THE CONTINUING PUBLIC HOSPITAL WOES IN AUSTRALIA

Two articles below:

Surgeons pulling out of pennypinching public hospital system

SURGEONS are pulling out of public hospitals' on-call rosters because of the "pathetic" pay - leaving patients waiting days for operations. Royal Australasian College of Surgeons president Ian Gough, himself a Queenslander, said Queensland surgeons were increasingly reluctant to be on-call because they felt under-valued - and that included pay issues.

Queensland surgeons say the issue is putting increasing pressure on public hospital beds and nursing staff because some patients, particularly those with trauma-related injuries, are having to wait longer for operations.

Professor Gough said that under Queensland Health's visiting medical officer agreement, the hourly on-call rate was between $7 and $11, depending on the frequency of on-call rostering. "During that time you may receive lots of telephone calls and have interrupted sleep. It has an effect on your family and social life," he said. "There has been a great deal of disenchantment among some surgeons and as a consequence, an unwillingness to continue to be on-call."

If a surgeon in Brisbane is called back to the hospital, the hourly rate increases to between $186 and $212 and relates to a doctor's seniority. Those working outside Brisbane receiver higher rates.

Professor Gough conceded that on-call surgeons were remunerated "reasonably well" when they were called back to hospital. However he said the overall on-call rates were insufficient incentive for many surgeons and called for a fee-for-service system to be considered. He said Queensland Health was relying on surgeons' altruism to be part of on-call rosters. "Surgeons don't have any incentive to be on-call other than their goodwill and wanting to care for the patients," Professor Gough said. "The money that's offered is actually very poor."

His comments were echoed by Royal Brisbane and Women's Hospital trauma services director Cliff Pollard, who said that not paying surgeons sufficiently for being on-call was a false economy. "It's a big cost in terms of beds," he said. "Surgery can be delayed and patients spend longer in hospital. "We're not talking about time-critical patients, they get treated in Australia very well. "But with things like single limb fractures, you may have to wait sometimes a few days (to be operated on)."

An RACS spokeswoman said about 60 per cent of all surgeons in Australia operated only in the private sector. "The more who leave the public sector, the more pressure there is on the people who stay," she said.

Professor Gough raised the issue with Queensland Health reform and development division executive director Stephen Duckett at the RACS's annual Queensland branch meeting at Coolum recently. Professor Duckett accepted at the Sunshine Coast meeting that public hospital surgeons had "punishing" on-call rosters and said the pay issue was being examined. He said yesterday that Queensland Health did not have central data that reflected whether senior surgeons were pulling out of on-call work at public hospitals. Professor Duckett said Queensland Health was about to enter into enterprise bargaining with public hospital medical staff over pay rates. "Details of Queensland Health's position are not yet finalised," he said.

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Some patients have to wait just to get on a hospital waiting list

More than 33,000 sick Victorians are waiting just to get on an official waiting list for treatment at public hospitals, the Opposition claims. They are in addition to almost 40,000 people already waiting for elective surgery on the State Government's official waiting lists. Documents obtained by the Opposition under Freedom of Information, and seen by the Herald Sun, show that in December last year 33,869 Victorians were waiting for an outpatient appointment. People must be assessed in hospital outpatient clinics before they can be put on a waiting list for surgery - meaning those who are yet to be assessed do not show up on the official elective-surgery waiting lists.

Liberal health spokeswoman Helen Shardey said public hospitals were being forced to manipulate waiting lists to avoid being penalised by the Government. "There are literally tens of thousands of patients languishing on the Government's secret outpatient waiting lists and thousands more who don't have appointments who are waiting to get on to these lists to see a doctor," she said. "We are now in the unconscionable position of having people waiting to get on to these lists in order to join the queue for elective surgery. In many cases these people are waiting years." The documents show that the "secret waiting list" grew by 8722 patients in just three months leading up to December 2007.

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