Dental meltdown in Britain

More than a quarter of a million people have lost access to a National Health Service dentist since the system was reformed last year.

The Department of Health admits that 266,000 fewer people had NHS dental treatment since a new contract for dentists was introduced in April 2006. Many dentists decided to leave the NHS rather than work under the new contract, which was nonetheless defended by Dr Barry Cockcroft, the chief dental officer. “Changes on this scale were always going to be challenging for the NHS,” he said. “As more and more new services get up and running, we expect to see increasing numbers of patients accessing services.”

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Australia: Major regional hospital needs first aid

Mackay is a lovely small city in the centre of a beautiful tropical area -- but don't get ill there. This report means that all four big hospitals servicing the tropics (Cairns, Townsville, Mackay, Rockhampton) have all recently reported major problems. As tourism is a major industry in the tropics this could well be very destructive economically. Government folly can be very costly even beyond what it takes in taxes



This bursting-apart medical facility is held together with Band-Aids and broken promises. The roof of one operating theatre leaks in tropical storms, damaging vital equipment. Staff cram into shabby pre-1930 buildings and rundown demountables. If it wasn't for dongas, those makeshift construction-site sheds, the place couldn't function for lack of storage. They are everywhere. There's even one on the roof and everyone's worried it will fly off in a cyclone.

Now, this hospital of dongas is not in some remote Aboriginal community or depressed low-growth area of Australia. Not that that would make it any less deplorable. This hospital is the Mackay Base Hospital, the only public hospital that services one of Australia's fastest-growing areas, in this country's most important coal-bearing basins, where they are digging out coal as fast as is humanly possible.

The prosperity and population explosion up there is hard to comprehend. Coalmining in this state employs more than 22,000 people, generating about $15 billion in exports last year and delivering $1 billion in royalties to the State Government. Thousands of miners live in the Mackay district and rely on the hospital.

Australian Medical Association Queensland president Ross Cartmill, a Brisbane-based urologist, puts it succinctly: "The Queensland Government's income from the Mackay district in coal equals something like Tasmania's entire Budget." Hard to imagine isn't it? All that money going out. And a hovel of a hospital in return.

Now don't take my word for it. "The people of Mackay are being stiffed." The voice at the end of the phone sounds strained and like a man who's been hitting his head against a brick wall for a long while. It belongs to an experienced senior physician at the Mackay Base Hospital. "What has gone on here is a disgrace. I want to stay in this town. I like Mackay and want to deliver quality health service. But I'm at my wit's end."

Now, having an inadequate hospital has far-reaching effects. Top specialists refuse to work there or even visit. So Mackay patients must travel 381km to Townsville or 978km to Brisbane. Some go to Melbourne. Talented junior doctors in Mackay don't get proper supervision. You can't learn when you have no one to learn from. So, if you don't want your career to stall, you have to leave.

There is no cardiologist, dermatologist, urologist, neurologist or vascular surgeon or ear, nose and throat specialist. You live in Mackay and your child needs grommets, usually a basic, run-of-the-mill ear procedure? Too bad. You'll have to get on a plane to Townsville, Rockhampton or Brisbane.

Cartmill says it is embarrassing to walk through the place. "Australia is supposed to be a First World country but there are employees in the office who work in demountables without plumbing. They have to wash their coffee mugs in a plastic bowl of water on their desk." Bet you don't see too many plastic bowls of dirty washing-up water on the desks in Brisbane's Executive Building.

Now, 20 years ago when I worked at the local newspaper, The Daily Mercury, the weekly headlines were about the appalling state of the Mackay Base Hospital. Various state and federal governments have come and gone. Nothing has changed. The paper is still campaigning. The only thing keeping the Mackay Base Hospital going is its staff. Despite the terrible conditions, there are dedicated doctors, nurses and other health professionals who believe in quality health care and are prepared to pay high rents to work there.

