Deadly government medicine in the Australian State of Victoria

Here is a frightening statistic that should focus the mind. On some estimates, 3500 people have died unnecessarily in Victoria since the Bracks Government was elected. Think that through. What if the road toll had suddenly surged by so many? There would be public fury. What if the murder rate had leapt by 500 a year or terrorists were picking off Victorians at about ten a week? What if poor regulation of hygiene in the food industry was killing two people each working day? The pressure to fix it would be massive. If any other collection of problems was allowing so many people to die unnecessarily there would be public outrage and the full community focus would be on analyzing and solving the problem. So why are these lives different?

They are all people with families, and they are all equally dead. Why accept this? These people haven't died behind the wheel or at the wrong end of a gun, the accusation is that they have died because Victoria's health system is not working well enough. That much now seems beyond dispute, although the awful statistics have been sharpened by a passionate doctor who represents medical staff in public hospitals. Dr. Peter Lazzari is chair of the chairs of medical staff in the hospitals and himself a senior physician. His concern has provoked a flair for dramatic language that has been overly harsh but aimed to seize attention and did.

He has accused Steve Bracks of behaving like an undertaker and claimed the Australian Medical Association has abandoned patients: ``I officially declare a state of war, ``he said. ``The beds are bursting and the Government is architect of genocide against innocent Victorians.'' That is the ridiculous language of intense frustration. But the government has not directly disputed his figures, and admits much needs to be done. The argument now is about how to do it, and that is why Dr. Lazzari is right to try to shock the public out of its apathy and acceptance.

He says there are 500 deaths each year on waiting lists, 250 of which are avoidable. The government's own figures, revealed under Freedom of Information laws, show this could be a realistic assessment. He further claims that overcrowded hospitals cause another 250 unnecessary deaths each year. Again, government figures show hospitals are short 550 beds, and although Dr. Lazzari cannot prove overcrowding kills 250, it is reasonable to assume that as a representative of doctors in the system he has a fair idea what is going on.

Of course the government does not want such death. It has worked hard to improve the system, but now in the face of such an appalling statistic it is defensive and secretive because it knows health is a dangerous political issue. Much of what official information is available has been dragged out through FOI laws. Now, rather than encouraging an all-in debate that might throw up ideas and save lives the government prefers chanting politically targeted statistics designed to confuse.

The acting Health Minister Gavin Jennings finally recognized reality, admitting that the government had to take responsibility for the 500 deaths and for ``continued suffering'' on waiting lists. But the minister's spokesman offered this: ``The Government is proud of its record in health. This year Victorian hospitals will treat around 300,000 more people than they did when the government was elected. We have employed 6035 extra nurses and 1365 extra doctors.'' Perhaps that is true, but it is little consolation to the families of the 500 dead who need not be dead. Quoting staff numbers and dollars spent only proves the depth of the problem, because it is still not fixed. What is urgently needed in this are facts, ideas, and less political spin.

The Government needs to put aside political sensitivity and the State Opposition needs to allow them the breathing space to do it. Accurate and detailed figures on waiting lists and bed shortages need to be released, not dragged out through FOI. For example, we need to know how many patients on the lists are being reclassified as their health worsens. We need to know whether official waiting lists include those waiting to see a specialist and if not how many are waiting. We need to know how many patients wait so long they are deemed unfit for surgery by the time their case is at the front of the queue. And we need to know whether Dr. Lazzari is right and how many died because they waited too long. Doctors, God bless them, would throw endless billions of dollars at the system because all they want to do is help people.

The country does not have endless billions of dollars to spend so instead we need co-operation, consultation, openness and ideas. Perhaps hospitals can work smarter, not leaner. Perhaps medical staff can be freed from bureaucratic duties so they can concentrate on medicine ahead of bean-counting.

Perhaps waiting lists can be better managed. Perhaps there are ideas that would allow specialists to see more patients. Perhaps we should ask why this country tolerates the expensive and ridiculous duplication of the system through state and federal bureaucracies that sit around getting fatter while frail people can't get a bed. It is unlikely there is a person working inside the health system without a view on how to make it better. Victoria must end the defensiveness and listen. The politicians must put aside point scoring and construct a bi-partisan think tank to chase solutions.

There will never be a zero avoidable death rate, just as the roads will always kill some people. But if the united community focus that has built around the road toll can be applied to hospitals, lives will be saved. Once, 1034 deaths on the roads were considered inevitable. Now that is unthinkable. Five hundred unnecessary deaths in the hospital system must today be considered equally atrocious.

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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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