UPDATE ON A HEALTH SYSTEM MELTDOWN

Bureaucracy is a sort of slow-growing cancer. Things look OK at first but the slow decline ends up with the function concerned in a very bad way eventually. The Queensland "free" health service is a very old one (dating from 1944) -- and it is now in such big trouble that patients are dying rather than being helped. The "Dr. Patel" scandal led to apparent reform attempts but the downhill slide continues nonetheless. That there are now three bureaucrats for every health worker is a large part of the cancer. Several articles below. The first is a letter to the editor of the Brisbane "Courier Mail" and refers to the story about elderly public hospital patients being slowly starved that was mentioned here on Feb. 27th. The letter appeared on Saturday, March 3rd.

Hospital shocks

I refer to reports of patients in hospital becoming malnourished. I was a patient in a major public hospital recently. On either side of me were two elderly patients.

Their meal trays would be put on their bed trolleys and half hour or so later the tray person would collect and remove the untouched tray.

I told nursing staff that these people could not reach the trays or feed themselves or get the items open. I was told in a roundabout way to mind my own business. I would struggle out of bed, place the trays close enough to them, open the little fiddly butter/ juice lids and encourage them to eat.

This caused me great distress as for the entire time I was there (three weeks) these two people had very little oral intake. Again when I took it higher to the ward supervisor, I was told politely she would look into it.

I have witnessed enforced a malnutrition on many occasions. It seems the lack of staffing is the crux of the problem. Staff have so many urgent duties to attend to that spending 30 minutes feeding up to 20 patients does not take priority.

On another topic, who made the brilliant decision to mix patient gender in wards at a certain public hospital? It is not good to wake up following surgery to see three elderly male patients sharing the bay with you, and have to spend your time with curtains around your bed to screen out the views of various parts of the male anatomy being left uncovered, as well as procedures being done without any form of privacy being considered. Maybe this is shock therapy to make sure you do not return to this hospital in future.

P. Townsend, Albion

Hypocritical health boss in damage control

Health bosses have sent an urgent memo to staff telling them Health Minister Stephen Robertson has "complete confidence in the public health system". The "Special Broadcast" came after an opinion column in The Sunday Mail criticising Mr Robertson's decision to have heart surgery at a private hospital.

In an email sent on Monday, Queensland Health director-general Uschi Schreiber said: "I am particularly concerned that these media articles include disparaging statements about Queensland hospitals and, by implication, of the people who work in them. "I want to stress that I know from working closely with the minister over the last 20 months that he has complete confidence in Queensaand's public health system and the highest admiration for the people working, in it. "He is a strong advocate for the public health system."

But staff are not convinced, describing the email as "hilarious". One doctor, who declined to be named because of a Queensland Health ban on staff speaking to the media, said if Mr Robertson had faith in the public system he would have used it. "He did exactly what we expected him to do, even though it was a bad political move," he said. "It was a life-or-death situation for him and he's not going to be a patient in a public hospital in a system that he knows is in trouble."

Mr Robertson, 45, chose St Andrew's Hospital at Spring Hill in Brisbane for an angioplasty operation to open his arteries. In the email to staff, Ms Schreiber said: "It is probably worth pointing out that the minister would have been equally criticised had he chosen to occupy a public hospital bed despite having private health insurance."

But one member of staff said Mr Robertson should have gone into a public hospital as a privately subsidised patient. "It would have been a big pat on the shoulders for staff if he had done that," he said. "Morale is low enough without having the Health Minister snubbing us. "They put the email out to stop people making comment, and everyone found it hilarious because we all know the real state of play."

Grandmother Lee Brown, 66, of Redland Bay, has no choice but to wait for her angioplasty at Redland Hospital because she cannot afford to be treated privately. "I read about Mr Robertson in The Sunday Mail while I was in hospital and I thought, `holy mackerel, that's just double standards'," she said. "I don't think these ministers have the faintest idea how to run the health system. They don't live in the real world, where people have to wait for nine hours in casualty."

The above article by HANNAH DAVIES appeared in the Brisbane "Sunday Mail" on March 4th., 2007

Ambulance response time slips

Response times for ambulances sent to code-one emergencies are getting worse despite record funding for paramedics. More than one-third of patients with life-threatening injuries or illness wait longer for help than the government benchmark time. Queensland Ambulance Service figures show response times have slowed for 2006-07. This comes despite a budget of $355.7 million, up $42.4 million on the previous year. If the trend continues to July, about 5000 additional patients will be affected.

A spokeswoman for Ambulance Commissioner Jim Higgins confirmed that the number of first-on-scene responses in under 10 minutes had dropped. But she said paramedics had attended more code one emergency cases than ever before. To March 1, the QAS had responded to 5506 more incidents within 10 minutes com- pared to the corresponding period last year. "Each year the demand for ambulance services continues to grow as a result of Queensland s growing and ageing population,' she said. The QAS continues to boost frontline paramedic numbers, with 280 new paramedic position since 2003."

Emergency Services Minister Pat Purcell last year said ambulances arrived at code one callouts within 10 minutes in 69.38 per cent of cases. The Government had set a benchmark of 68 per cent which had been lowered from the original 70 per cent. But sources told The Sunday Mail the latest figure had dropped to 66 per cent statewide this year. In some regions of Brisbane, the Gold and Sunshine Coasts, response times had fallen to under 60 per cent.

Opposition emergency services spokesman Ted Malone said the slower response was costing lives. "Taking longer than 10 minutes to respond to an emergency (code one) is a matter of life and death," Mr Malone said. "There can be no arguments that patients have died because ambulances have not got to them on time." He also slammed the Government over the $100 annual ambulance levy paid by all Queenslanders - "with little to show for their money"

"Peter Beattie's promise of the world's best anibulance service has proved to be as hollow as most of his promises", Mr Malone said.

The above article by DARRELL GILES appeared in the Brisbane "Sunday Mail" on March 4th., 2007

Injured woman waits in pain

A grandmother who broke her leg had to wait in the sun for more than an hour for an ambulance. Lynne Jones, 59, slipped and injured herself at Redland Bay last month. "I was in a lot of pain. I was lying on the grass in the heat, with ants crawling all over me," said Mrs Jones, of Thornlands in Redland Shire. "It was a Sunday morning. You would expect 15-20 minutes for an ambulance to turn up, not 65 minutes. It was totally unsatisfactory."

Mrs Jones' grandson had called Triple-0 and the operator advised not to move her until the ambulance arrived. When her daughter called about 30 minutes later she was told there was no ambulance at Redland Bay and one had to be sent from Wynnum, 25km away. Mrs Jones said Lions Club volunteers who were running a sausage sizzle nearby kept her comfortable, shading her with an umbrella and using a wet towel to keep her cool in the 30C heat.

One of the volunteers drove to the Redland Bay ambulance station, only to find it locked up. "They were starting to get a bit worried for me," Mrs Jones said.

The paramedic who eventually turned up needed help from the volunteers to get her into the ambulance. He expressed his dismay to her about the delay, she said. "It does make you wonder what we pay our ambulance levy for." Mrs Jones said she had waited 45 minutes for an ambulance after a previous fall at a shopping centre. "The service has got worse, not better," she said.

A Queensland Ambulance Service spokeswoman said higher-priority incidents came ahead of Mrs Jones' non life-threatening case. "At the time, the QAS was experiencing an unusually busy period with nearly twice the average workload for that area," she said.

The above article by DARRELL GILES appeared in the Brisbane "Sunday Mail" on March 4th., 2007

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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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