when something goes wrong. Why do you need rules about it?"

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Tenncare cuts approved: "A federal appeals court panel has approved Tennessee’s procedures for kicking people off TennCare, the state’s expanded Medicaid program. The ruling, which overturns a lower court decision, means the state does not have to hold a hearing for each TennCare recipient before removing them from the program. A three-judge panel of the 6th U.S. Circuit Court of Appeals heard arguments in Columbus, Ohio, on Tuesday and handed down a decision Friday. The court said decisions on how to run TennCare were up to the elected officials in Tennessee, "so long as the State’s disenrollment process satisfies the requirement of the Medicaid regulations and statute, any relevant consent decrees and the Constitution." Gov. Phil Bredesen has proposed removing up to 323,000 adults from TennCare to save money, but he recently released a plan to keep the cuts at only about 225,000 people. The appeals court overturned a decision by U.S. District Court Judge William J. Haynes, who said all TennCare enrollees deserved a neutral hearing in case they had been wrongfully terminated. The state had argued that hearings for every TennCare recipient cut from the program would be impractical, and that the disenrollment procedure met all legal requirements".

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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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