THE QUEENSLAND DISASTER CONTINUES

Below are three stories from the one day (Sat 23 July, 2005) -- the first two in "The Courier Mail" and the third in the "Townsville Bulletin" about a long-established government-run health system that gets worse by the day despite huge political fallout -- even though lots of Queenslanders opt out of it and go private. This sort of thing is what all advocates of "single-payer" health schemes are in effect pressing for

Finger lost after medics drive Allan 400 km away

By: Glenis Green

It takes a lot to faze a tough old bushie like Allan Benson. But when he accidentally chopped most of a finger off with a tomahawk, even he did not expect to be told he'd have to bypass the new multimillion-dollar Hervey Bay Hospital just down the road and instead drive almost 400km to Brisbane to get the appropriate medical attention.

Mr Benson, 64, said that he did not blame medical staff, but the unwieldy health system culture in Queensland. Mr Benson said when he accidentally sliced the index finger on his right hand on Monday last week it had been left hanging by a thread. With blood pouring he made it back to the house, packed it in ice and wrapped it in a towel and then drove to the Bay's nearby hospital. "I've got no qualms with the hospital staff - they were phenomenal - but it's the administrative and government part of the system that's bad," he said.

Mr Benson said a neurosurgeon was called, only to explain that he could not operate to try and save the finger because there was no head surgeon available. Instead staff began ringing around other hospitals before finally booking him into Royal Brisbane Hospital, but said they could not justify an ambulance transfer until the following day. Mr Benson's son-in-law, James Stott, ended up driving him that afternoon to his booking in Brisbane - bypassing not just the Hervey Bay Hospital but also major, closer hospitals at Maryborough, Gympie, Nambour and Caboolture.

Because of the severity of the wound the end of the finger could not be saved and it was amputated, with Mr Benson being driven back home by Mr Stott the next day. Mr Benson said doctors at Royal Brisbane were "amazed" that he had ended up travelling such a long distance for treatment.

"Yeah, I've got a crook heart," he said. "I was on the transplant list, but after they gave me some tablets I got a bit better and I took myself off it (the list). "It just seems so stupid that they send me to Brisbane (for my finger) and someone else in Brisbane has to go without. "Hervey Bay is a new, state-ofthe-art hospital and they can't even do minor operations there."

Mr Stott described what happened as "irresponsible". "The person (at Hervey Bay Hospital) who saw us was capable of doing the surgery, but because there wasn't a supervising practitioner available - a case consultant - they were not able to do it," he said. Mr Stott said the whole episode had been traumatic and costly.

A Queensland Ambulance spokesman said it appeared Mr Benson's case had not been rated by the hospital as an emergency and as the local ambulance did not do non-emergency transfers between Hervey Bay and Brisbane, it would have been a clinical decision whether or not to call in the Royal Flying Doctor Service to airlift him to Royal Brisbane.

Fraser Coast Health acting district manager Kerry Winsor said the region's orthopedic services were suspended in May this year following the withdrawal of the Australian-trained supervising orthopedic superintendent in response to the Australian Orthopaedic Association report recommendations. She said this now meant that patients requiring specialist orthopedic treatment had to be referred to an appropriate facility.




Ignored doctors threaten to strike

By: Jeff Sommerfeld

Queensland's ongoing health crisis is set to deepen with senior specialists at public hospitals threatening to take industrial action that could increase waiting times for elective surgery. Doctors yesterday blamed the worsening health crisis on Premier Peter Beattie, whom they say was trying to create conflict to deflect attention from his Government's political woes. The conflict surrounds an overdue employment agreement for part-time medical specialists in the state's public hospitals. A significant portion of elective surgery in public hospitals is performed by the specialists known as visiting medical officers or VMOs. The agreement was supposed to have been finalised in February, with Queensland Health and the VMOs at that time mainly in agreement.

Australian Medical Association past-president David Molloy yesterday said Mr Beattie had advised the AMAQ in April that he was personally handling the VMO negotiations. "He has stonewalled it at a time when the Queensland public hospital system needs as many Australian-trained doctors as it could get," Dr Molloy said. "VMOs do very little administration work - it's all patient care. The full-time doctors do most of the administration," he said.