Now, what Mackay residents don't want is more government buck-passing. There is absolutely no bank of trust left when it comes to the base hospital. The people of Mackay and staff at the hospital have been screwed by successive state and federal governments. So, here we are in 2007, with a new Premier and a new Prime Minister, both of the same politics, both banging on about fixing Australia's hospitals. Anna Bligh says she will fix Queensland's health system. Prime Minister-elect Kevin Rudd has pledged $2 billion to overhaul the nation's health system and vowed to seize control of hospitals if states fail to get reform under way by 2009.

Do you realise how little $2 billion is when stretched across the whole country's neglected health system? Take it from Cartmill. It's peanuts. Just remember, there was $30 billion lying around in the coffers for promised tax cuts alone. And 2009? Forget it. Doctors at the Mackay Base Hospital are desperate right now. They feel completely unsupported. They are driving home from their night shift this morning terrified of what they will find when they return for the next shift. They dread the next emergency that could go wrong, not because of negligence by a doctor or nurse but because of the lack of funding, training, resources and supervision. The blame lies squarely at the feet of the Federal and State Governments.

The Mackay Base Hospital does not need some quick-fix or sporadic dribble of cash for a coat of paint or the purchase of more dongas. Little grey men in suits with clipboards will talk of the "cost-effective" option of redeveloping the present site. It's a joke. There's not enough room to swing a cat on the grounds.

Want to know something jaw-dropping? Years ago a local businessman donated a large block of land that adjoined the hospital specifically for future development. Donated. It was just cow paddocks then. So what happened to it? Queensland Health flogged it off for a quick buck and it's now all houses. Do the words incompetent, short-sighted morons spring to mind? Or is that just me?

Let's not fall for bureaucratic talk of redeveloping this hovel of a hospital. No. That would all be too little, too late. Nothing less than a brand-new base hospital is acceptable. A commitment needs to be made immediately. Cartmill says State Government already owns a perfect piece of dirt, smack bang in the middle of town, the Mackay Showgrounds. It's big, flat, empty, with ideal highway access.

Cartmill's got six months left in his AMA role. "I don't want to leave without knowing we've fixed Mackay's hospital problem. I want no other legacy." Only a Federal/State solution will fix Mackay's hospital woes. Bligh and Rudd don't live far from each other in Brisbane. Maybe they could get together over coffee one morning. They are two smart people. And it's really only one little hospital. If they can't fix that, what hope the rest of the health system?

And the solution is so simple. Do I have to write it in Mandarin? Build the bloody hospital. Or it will forever be known that Anna Bligh and Kevin Rudd, in Queensland's biggest economic boom, were just another couple of politicians who couldn't fix one crooked hospital.

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Australia: A medical bureaucrat to be finally made accountable?

A FORMER deputy director-general who was protected by then-premier Peter Beattie has been referred to the Health Practitioners Tribunal over the Jayant Patel affair. The newly formed Office of the Medical Board filed a referral notice to the tribunal on Thursday, outlining the case against Gerry FitzGerald, who was the state's chief health officer during the Dr Patel scandal. A seven-page referral notice said that the board believed Dr FitzGerald should face disciplinary action for behaving "in a way that constitutes unsatisfactory professional conduct" between December 16, 2004 to March 25, 2005.

If the tribunal finds against Dr FitzGerald, he faces sanctions, cautioning, fines and deregistration. But former colleagues have asked how he face action when Dr Patel has yet to front a court. Dr Patel, who is living in the US, is facing charges of manslaughter over the alleged treatment of his patients.

The document outlines examples of how Dr FitzGerald was too slow to respond to queries about Dr Patel and failed to assess the serious nature of the allegations put to him. The board said Dr FitzGerald failed to recommend immediate suspension against Dr Patel. It also argued Dr FitzGerald provided a report on the hospital which was misleading and incomplete.

While Mr Beattie sacked former health director-general Steve Buckland in mid 2005, the then premier promoted Dr FitzGerald to deputy director-general despite questions being asked about why it took him so long to act against Dr Patel.

Asked why it has taken more than two years to come to its position, in a statement to The Courier-Mail yesterday, the board said: "The investigation into Dr Gerry FitzGerald followed standard procedures. "It took no longer than other investigations conducted by the Board that have been referred to independent external investigators." Dr FitzGerald could not be contacted yesterday.

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