INCREDIBLE: HOW AN ENTRENCHED PUBLIC HEALTH BUREAUCRACY DEALS WITH A RISING POPULATION

In exactly the opposite way a business would: By REDUCING the medical services available -- i.e. by cutting the size of its major hospitals. Only paying to send 15,000 people a year to private hospitals ("outsourcing") keeps the system afloat at all. I guess it's privatization by stealth. But you have to wait years before the government system gives in and farms you out

"Secret State Cabinet documents tabled at the Public Hospitals Commission of Inquiry show more than 30 patients each day during June were turned away from the Royal Brisbane and Women's Hospital because of a bed shortage.

Considered to be the largest hospital in the state, almost 550 beds were cut from the RBWH when its redevelopment was completed almost two years ago. The Princess Alexandra Hospital has undergone a similar reduction from 1100 beds in 1976 to its present 745.

To "reduce the likelihood of cancellations", Queensland Health has been forced to assess patients "with some reduction in the booking of elective surgery patients that require post-operative beds", the Cabinet documents reveal. The documents presented to the inquiry show that during the Beattie Government's seven-year term, the numbers of patients awaiting the most urgent Category 1 operations have almost doubled from 1285 when the Government came into office in July 1998 to 2383 in July 2005.

The documents also outline the political sensitivity of elective surgery lists, with Queensland Health warning Cabinet "that hospitals have been required to make financial decisions on which clinical services will be compromised to ensure elective surgery targets are met". "To continue to maintain the urgent Category 1 workload, improve Category 2 waiting times, and reduce 'long waits' in the public sector, existing election commitment funding will need to be made recurrent, and Category 3 activity will need to be significantly reduced," the documents state. "It is estimated that approximately 15,000 Category 3 procedures will need to be outsourced on an annual basis which will cost in the vicinity of $88 million per year."

The number of patients needing to be outsourced are further proof that beds have been slashed from public hospitals, according to Australian Medical Association Queensland president Dr Steve Hambleton. "There is no doubt that way too many beds were cut and the planners got it wrong," Dr Hambleton said. "We now have an impossible situation with the two major tertiary referral centres in Brisbane now at peak capacity." Dr Hambleton said the Queensland Health Code of Conduct gagged employees from speaking out, and the Cabinet documents show "senior bureaucrats were gagged as well".

The office of Health Minister Stephen Robertson yesterday refused to provide any specific answers to questions, but issued a statement saying the matters were being considered "by both the Forster review and the Queensland Public Hospitals Commission of Inquiry". "We expect both the Forster review and the inquiry to make recommendations on the management of waiting lists and elective surgery. We look forward to any recommendations regarding waiting lists from both inquiries and will comment further then."

Source

And the coverup of the problems goes right to the top of the State government:

More evidence of a political cover-up of sensitive hospital safety data has emerged to contradict denials by Premier Peter Beattie and his deputy Anna Bligh. The written evidence to the health inquiry comes as:

* Secret documents revealed more than 30 patients a day were turned away from Royal Brisbane and Women's Hospital in June because of a bed shortage.

* The State Government prepares to launch a massive recruiting drive for doctors in England.

* Details emerged of how government officers were ordered by the Premier's Department to water down critical health findings to "reflect a less negative view"....

But a synopsis of "risks and issues" of an internal report by senior bureaucrats Dr Suzanne Huxley and Dr Frank Fiumara said there had been "a failure to release the public report due to potential political sensitivity of indicator data. " The reference was included as one of 90 attachments to a statement by sacked Queensland Health chief Dr Steve Buckland.

Mr Beattie's involvement in the cover-up was revealed in a November 2002 e-mail by a Cabinet liaison officer, Brad Smith. It has also emerged that public servants within Queensland Health were ordered to rewrite sections of the report because its original version was considered too negative for public release.

A spokesman for Mr Beattie said on Monday that the report had been released "almost unchanged" in June 2003, after it was "finalised" under the supervision of the Premier's Department. But notes made by Queensland Health staff member Justin Collins, tabled in the inquiry, show the release of the report was delayed so it could be recast in a more favourable light. The notes show the report team was instructed by the Premier's Department to reword parts of the report "to reflect a less negative view on some of the indicator results".

More here

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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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