VMO committee chairman Ross Cartmill said Mr Beattie had advised him he wanted to delay finalising any agreement with the VMOs until he received final reports from health inquiry head Tony Morris and consultant Peter Forster. "I sent a letter saying we would accept no pay rises for VMOs until the end of the inquiries," Dr Cartmill said. "That was on the proviso we reached an agreement within two months of the end of those inquiries." He said the first contact he had with the Premier's Office was yesterday, and only after Mr Beattie had sent out a media release stating his position.

Although VMOs had threatened to take action from Monday, Dr Cartmill yesterday made a further plea for the Government to negotiate a final agreement to prevent industrial action.

In his media statement, Mr Beattie said VMOs "play a crucial role in our public hospital system. The Government values the enormous contribution they make. The public hospital system could not function without them." He said he had written to Dr Cartmill advising of 7.8 per cent pay rises for VMOs pending the conclusion of the health reviews. "The decision by the Government to award the increase in the way we have, allows for further negotiations to take place if recommendations from the Bundaberg hospital inquiry and Health Systems Review impact on the employment status and conditions of VMOs," Mr Beattie said.





Probe dropped as doctor fled

He kills someone but gets off scot-free because of regulator incompetence

The Queensland Medical Board had dropped its investigation into the operating theatre death of a Charters Towers woman when the overseas-trained doctor in charge of the procedure resigned and left the country, a Townsville inquest was told. The five-day inquest, which wound up yesterday, was inquiring into the circumstances surrounding the death of Kathryn Marnie Sabadina in December, 2000, and the possible responsibility of South African-trained Dr Izak Schalt Maree. Dr Mary Cohn, chairwoman of the Medical Board of Queensland, the body which registers doctors in the State, said at the time of Dr Maree's resignation, in 2001, the board had 397 investigations to conduct.

Counsel assisting the Coroner Michael Tate said he and several expert witnesses had been surprised to hear that the investigation had been dropped. Mr Tate said this was especially so since the board itself had written to Dr Maree, telling him it had received complaints from a senior doctor about his conduct. "The board is concerned that you may prove an imminent threat to the health and well-being of the public," Mr Tate quoted from the letter. Dr Maree resigned and left shortly after receiving the letter.

Dr Cohn said, with a workload of 397 investigations, it was decided the inquiry into Dr Maree was best put on hold. But she said the inquiry would be immediately reactivated if Dr Maree returned and again sought registration. Asked if procedures had changed, Dr Cohn said they had. Today, the investigation would have continued because there were only 170 cases in train. Dr Cohn said the board simply registered Dr Maree on his references and credentials from South Africa. It had not known he was being appointed medical superintendent at Charters Towers Hospital. "That has been changed, and the board now needs to have a job description available before interviewing a doctor for registration," Dr Cohn said.

Peter Sladden, who was the Queensland Health district manager in 2000, denied Dr Maree had been hired because he was cheap. Mr Sladden said another doctor mentioned in connection with the matter was never an applicant for the medical superintendent's job, and Dr Maree was the only applicant.

Townsville Hospital director of anaesthetics Professor Vic Callanan said Ms Sabadina's death was most probably caused by a severe allergic reaction to one of the anaesthetic drugs used in the procedure. Ms Sabadina's father, Heath Sabadina, told the inquest he did not believe his daughter had died in vain. "My daughter's death was a bit of a wake-up call for Queensland Health," Mr Sabadina told State Coroner Michael Barnes. Mr Sabadina made the comment after hearing a morning of testimony about the procedures Queensland Health has put in place as a result of his daughter's death.

Dr David Farlow, the co-author of an investigation critical of Dr Maree, agreed the events in Charters Towers during Dr Maree's time there had prompted change. He said there were now programs in place for frequent peer reviews of skills. 'Privileges', or formal permission to perform specialist functions, were now checked and refreshed every three years. There was also a closer link between regional hospitals such as Townsville and the smaller ones in the region. Dr Farlow said creating a network of contacts through refresher courses at the main hospitals allowed rural and remote doctors to increase skill levels and gain quick access to advice. He said medical equipment throughout Queensland was being standardised.

Coroner Barnes said he hoped to have his findings ready to be published in about two weeks. These findings will include consideration of whether further action should be sought against Dr Maree.

Source

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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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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