Australian prisoners lap up $70 million worth of medical perks

And that's just in the State of New South Wales

Inmates are undergoing plastic surgery, hormone therapy and erection dysfunction procedures as taxpayers fund an expanding prison health system costing nearly $70 million-a-year. An investigation by The Daily Telegraph has revealed inmates are getting premium medical care that has featured 256 elective surgery operations over the past two years, including a series of bizarre optional procedures. The erectile dysfunction surgery was required to stop a young inmate feeling pain during erections - despite sex being officially banned inside New South Wales prisons.

Other procedures since 2004 revealed in official Justice Health documents include five cases of plastic surgery, a male circumcision, a tubal ligation, a tonsillectomy, a facial lesion removal and two hip replacements. Seven procedures involved removal of ingrown toenails with one on March 14 this year including "trimming of other toenails". The inventory of elective surgery procedures, obtained under Freedom of Information, even included a caesarian birth five days before Christmas last year. Six natural births also took place and six inmates are receiving hormone therapy. About 1120 are receiving methadone.

Taxpayers spent $69.15 million last year funding Justice Health, an 80 per cent increase on the $38.26 million in 2001. The bill does not cover the costs of surgery and clinical procedures in public hospitals. These are picked up by NSW Health and not covered by Medicare.

The runaway prison medical bill will add to concerns the Iemma Government has gone soft in its management of the state's jails. Last week The Daily Telegraph reported the Government had returned a television set and sandwich maker to serial killer Ivan Milat, despite an outcry from victims' families. The Government was also embarrassed last month by revelations that a gang rapist with cancer had his sperm frozen before undergoing chemotherapy so he could have children on his release.

A spokesman for the the prison officers division of the Public Service Association said he believed inmates got better health care than the rest of the community. "These guys in jail see the nurse for anything and if they need to see a specialist they are referred straight away. Somebody else organises it all for them. They don't have to do a thing," the spokesman said. "Even if they get a pimple on their backside they get themselves down to hospital to get it lanced."

Nurse numbers alone have surged over the past five years, from 142 to 506, equal to one nurse for every 20 prisoners. Martha Jabour, of the Homicide Victims Support Group, said it was disturbing prisoners were getting access to elective surgery for procedures such as erection dysfunction.

Justice Health chief Dr Richard Matthews vigorously defended the care offered to inmates. He denied they jumped waiting list queues that all other patients faced. Dr Matthews said the Justice Health's budget had increased in line with the prison population. But he said inmates should not get inferior care as "punishment". "Our view is that these folks are our patients. We have no interest in their offences, in fact we prefer not to know," said Dr Matthews.

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Australia: More of the usual high standards in a government hospital

An expectant mother was forced to wait more than half an hour in the delivery room of Caboolture Hospital while medical staff searched for a clean set of forceps. Now the woman must be tested for hepatitis C because the forceps, when they were found, were not properly sterilised. A Queensland Health spokesman said the hospital had only four sets of forceps, now increased to five. The forceps were not sterilised because there was not time, and excessive demand on the day had used up all the sets. In the end the forceps had only been sterilised chemically, the spokesman said.

Dr Michael Whitby, an expert in infectious diseases, said it was not ideal practice for the hospital to have reused the birthing instruments, but the risk was very low of the mother contracting a disease as long as they were chemically sterilised. Testing the woman was a prudent action, he said. AMA president Dr Zelle Hodge said some visiting doctors take their own surgical instruments to hospitals because the state's equipment was not always good enough. The state Budget did not contain enough funding for basic infrastructure and service delivery costs, Dr Hodge said.

Susan Wheatley's husband, Noel, was in the delivery room as the doctor waited more than 30 minutes for a midwife to find forceps to deliver his child. The doctor had used suction on the baby's head, but the procedure failed. "It just seemed very disorganised to me," he said. "Emergency equipment should be kept in a emergency cupboard, not have people searching for it - I was livid. "I don't know what a set of forceps cost, but probably less than a lunchtime engagement in Parliament."

Opposition health spokesman Bruce Flegg said there should be an immediate inquiry. "You don't use unsterilised instruments - you just don't do it," Dr Flegg said. "The reason you need a sterilisation unit is you don't always know what instruments you need when you do a procedure. "Chemical sterilisation doesn't meet accreditation standards for a hospital. Even in a general practice, it wouldn't pass." Mr Wheatley said he did not plan to sue Queensland Health unless his wife contracted hepatitis. However, he said he wanted to let other women know what his wife endured.

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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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