MORE SIGNS OF NHS PRIVATIZATION

Post lifted from the Adam Smith blog

A few days ago the House of Commons Health Select Committee published its report on NHS Charges, dealing among other things with the controversial charges for when you park at a hospital to visit your seriously ill relatives. However, much more important, MPs admitted for the first time that tax financing alone will not be a sustainable future for the NHS in view of future challenges to health care.

Given the three major cost driving forces of an aging population, increasing consumer demand and rapid medical progress "the NHS may not be able to pay for every possible medical treatment….", the report states. "Some treatments or procedures may have to be charged for."

This approach would divide NHS care into a free core service and an additional choice-driven service with co-payments. Which is exactly what many health experts and doctors are expecting as the solution to the current financial difficulties of the NHS.

That is a significant shift and certainly good news, because the long-due debate on mixed funding of health care has now begun. And it also heralds a healthy paradigm shift for the NHS from a reactive to a proactive service that will favour prevention over mere cure, by increasing patients' involvement and responsibility.

That this actually works is why US "consumer-driven health care plans are placing more emphasis on preventive care as patients seek to avoid medical complications" according to a recent report. In response, more US employers are investing in wellness programmes, hoping to temper insurance cost increases by improving the health of their employees. And those who have already done so report positive results. So why not kill two birds with one stone: improve your health now and thus save money in the long term? It is a principle that certainly makes sense for the NHS too.






Killer doctor still practicing

Yet Another case of your regulators protecting you

A manslaughter charge has been recommended against a prominent Queensland surgeon who continues to operate out of a private hospital with full registration through the state's Medical Board.

Four years ago, Nardia Annette Cvitic checked into Brisbane's Mater Hospital for a hysterectomy to be performed by David Ward, who was then a respected professor of medicine at the University of Queensland. But the 31-year-old mother of two died after a drain inserted into her pelvic area during surgery reportedly punctured a major vein - an error that was allegedly compounded by Dr Ward prescribing her a bloodthinning agent.

An inquest into Cvitic's death, headed by Deputy State Coroner Christine Clements, has heard evidence that after the operation the operating theatre resembled the scene of the Granville train disaster in NSW in the 1970s. The Weekend Australian has obtained a draft submission from counsel assisting the inquest. Richard Perry informing Ms. Clements and other parties in the case: "There is sufficient admissable evidence upon which a properly instructed jury could conclude that Dr Ward is guilty of the offence of manslaughter."

He recommended that Dr Ward be committed for trial. "Further, it must be acknowledged, and done so openly and honestly, that a great tragedy occurred in this case." Mr Perry states in his draft submission. "Ms Cvitic's death is one which was, in some senses, entirely avoidable, not simply because of what may or may not have occurred during the operation ... but also because her condition, however it was caused, was one which ought not to have resulted in her death."

Dr Ward's barrister, David Tait, did not return calls yesterday and Dr Ward has previously declined to comment. Cvitic's family was unavailable. Michael Coglin, medical officer for Healthcope, which owns the Sunnybank Private Hospital in Brisbane, said yesterday Dr Ward "occasionally" operated at the hospital and there was no reason for him not to do so. "In view of some of these concerns, we've checked with the Medical Board of Queensland and we've been advised that Dr Ward is in good standing with the board, he's fully registered, and there's no reason he should not continue to practise in Queensland and our hospital," Dr Coglin said.

While the Mater had referred Dr Ward to the Medical Board, a spokeswoman has said "all appropriate action was taken" and no conditions had been attached to his registration. A District Court judge recently sanctioned an out-of-court settlement in which the Mater, the University of Queensland and the Queensland Government will put $115,000 in a trust fund for Cvitic's 10-year-old son and $60.000 in trust for her 16-year-old son.

The coroner has heard there had been complaints about Dr Ward's surgical techniques and management style before Cvitic's death, and two professors who audited some of his patient files in 2003 warned: "Something is radically wrong and it cannot continue." Russell Strong and Alex Crandon, commissioned by the Mater to conduct the audit, raised problems over Dr Ward's surgical techniques, communication skills, post-operative care and medical judgment. In only three of the 10 patient files examined did they find Dr Ward had no case to answer.

The Mater subsequently withdrew Dr Ward's surgical credentials, as did the Royal Women's Hospital, and he lost his role with the university the same year.

The above article appeared in "The Australian" newspaper on 29 July, 2006

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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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