Australia: Wealthy get faster access to surgery even in public hospitals

Rather surprising that rich people go to public hospitals at all. Over 40% of all Australians have private health insurance and Australian private hospitals are generally first-class. The rich go public mainly because they or their doctor "knows someone", I suspect. Bureaucracies are particularly susceptible to that. If you are "in favour" in a bureaucracy, they will throw the rule-book right out the window for you on occasions. I have seen some remarkable examples of that in my own circle

Rich people have the shortest waiting times for elective surgery while middle income earners wait the longest, a new report on public hospital waiting lists shows. The Australian Institute of Health and Welfare study shows middle income earners wait an average of 31 days for elective surgery while the rich wait just 24 days. The poorest Australians wait 30 days for surgery.

And living in a big city doesn't guarantee faster access to a public hospital operating table -- those living in inner regional areas get into hospital faster, waiting an average of only 27 days for surgery, while those in big cities wait 29 days.

Private health insurance membership has nothing to do with the rich getting faster access to hospital. AIHW spokeswoman Jenny Hargreaves says the waiting-time figures applied only to public hospitals and had no connection to a person's insurance status. And she could give no explanation for the finding that rich people had shorter waiting times than others.

The report shows private hospitals are now carrying out 61 per cent of the 1.6 million elective surgery procedures every year while public hospitals perform just 39 per cent. The rich were more likely to use private hospitals, with the report finding 261,358 of them went private for elective surgery. But over 73,000 wealthy people used a public hospital when they had elective surgery.

More middle income earners used private hospitals than public for elective surgery, with 127,596 going public and 184,617 going private. Only the poorest Australians relied more on public hospitals than private, but 149,571 still used the private system.

The report found the waiting times varied a great deal depending on the patients diagnosis, with cancer patients waiting on average 15 fewer days before surgery. The longest waiting times were for knee and hip replacements. Those with gonarthrosis of the knee had an average waiting time of 119 days, and one in five waited longer than a year for surgery. Patients with senile cataracts waited much longer for access to surgery than other cataract removal patients.

More than 87,910 patients had an adverse event connected with their elective surgery. Over 23,000 had complications with the hip and knee replacements or other implants inserted during surgery.

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NHS in England spends 400 pounds less per patient than Scotland as 'health apartheid' widens

Scots have 400 pounds more of taxpayers' money per head for health and social care than the English. Official figures showed yesterday that the difference between NHS and social spending on the two sides of the border means everyone in Scotland has 20 per cent extra. This means Scots have more hospital beds, a higher ratio of GPs to patients and more qualified clinical staff in their health service.

The report from the Office for National Statistics said that total expenditure on health and personal social services during 2006-07 in England was 1,915 pounds for each person. In Scotland the figure was 2,313. Scots also have on average 16 per cent more to spend per head on NHS drugs than the English. The cost of their prescription drugs is on average 191.40 a year compared with 164.40 in England.

This form of 'health apartheid' means Scots are routinely prescribed drugs on the NHS that are not available free across the border.

The illustration of the scale of the gap in health spending between England and Scotland was set out in a volume of health statistics published by the Government yesterday. It comes amid growing tension over the way public money is directed towards Scotland. Tory leader David Cameron has promised to tackle the 'West Lothian question', the system that allows Scots MPs to have a say on NHS and social spending in England while English MPs have no equivalent input on Scottish affairs.

Concern has centred on the way that key NHS drugs - to treat conditions such as Alzheimer's and lung cancer - are available on the NHS in Scotland but not in England. The number of hospital beds available for Scottish and English patients is also affected. There were 3.5 daily hospital beds for every 1,000 people in England in 2006, the analysis showed, but 5.6 in Scotland.

The ONS warned that 'comparisons between countries have to be treated with caution because of differences in the classification of services'. However officials confirmed that health and social spending in England in 2006-07 was lower than in Scotland, Wales, or Northern Ireland.

The publication of the figures triggered calls to correct the imbalance in spending between England and Scotland and for a revision of the Barnett formula. The Barnett formula was the system developed in the 1970s under which Scots received 1,500 pounds a year more each of taxpayers' money to compensate for not getting devolution.

Jill Kirby, of the think-tank Centre for Policy Studies, said: 'These figures confirm that we have a two-tier health system and that the English are on the wrong side of the bargain.

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