Just one weekend's news from the three most populous States below:
NSW hospitals close surgery for long periods
Waiting lists are set to rise as some of the state's largest public hospitals prepare to shut down elective surgery for up to three weeks over Easter. Doctors have labelled the closures as a cost-saving exercise with many hospital budgets already stretched to breaking point, months before the end of the financial year. Except for emergency cases, hospitals including Westmead, Wagga Wagga, Mona Vale, Manly and St Vincent's, are shutting down or reducing elective surgery services for about a fortnight next month. Staff at Ryde Hospital, in north-west Sydney, have been told no elective surgery will be carried out for three weeks.
Australian Medical Association NSW president Dr John Gullotta said next month's close-down period was longer than previous years. "We really have to ensure that these shutdowns don't get longer and longer every year," he said. "It is a blatant cost-saving exercising. It's an attempt to constrain the budgets. "It's also forcing further cancellations of elective surgery and increasing the list."
But a spokeswoman for NSW Health Minister John Hatzistergos said the number of patients waiting longer than 12 months for elective surgery had been halved, decreasing from more than 7000 in February 2005 to about 3400. Latest figures show more than 56,000 patients are waiting for surgery in NSW.
The Easter shutdown comes after many hospitals closed their operating theatres for up to six weeks during Christmas. Dr David Jollow, a visiting gynaecologist at Manly and Mona Vale hospitals, said those hospitals normally only closed for one week at Easter. "It's all to do with saving money," he said. "I don't how much money they save by doing these things. "I think realistically if they were really keen to get rid of the elective surgery waiting list, they would be open 52 weeks."
Dr Gullotta said close-downs were becoming so common, some hospitals did not provide elective surgery for up to three months of the year. Health Opposition spokeswoman Jillian Skinner said it was not a case of hospital staff wanting time off at Easter. "We really do have part-time hospitals and it's not because doctors want to take leave," she said. "It's because the Government can't afford to run them."
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Victoria's health system in big trouble too
A severely-ill pensioner says she was taken off a drip at a Melbourne hospital emergency ward and told to leave -- because no public beds were available. Another woman in agony after a procedure at the hospital claims she was denied painkillers and told that she should have brought her own. The Health Services Commissioner is being called on to investigate the allegations against Casey Hospital.
The claims come as waiting lists soar and specialists say vital tests to check for bowel cancer in at-risk Victorians are being secretly cancelled. In the first case, a woman, 61, who was too frightened to be named, said she had suspected pneumonia and had been referred to the hospital by her doctor. The woman, who had needed treatment for pneumonia three times previously, had a temperature of 38, was vomiting and struggling for breath, her distraught husband said. On arrival at Casey's emergency department, the Pakenham woman was put on an intravenous drip and blood tests were taken for analysis at Monash Medical Centre.
But her husband alleged that when she had said she did not have private health insurance, the emergency duty doctor had told her there were no beds available and she had to leave. Her husband said he learned later that the blood tests had not been forwarded to Monash for analysis.
In the other case, a woman, 43, who went into Casey for an epidural steroid injection to ease back pain, said she had been denied painkillers despite being in the worst agony of her life. "I couldn't move -- I've never felt pain like that in my life," she said. "When I asked for painkillers the staff said I should have brought my medication -- even though I was not told that before I came in."
Opposition health spokeswoman Helen Shardey said the cases were "appalling" and should be investigated by the Health Services Commissioner. "The treatment of these patients appears to have been cruel to the extreme," she Shardey said. Casey Hospital said it could not comment specifically on the cases because no complaints had been received.
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The coverups never end in the Queensland health system
Ambulance officers have been gagged from mentioning delays or bed shortages at hospital emergency departments. A top-secret email has gone out to staff warning them not to use the words "ramping" or "access block" when sending radio messages to Queensland Ambulance Service communications centres. Ramping, or access block, is when hospitals refuse entry to paramedics and patients because no beds are available. Ambos have been told to use the terms only on a telephone. If they can't get through on the secure land-line after two attempts, they are advised to use their radio, with the provision: "Do not refer to ramping or access block." Sources said the order had come from "high places" in the State Government due to concerns that media and the Opposition were being tipped off about the problem.
The Government has been under fire after reports that Royal Brisbane and Women's, Mater and Caboolture hospitals were diverting emergency patients. Queensland Health figures in February revealed nine of Queensland's 23 major hospitals were at capacity, and many others were struggling to cope with their workload.
A frontline ambo, who declined to be identified, told The Sunday Mail that paramedics and communications officers had been advising each other by radio when ramping occurred, and they were pleased to see the issue brought to public attention. "Some crews are being ramped for several hours at a time and, while the paramedics can readily give treatment to a ramped patient, a ramped ambulance crew is, of course, unable to respond to any emergencies," he said. "Multiply that by five or six crews and you can see the size of the problem if an emergency goes off."
The ambo said an email was sent out this week "explicitly telling them to never use the radio when discussing ramping". "There is only one reason for this, and that is to stop the media picking up on the frequency and severity of the problem," he said. It was not the first time ambos had been gagged. The Sunday Mail reported exclusively last May that staff were threatened with $3000 fines if they spoke out publicly about their controversial new roster system. QAS bosses closed down paramedics' online forum last September due to contentious issues being raised there by concerned officers.
