Desperate dentistry in England

Where socialized medicine ends up. Brits are told that they are entitled to "free" dentistry but the pay the NHS offers to dentists is so lousy that there are fewer and fewer NHS dentists around. So Brits pay for health insurance but cannot collect what they have paid for. Very often their only option is to pay a second time -- to go to an expensive private dentist

A woman told today how she got a friend to pull out one of her teeth with a pair of pliers and filmed the gruesome process on a mobile phone after failing to find an NHS dentist. Diane Hunter, 45, described how she became so exasperated after two years of toothache she opted for a DIY option. "In the end I just got really drunk and got a friend to pull it out with a pair of big pliers," she told the Bradford Telegraph and Argus. "There was a lots of blood but I just needed the tooth out - it was causing me great pain and it still is."

Miss Hunter, who lives in the Listerhills area of Bradford, said she has not seen a dentist for more than 20 years and failed in her search for any offering NHS care. She said she first tried the old schoolboy trick of tying one end of a piece of string around her tooth and the other around a door handle before slamming the door but it did not work. Miss Hunter told the paper she would never pull her own teeth out again. "I was going to do it again but I showed a nurse at the doctor's surgery what I had done and she said it could cause a heart attack," she said.

She even went to hospital for help at one point but was never given anything more than paracetamol. Her friend performed the DIY dentistry about six months ago.

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More dangerous public medicine bungling in Australia

Melbourne's busiest trauma hospital is rebuilding its intensive care unit to eradicate a potentially dangerous fungus that has troubled it for four years. Just six years after it was opened, the State Government is spending $20 million upgrading The Alfred's intensive care unit, which the hospital expects to be completed in 2008. The Government initially announced the upgrade in October last year but failed to mention the aspergillus problem of 2002, instead alluding to "a range of challenges", citing emerging infectious diseases.

The airborne aspergillus fungus is no threat to healthy people. But it has the potential to harm people with vulnerable immune systems after a bone marrow, heart or lung transplant. In 2002, the hospital's intensive care unit had levels of aspergillus two to three times higher than acceptable. The hospital said levels were now "acceptable", and no patient was at risk.

The Alfred responded at the time by creating a separate intensive care unit with six beds for patients who had had transplants. Other patients are not believed to be at risk. The Alfred monitors levels of aspergillus each month and has changed the airflow management to increase the pressure within the unit and reduce the entry of outside air which may contain aspergillus.

But now the hospital wants to operate a single intensive care unit, bringing patients in from the secondary unit. The hospital's chief executive, Jennifer Williams, said a series of reviews had recommended that the safest solution was to rebuild it. "We very much want to get back to the situation we were in in 2002, where we had one intensive care unit," she said. "We don't want to put at risk those particularly sick patients in case the levels were to go up again, but they haven't gone up again. There have been no aspergillus infections since 2002 and we want this to continue."

Canberra Hospital director of infectious diseases, Peter Collignon, said aspergillus affected people when they breathed it in. It can often then form a lung infection and sometimes via the blood go to other parts of the body, but that only occurs in people who are very immuno-suppressed," he said. He said most major hospitals that cared for people with damaged immune systems would have infections caused by aspergillus, but it was difficult to know whether they picked it up in hospital or elsewhere.

Ms Williams said the unit would be built on the same site as the existing one. Planning is under way and the hospital will relocate patients when construction begins. She said it would be designed to minimise the chances of aspergillus entering the unit. "It's a matter of ensuring that the roof and the perimeter walls are completely sealed and the air-conditioning system is replaced with increased levels of air filtration capability," she said. The redesign will also boost the hospital's capacity to treat more patients, with more beds and facilities to deal with infection control, and new technology.

The Alfred acknowledged the elevated levels of aspergillus in 2002 when a patient with a compromised immune system died of aspergillus pneumonia. But it cannot be determined whether the patient contracted it in hospital or in the community. The fungus was also found in 41 other patients, but they were not infected with it. There have been no deaths or infections since.

Ben Hart, spokesman for Health Minister Bronwyn Pike, said The Alfred had tried a number of measures to solve the aspergillus problem, including building works to the air-conditioning and the roof. "But following that, it became apparent after a number of years that those measures weren't solving the problem and so therefore expert consultants were brought in to provide advice on what was the best course of action and The Alfred formed a view that the best course of action was a total rebuild," he said.

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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