CRAP LOS ANGELES PUBLIC HOSPITAL STILL GOING

Because it's mainly black, nobody can really close it down, no matter how many it kills and injures

Federal regulators began their critical inspection of a troubled inner-city hospital Monday to determine if it has fixed the many patient-care problems that have led to patient deaths. A team of 11 inspectors from the U.S. Centers for Medicare and Medicaid Services arrived unannounced at Martin Luther King Jr./Drew Medical Center to conduct the review. The results were due in several weeks.

If the county-run hospital fails any part of the inspection, it could lose $200 million in annual federal funding - more than half its budget. Los Angeles County supervisors say that would force them to downsize the hospital, close it or turn it over to someone else to run.

County and hospital officials say they have implemented a host of reforms at the hospital, including hiring outside consultants to take over operations, recruiting a new permanent management team, disciplining hundreds of employees and spending millions on renovations. "We are cautiously optimistic that the survey will go well," said William Loos, acting senior medical officer with the county Department of Health Services

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FUNNY MONEY IN THE NHS

Millions of pounds intended for improving sexual health services are being diverted to pay off debts, a government advisory group said yesterday. The Independent Advisory Group on Sexual Health and HIV said that a substantial part of the 300 million pounds set aside had been absorbed by primary care trusts (PCTs).

A survey for the group found that cash set out in the Choosing Health White Paper is reaching frontline services in only 30 of the 191 PCTs questioned. Fifty-one said that they had absorbed their entire allocation into the general budget, and 33 had withheld some or most of the sexual health funding. A further 40 said that funding had not reached contraceptive services.

Baroness Gould of Potternewton, the group's chairman, said that many trusts were experiencing financial difficulties and that sexual health services were suffering problems such as recruitment freezes and clinics closing. Nick Partridge, the chief executive of the Terrence Higgins Trust, said: "It would be a great disappointment if sexual health was sacrificed on the altar of financial balance in the NHS." The Department of Health said that trusts were responsible for sexual health. "We have provided . . . more sexual health funding than ever before."

Three PCTs in Lincolnshire have closed all family planning clinics and a network of teenage advice centres to help to tackle a 13.5 million pound budget deficit. Jim Moss, of East Lincolnshire PCT, one of the trusts that is making the cuts, defended the decision. "Family planning services are available at pharmacies and GP surgeries," he said.

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Deadly delay for public hospital victim

A Central Queensland woman diagnosed with cancer requiring urgent treatment was put on a waiting list at the Royal Brisbane and Women's Hospital and not offered help until after she died. Lynette Williams, 46, of Rubyvale in Central Queensland, died on June 29, a month after her Emerald-based GP told her that tests revealed she had suspected cancer and needed urgent treatment in Brisbane.

Mrs Williams's husband Russell said yesterday the GP made an appointment for her at RBWH on May 31 and she took the scans and medical reports to that meeting. Mr Williams said the doctor at RBWH rang the hospital's cancer unit and was told to book her in for a liver biopsy. "We never got to see the cancer specialists at the Royal. I kept ringing every day to find out when they were going to do the test. They said 'you would get a letter'," Mr Williams said.

The RBWH also put Mrs Williams on a waiting list for an endoscopy and sent her a letter on June 16 scheduling the procedure for July 16 - two weeks after her death. Mr Williams said the hospital eventually contacted him two days after his wife's death to arrange a time for the liver biopsy.

Mr Williams said he wanted to know why doctors at Queensland's largest hospital did not provide urgent care or offer any assistance with pain management. A spokeswoman for RBWH confirmed that Mrs Williams had been referred to the hospital and "scans indicated that when Mrs Williams presented to the RBWH she had progressive secondary cancer". A communication breakdown led to a delay in the biopsy being performed. The hospital apologises to the family for this delay and has offered to meet with the Williams family to discuss the issue."

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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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