SOMETHING HOPEFUL BEING DONE ABOUT KING/DREW AT LAST

The black hospital in Los Angeles that kills blacks

A federal report detailed the reasons why a troubled inner-city hospital failed a critical inspection, including sloppy nursing care, medication mistakes, expired baby formula and blood-stained equipment. Martin Luther King Jr./Drew Medical Center came up short in nine of 23 health care categories, according to the 204-page final report released Friday by the U.S. Centers for Medicare and Medicaid Services. The troubled Willowbrook hospital had its $200 million in annual federal funding yanked after failing last summer's inspection.

As a result, county supervisors unanimously approved a plan to turn over the hospital's management to the Harbor-UCLA Medical Center. The hospital will be renamed Harbor-MLK Community Hospital on March 1. All of its staff will have to reapply for jobs, and it would be stripped of specialty services.

The document cited shortcomings in nearly all departments including management, the pharmacy, nursing and infection control. It focused on three areas in particular: the administration of medicine, errors by staff and the hospital's general lack of upkeep. County health department chief Dr. Bruce Chernof declined to comment on the final report.

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Australia: Foreign doctors bypass skills tests as shortages grow

Thousands of overseas-trained doctors are working in Australia without undergoing standard competency checks despite pledges of a shake-up in the wake of the Jayant Patel case in Queensland, new research has found. The number of unchecked doctors from non-Western countries is likely to rise because shortages are increasing dependence on foreign recruits, but there is no immediate prospect of a nationally agreed check on their skills, the research concludes. More than 3000 overseas doctors are granted work visas each year, but many are not required to have their knowledge and clinical skills formally assessed because of pressure to fill vacancies in many hospitals and country towns, the researchers Bob Birrell and Andrew Schwartz say.

Promises by health authorities of a tougher regime for overseas recruits have had "little effect on levels of recruitment of overseas-trained doctors, or on the way in which they were assessed", say Professor Birrell, a leading medical workforce analyst, and Mr Schwartz, president of the Australian Doctors Trained Overseas Association. Their research appears in Monash University's People and Place journal, published today.

In a separate development, the Australian Medical Association has asked the Federal Government to tighten assessment requirements for overseas doctors if states and territories are not able to agree on a national scheme.

The research finds that not only do many imported doctors bypass Australian assessment authorities because of provisional postings and acceptance by state medical boards of their employers' assurances, but also that many who do sit exams fail. The proportion of overseas general practitioner candidates initially deemed eligible to practice who passed their Australian exams had dropped from 61 per cent in 1999 to 40 per cent in 2004, figures supplied by the Royal Australian College of General Practitioners to the researchers said.

Professor Birrell and Mr Schwartz say the scale of the dependence on overseas doctors is shown by the number of occupational trainee doctors granted work visas. In 2004-05, there were 1400 registered in NSW alone, about a third from Britain and another third from Asian countries. The researchers say a national assessment scheme for overseas doctors has been proposed since the early 1990s but has foundered on the states' insistence on being able to bypass requirements to fill vacancies "in the public interest". In the wake of the Patel scandal, the state and federal governments had agreed to establish a national scheme by December, but there was "no immediate prospect" of a scheme coming into effect.

A spokeswoman for the federal Health Minister, Tony Abbott, said a "fully developed proposal" on national accreditation was expected by December and this would be "ready for further discussion and endorsement between the states and Commonwealth".

The researchers say there has been no outcry from Australia's medical profession, even though many medical authorities "care deeply about the situation". "Their silence partly reflects worries about doctor shortages and partly a reluctance to comment for fear that they will be regarded as feathering their own nest." But the scale of the shortage and the limited supply of British doctors "means that there will be increasing dependence on overseas-trained doctors drawn from non-Western medical settings", the researchers say.

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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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