THE OLD, OLD SOCIALIST STORY: WAITING LISTS FOR TREATMENT GROWING EVER LONGER:

As the health bureaucrats get more and more numerous

Patients throughout Australia are waiting longer to have elective surgery than they were six years ago. The worst performers were Tasmania and the ACT, where only 59 per cent and 72 per cent of patients were treated within what the federal Government recommends is a clinically appropriate time. The government report, the State of Our Public Hospitals 2003-04, found the number of patients who had elective surgery within the clinically appropriate time fell in all states and territories compared with 1998-99.

The waiting times for common procedures such as total knee replacements and cataract surgery varied significantly around the country. In Queensland, patients waited an average 68 days for a total knee replacement compared with 432 days in Tasmania. Cataract surgery was usually performed within 40 days in Queensland and 393 days in Tasmania. The report says many people mistakenly thought the term "elective surgery" meant choosing to undergo a non-essential or optional surgical procedure. "Much of the elective surgery undertaken in Australia's hospitals is urgent and critical, such as coronary bypass operations and hip replacements, which are clearly necessary and often fundamental for a person's well-being," it says.

Health Minister Tony Abbott said the Government was taking pressure off the public health system through private health incentives that had lead to a jump in private health membership from 30per cent of Australians in 1999 to 43 per cent last year. However, according to the report, patients with private health insurance were increasingly going to public hospitals for treatment. The number of private patients admitted to public hospitals increased from 321,000 patients in 1998-99, or 8 per cent of all public hospitals admissions, to about 360,000, or 12 per cent, in 2003-04.

A spokeswoman for Mr Abbott said admissions to private hospitals was growing at a much faster rate than in public hospitals. "Something like 56 per cent of all surgery now is done in private hospitals. If that all had to be done in public hospitals can you imagine their elective surgery lists," she said. "Every person who is treated in a private hospital is one less person who has to be treated in a public hospitals."

Australian Healthcare Association executive director Prue Power, whose organisation represents public hospitals, said the public sector was struggling to cope.

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AND WHO NEEDS AN AMBULANCE ANYWAY?

In Britain you'd better not

Ambulance response times for potentially serious cases will rise under an overhaul of the service. A report detailing plans for a 25 per cent reduction in ambulance visits to accident and emergency departments, with more treatment at home by paramedics, will be published by ministers today. The response times for those with life-threatening conditions such as severe chest pain (category A) will be eight minutes from the time the 999 call is connected. But for other potentially life-threatening conditions such as acute abdominal pain (category B) it will rise from 14 minutes in urban areas to 19 minutes. In rural areas it will remain at 19 minutes. For non-urgent cases such as small cuts, knee injuries and sprains (category C) the response times will be up to local services.

Under the reforms, to be phased in from April next year, fully equipped ambulances will mainly be used for the most critical cases. The remainder of the 999 calls will be dealt with by emergency paramedics, driving people carriers, who will be able to treat many people at home, avoiding a hospital visit.

The report says that 10 per cent of all calls are from older people who have fallen in their homes, some of whom have suffered no injury. The paramedics would be able to take a blood sample, prescribe drugs, treat asthma and diabetes and refer patients to GPs. The Government believes that up to one million people a year are taken to hospital unnecessarily.

Ministers conceded that the number of fully equipped ambulances would fall as a proportion of the overall fleet in the next few years as the number of new emergency paramedics increased. Lord Warner said: "We will make sure that the ambulance services are able to respond to life-threatening emergencies as quickly as possible

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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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