SLOW COLLAPSE OF GOVERNMENT HEALTH SERVICES IN AUSTRALIA

Two current articles below from Queensland and two from Victoria

MP accuses Egyptian surgeon

North Queensland hospital has been accused of allowing an incompetent surgeon to perform unauthorised operations, with dangerous consequences for a host of patients. In a case certain to draw comparisons with Bundaberg's Jayant Patel affair, it has been alleged that an Egyptian-trained surgeon, known only last night as Dr Khalifallah, performed operations at Mackay Base Hospital against expert advice.

Federal Nationals MP DeAnne Kelly told Federal Parliament last night that Dr Khalifallah was employed by Queensland Health in 2004 and by July last year the hospital's credentiality committee determined he must be supervised during all major surgery. "Within four weeks he undertook three major surgical cases without supervision, with complications arising," she said. Ms Kelly said that in one case the removal of a bowel tumour resulted in faecal matter entering the intestinal cavity.

In November last year, the hospital wrote to Dr Khalifallah directing him to cease performing elective abdominal surgery altogether and emergency abdominal surgery unless he had consulted superiors. Ms Kelly said duty of care to patients was overlooked because the hospital reversed its position out of fear that Dr Khalifallah would lose his job. Earlier this year, Ms Kelly said the Royal Australasian College of Surgeons contacted the hospital again, listing a host of operating and clinical errors.

The cases detailed included: botched keyhole surgery; performing a procedure in a ward which should have been done in an operating theatre; wrongly ordering "no further visiting" for a patient, who subsequently - after intervention from staff - required five to six operations; claiming a cow kicking a patient was the cause of post-operative complications and tampering with surgical notes to "cover up" that he had operated alone.

Despite being backed by the hospital's director of surgery Raad Almehdi to return to full duties, Dr Chris Perry from the college wrote to the hospital on July 19 this year warning of serious concerns about Dr Khalifallah. A spokesman for Queensland Health Minister Stephen Robertson last night said: "We are aware of the case and appropriate undertakings have been put in place. The doctor is working under close supervision by senior doctors and he has been on restricted practice since February."

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Intensive care shortage in Queensland

The Queensland Government has conceded that hospital intensive care units had too many patients and not enough beds in the state's southeast on Monday night. Opposition Leader Lawrence Springborg yesterday quizzed the Government in Parliament over claims that after 8pm Monday not one intensive care unit bed was available in any ward south of Nambour on the Sunshine Coast. Mr Springborg said patients on life-support systems were put in corridors and ambulances were put on bypass. "Minister, if that is the present situation in our hospitals, isn't there going to be a major crisis when the flu season strikes in earnest and what will happen if a major incident occurs?" Mr Springborg asked.

Health Minister Stephen Robertson said he had been advised that only two patients in the whole of southeast Queensland could not immediately access a hospital intensive care bed. But he said it was true that all available staffed ICU beds in both public and private hospitals in southeast Queensland were full on the night. He said the two patients at Royal Brisbane and Women's Hospital who could not immediately access an ICU bed were kept ventilated and cared for in the emergency department.

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Melbourne ambulance service deteriorating

Health Minister Bronwyn Pike is under fire for claiming ambulance emergency response times are on target. The claim comes just weeks after Herald Sun reports highlighting growing delays and a state Budget report that found emergency response targets had been missed by an average of two minutes. Opposition health spokeswoman Helen Shardey accused Ms Pike of misleading Victorians and Parliament. Ambulance Employees Association boss Steve McGhie said all the evidence from paramedics and data seen by the union showed response times were getting worse.

Responding to a question from a government MP on improvements to ambulance services, Ms Pike said Melbourne's ambulance service now ranked among the best in the world. She said money provided had more than doubled to add 652 extra paramedics, 54 extra ambulances and to upgrade and build new ambulance stations. "While caseloads are up -- 64,000 additional emergency services in metropolitan Melbourne and 30,000 extra emergency services in rural areas -- response times are on target," she said.

The May Budget reported that the ambulance response time for 90 per cent of code one emergencies in metropolitan Melbourne was two minutes slower than the 13-minute target for 2004-05 and was expected to be 14 minutes in 2005-06. Statewide, response times were also two minutes slower than the 15-minute target for 2004-05 and were expected to be 16 minutes in 2005-06.

"If the Minister is referring to the past then I'm astounded she is claiming the response times have been on target because clearly they have never been met by this Government," Ms Shardey said. "And if she's referring to this current year she must looking into her crystal ball because we are only six weeks into the current year." A spokesman for Ms Pike said when the impact of lengthy industrial action in 2004-05 was allowed for, the target had been met.

In May the Herald Sun revealed ambulances called to emergencies took at least 20 minutes to respond on more than 900 occasions in Melbourne last year. Documents seen under Freedom of Information revealed Sunbury was the worst-hit suburb, with 60 delays, including one 77-minute wait for a patient with breathing problems. Leaked ambulance figures revealed that just 68 per cent of metropolitan Code One emergency calls were reached within 14 minutes in March, 74 per cent in February and only 72 per cent in January.

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Hospital waiting lists in Victoria

Health Minister Bronwyn Pike has attacked the Liberals for using sick people as political pawns -- but conceded the tactic could get them treatment sooner. Her comments came amid growing political controversy over the number of people on hospital waiting lists.

Ms Pike defended the handling of the case involving 11-year-old Georgia Duncan, who suffers a life-threatening illness and is fed through a tube. Georgia's family say they were told she would have to wait from six to 18 months for surgery to improve her mobility, but Labor and the Royal Children's Hospital say she had only been on the waiting list for nine days and would have to wait for up to three months.

Her case has sparked a political row, and Ms Pike accused the Liberals of using Georgia and her family as political pawns -- but then admitted the strategy could help her get treatment sooner. "When people draw public attention and the Government's attention to their particular plight it does give an opportunity, as it does when you go to your doctor, to have a reassessment," Ms Pike said. "We genuinely care that people do have the opportunity to be reassessed if they are in pain."

The Opposition has set up a phone hotline for Victorians who have been left languishing on hospital waiting lists. But Ms Pike said the Liberals are giving false hope to sick people and called on them to release the details of those who had called the hotline. "It's not up to the Opposition to set themselves up as some kind of quasi-triage operation," she said. "I . . . am open and accountable about the fact that our system doesn't always provide the most timely care for some people. "We know we have to improve it. We are committed to improving it . . . but there is a lot more work to be done."

Royal Children's Hospital spokeswoman Julie Webber said Georgia was always listed as a category two patient. "Before this time, Georgia was not on a surgical waiting list and therefore not classified," she said. Opposition health spokeswoman Helen Shardey said Georgia's case was systematic of a public health system in crisis, but she refused to detail what policies the Liberals would put forward.

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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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