The ambo speculated pressure had been put on QAS by Queensland Health or a Government minister: "Perhaps the QAS thinks that by gagging staff, the problem of ramping doesn't exist." Opposition health spokesman Bruce Flegg said the email was "unbelievable". "It is political interference of the very worst kind," he said. "This Government would rather cover up the problem than try to fix it."
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This guy should have been a crook
He would have had no problem then -- even if he had been struck off overseas
A highly respected foreign doctor working in Brisbane may be kicked out of the country because the Federal Government does not want to pay for medical treatment for his Australian-born son. The Indian doctor, a member of the Royal Australian College of General Practitioners and the Australian Medical Association, has a temporary resident visa, valid until 2008. He recently applied for permanent residency for him and his family. But the Immigration Department has stalled after a report from the Commonwealth Medical Officer said the doctor's infant son would require ongoing orthopedic and pediatric care for a minor disability.
The Queensland Government has expressed its outrage to Canberra as it struggles to employ 300 new doctors over 18 months to solve its health crisis. Deputy Premier Anna Bligh has written to Federal Immigration Minister Amanda Vanstone asking her to intervene and approve the application. She said the doctor was highly regarded by Queensland Health. "I find it remarkable that, at a time when Australia is facing critical doctor shortages, (the Immigration Department in Canberra) would disregard an application for permanent residency by a highly qualified, well-regarded medical professional on the grounds that his son suffers a disability, despite the fact the child was born in Australia and the family has taken full responsibility for his current and future medical needs," Ms Bligh said.
The doctor, who had been in Australia since 2003, had worked at Ipswich and Logan hospitals, at Wacol and Borallon prisons, at Aboriginal health centres and as a GP in Brisbane. Ms Bligh said the family was prepared to meet all future medical costs and take full responsibility for the care and support of their two-year-old son. The doctor, who asked not to be identified, declined to comment on his case for fear of upsetting immigration officials.
The State Government had received letters of support from patients of the GP. He also received backing from Health For All, an organisation sponsoring overseas-trained doctors, after he had helped train foreign doctors and set up their patient database. "We desperately need doctors," said director Madonna Abella. "It would be good if the Department of Immigration could change its policy to make it more attractive for overseas-trained doctors to come here."
AMA Queensland president Steve Hambleton also urged Senator Vanstone to intervene. "We have to be a bit more tolerant, open and welcoming," he said. An Immigration Department spokesman said a final decision had not been made. But he confirmed medical advice said the doctor's son "does not meet the health requirement". The department had invited the doctor to supply further medical opinion to support his application.
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BRITISH NHS TO CUT DENTISTRY
Cuts, cuts and more cuts, despite getting more and more money
Dentists are expected to remove more than half a million children from lists entitling them to free NHS treatment when a new pay deal comes into effect next month. Thousands of practitioners are likely to reject the contract offered by the government and quit the National Health Service to treat only patients prepared to pay, according to a survey of NHS primary care trusts. The trusts, which provide GP and dental care locally, have admitted that thousands of children will be hit. Some have already written to patients warning them that from April 1 both adults and children will be obliged to find another dentist unless they are prepared to pay for treatment or buy insurance.
The NHS has been losing dentists to the private sector since 1992 when it introduced changes to their payments. Tony Blair pledged in 1999 that everybody would be able to see an NHS dentist within two years, but the exodus has continued. It is expected to accelerate when the new employment contract for dentists takes effect and children will be removed en masse from dentists' lists for the first time. A Sunday Times survey of 29 primary care trusts found that 133,000 patients, about 40% of them children, have been told they will no longer be able to get NHS treatment from their current dentist after the end of the month. There are 302 primary care trusts in England and, if the pattern is reflected across the country, about 830,000 adults and 550,000 children will be dropped by their dentists.
The Dental Practitioners Association said the figures were a "reasonable estimate". Among those who have already received a warning is Adette Lodge, 34, from Gloucester, who was told that her three children, aged 12, nine and five, would no longer be offered NHS treatment. She said: "I was shocked, upset and angry. It is important that children's teeth are formed properly in their early years. If their parents can't pay, care is being taken away from them."
Among those leaving the NHS is John Renshaw, who was chairman of the British Dental Association until last month. He said he regretted that some parents would not be able to afford dental fees and that children would be left without care. "I have been committed to the NHS for the last 37 years but the new contract has forced me to make this decision," he said. "It was not an easy decision but it had got to the point where the NHS was not supporting the kind of service we wanted to offer our patients. "There will be some patients who will not pay. I expect the number of children who are not getting dental care will increase."
Graham Barnby, honorary vice-president of the British Dental Health Foundation, runs two dental practices in north Dorset. One has told 1,000 patients, including children, that they will no longer be offered NHS treatment. Barnby said: "We have put in place low-cost insurance for children. The reaction from parents has been mixed. Just the other day we had one parent who paid the fees for their children for a year. "Other patients have said, `I know my rights under the health service and I have a right to NHS treatment'. I feel sorry for those who cannot afford to go private."
The new system pays dentists a fixed rate for a series of treatments. Some dentists argue that the fees are not high enough to pay for high-quality care. The Department of Health insists that patients thrown off practice lists will be able to find another NHS dentist in the area. Rosie Winterton, the health minister responsible for dentistry, said: "The early signs are that the vast majority of dentists will sign up to the new contracts."
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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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