INSANE WORKING HOURS FOR AUSTRALIAN PUBLIC HOSPITAL SURGEONS

Surgery by doctors who have had no sleep for days!! There's nothing like the government to look after you! Thankfully

A trainee surgeon has told how she feared she would kill a patient, after being forced to work four days straight without sleep. The surgical registrar, from a major southeast Queensland public hospital, said she routinely had to operate on patients when she was so tired she felt drunk. I haven't killed someone yet, but probably one day it's going to happen because of my lack of sleep," she told The Sunday Mail. "I'm regularly operating on people when I haven't had sleep for two days. I know I'm making mistakes, I am just fortunate they haven't been any huge errors. "I know some of my colleagues have made errors and they're also worried."

The medic said anyone who spoke out risked being kicked off the surgical training program. She said that over the Christmas long weekend, she worked from Friday to Monday without sleeping at all. Junior doctors - residents and interns - are also working excessive shifts on relatively low pay while they try to establish themselves. They say "mandatory" eight-hour breaks between shifts are non-existent.

"It feels a bit like when you were 16 and you had a really big binge-drinking session," said the surgeon. "Of most concern to me is, I think, your hand-eye co-ordination skills go after two days. Performing surgery in those conditions is poor." She said the most dangerous shifts were on weekends, when doctors were commonly "on call". The weekend shift involves staying at the hospital from 7am Friday until Monday afternoon, and sleeping no more than three hours at a time. "We just need our mandatory break. You need someone to cover you," she said.

The surgeon spoke out as Australian Salaried Medical Officers' Federation president Don Kane seeks an urgent meeting with Health Minister Stephen Robertson to try to combat dangerous work hours. "Queensland Health has sat on its hands and done nothing. It is all promises," Dr Kane said. The union has been keeping examples of "horror shifts" to expose the dangerous working hours. In some cases, doctors had reported working three weeks without a day off.

The shifts continue five years after an overworked junior doctor was involved in a young girl's death. Elise Neville, 10, died two days after being sent home by a junior doctor in charge of Caloundra Hospital's emergency ward in 2002. Dr. Doneman was 20 hours into a 24 hour shift. He did not admit the girl to hospital or perform tests that would have shown she had a serious head injury.

Judge Debbie Richards, from the Queensland Health Practitioners Tribunal, said in 2004: "If this tragedy leads to nothing else, it should lead to the abolition of such brutally long shift hours." Dr Kane said little had changed since.

Health Minister Stephen Robertson said he was concerned by the doctor's comments but blamed long hours on a national shortage of doctors and said hospitals had always used on-call shifts. "That's been a feature of doctors' working hours for you would have to close hospitals, particularly in rural Queensland." He said the Government had been on a recruitment drive to increase the number of doctors in the state and decrease working hours. Rural Doctors Association president Christian Rowan said solo doctors in remote areas were routinely rostered to work 22 days on, then six days off. The Australian Medical Association's Alex Markwell said Queensland's public hospitals relied on junior medics working long hours. "If they go home because they're tired, there's not necessarily anyone else to do their work. People can die if there's no doctors around," Dr. Markwell said.

The above report by David Murray appeared in the Brisbane "Sunday Mail" on January 28, 2007





NHS patients need to buy organs from Third World to survive

British doctors had written "Joseph" off, saying he was too old to be treated on the National Health Service. But, at 72, he flew to Asia for a double-lung transplant and now claims to be the oldest man in Britain to have survived the operation. Joseph - not his real name - is one of a growing number of Britons who, frustrated with NHS waiting lists, are venturing into the murky world of organ brokers offering kidneys and livers harvested from the poorest quarters of the world, sometimes illicitly. Buying an organ is illegal in Britain, but generally not in Asia.

A former factory worker, Joseph is far from wealthy. He owes his life to his two daughters who used their savings and sold a holiday home to pay the 220,000 pound bill. "Without their sacrifice I would probably have been dead by now," said Joseph. He remains unsure where his new lungs came from. The Singapore surgeons told him only that they had been donated by the family of a much younger man who died from an unspecified head trauma.

His daughters are delighted with his recovery. "You cannot guarantee the success of any major operation. But now he is out hiking," said the eldest last week. "Just looking at him, smiling, brings tears to my eyes."

The family acknowledges its debt to James Cohan, a self-styled "organ transplant co-ordinator" from California who spoke for the first time last week about his pioneering role in the booming organ trade. Cohan has been "matchmaking" dangerously ill Europeans and Americans with Asian and African hospitals for 20 years. He says that over the past decade British inquiries have grown from a trickle into a flood.

Cohan, a tall, slim 66-year-old who lives in the hills outside Los Angeles, works like a stock-market day trader - with a phone and internet connection in a bedroom. He says he has seldom left home since he was arrested in Italy in 1998 for allegedly dealing in stolen body parts from South Africa, charges that were later dismissed. He says he breaks no American laws and deals with 15 hospitals that he has verified are using only legally donated organs.

A cultural and legal mismatch between Asia and the West has led to the current "grey market" where criminal gangs thrive and the sick die on waiting lists, he claimed. "Nightmarish tales of children snatched from streets for their organs will carry on until supply and demand are balanced. Right now there are 300,000 people on waiting lists whose lives could be saved with a more open approach to donation," he said.

This week David Kilgour, a former Canadian MP, will publish a follow-up report to his 2006 investigation that forced China to admit its hospitals sold organs taken from executed prisoners. Kilgour is concerned that executions are timed to coincide with operations, and that surging demand may even influence sentencing.

In May, Nancy Scheper-Hughes, professor of medical anthropology at the University of California, Berkeley, will publish The Ends of the Body, which will expose the horrors of the 300m-a-year trade. She will name Asian towns known as "kidney zones", where hundreds of locals bear a diagonal scar marking the removal of an organ for 300 pounds, and have suffered ill health ever since. "This is a cruel, unfair trade," she said. "Technology and greed have far outstripped any government's abilities to regulate it. It's out of control."

Doctors at the Aadil hospital in Lahore, Pakistan, which charges 7,500 for a kidney transplant and deals with up to 30 western organ brokers at a time, say they seek healthy organs from dozens of countries. "Our priority is health, not politics," said a spokesman last week. "We always abide by current laws."

However, surgeons have warned that the failure rate of overseas operations is high and have called for the trade to be banned. Professor Nadey Hakim, president of the International College of Surgeons, said that more than half such operations end up with a bad transplant or the patients die. "The donors get paid very little. The recipient who gets the organ is not treated well either and they get sent back in a very bad condition," he said. I am betting that patients get BETTER treatment in Singapore than they do in the filthy NHS. Han Chinese surgeons are often brilliant and Singapore is immaculate.

Source

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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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