Thursday, January 19, 2006


When you have been told that your government will look after you, it is a shock to find that it doesn't

The astronomical cost of charges imposed on relatives and friends comforting their sick loved ones in hospital has been laid bare by The Scotsman. Visitors to Scotland's hospitals face a postcode lottery of parking fees. Families also face exorbitant costs contacting their relatives in hospitals using private telephone lines that charge up to 49p per minute for incoming calls, more than the cost of phoning Australia on standard land lines. Charges for patients watching TV add to the overall burden, which can reach £55 a week or more. Families and friends of the most seriously ill on extended hospital stays are having to pay hundreds of pounds to comfort their loved ones.

Colin Craig, whose partner Elaine McFadden was a patient at the Royal Infirmary in Edinburgh from April 2003 to March 2004, when she was battling pancreatitis, racked up £1,600 in parking fees. Widower Henry Robertson paid out £600 over seven months while visiting his dying wife at the same hospital.

The survey of charges highlighted by The Scotsman prompted cancer charities and unions to condemn the practice as immoral, while opposition politicians called on hospitals to review their systems. Ministers have forbidden any health board from using car parking to make a profit, but private companies are subject to no such controls. The most costly parking is at the Private Finance Initiative-built Royal Infirmary, Edinburgh (RIE), where visitors are charged £10 for more than six hours' parking. The car park is managed by Meteor Car Parks for Consort, the firm that built the hospital and runs facilities. The Western General in Edinburgh also charges £7 for more than four hours, while St John's Hospital in Livingston charges £1 per day. At Glasgow Royal Infirmary, where private firm Apcoa runs the car park for owners Impregilo, visitors are charged £1 per hour between 8am and 6pm and a maximum of £1.80 for staying overnight....

However, the Scottish Executive said guidelines issued to health boards should prevent anyone visiting hospital regularly being charged and Lothian Health Board said parking is offered free of charge to relatives, where attendance at hospital relates to trauma or a bereavement. It also offers reduced fees for those visiting hospital on a regular basis over a prolonged period of time.

However, Margaret Watt, chairwoman of the Patients' Association Scotland, said these concessions were unknown to most families and, as a consequence, they were paying out. "It is morally wrong that they are taxing the people who are visiting people who are ill, perhaps seriously," she said. Elspeth Atkinson, Macmillan Cancer Relief director for Scotland, said the experience of being in hospital was stressful enough without having to worry about the extra costs of parking, television or telephone. "Travel costs are the biggest financial burden on people with cancer and that's why Macmillan is calling on the Executive and all health boards in Scotland to ensure that cancer patients do not have to pay for hospital parking," Ms Atkinson said....

Unions representing health workers in Glasgow and Edinburgh have consistently complained about the costs of parking, although the Executive recommends sufficient car parking space and concessionary car parking rates should be available. Apart from the ten named hospitals, all others provide parking for free. However, patients are also being charged to contact patients by phone in many hospitals. Eight hospitals in Scotland have a system installed which is run by the Patientline firm: Crosshouse Hospital in Kilmarnock, Ayr Hospital, Dumfries and Galloway Royal Infirmary, Aberdeen Royal Infirmary, Monklands hospital in Airdrie, Edinburgh Royal Infirmary, Raigmore Hospital in Inverness and Glasgow Royal Infirmary. The firm charges £3.50 a day for watching television, although under-16s get free access, while it is half price for OAPs and long-stay patients. Patients can use the phone for the same cost as a payphone but incoming calls are 39p per minute off peak or 49p per minute at peak times. Phoning Australia from home during the day costs just under 22p a minute.

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Feds pressure bureaucrat-heavy Queensland public health system

The Caboolture Hospital fiasco could cost Queensland $67 million in health funding, after the Federal Government yesterday ordered an investigation into possible breaches of the Medicare Agreement. Acting Federal Health Minister Julie Bishop said she was "extremely concerned" about the closure of emergency services at the hospital and the decision to send patients away to see GPs instead.

The State Government yesterday announced it was a step closer to restoring full services at Caboolture, with an agreement for three senior staff from the Mater Hospital in Brisbane to reopen the emergency department on Friday. It had been closed since Monday because of a doctor shortage.

But even as it solved the Caboolture problem, the Government was handed another as Ms Bishop asked her department to investigate the affair. Under the Australian Health Care Agreement, patients who present for treatment at the emergency department of a public hospital must be treated. The hospital is allowed to suggest other "clinically appropriate" service providers "but must provide free treatment if the patient chooses to be treated at the hospital". This agreement also stipulates that "hospital employees will not direct patients . . . towards a particular choice". The contingency plan enacted by the [Queensland] Government to cover the doctor shortage involves less-serious patients being advised to see their GP. Ms Bishop said the referral of more-serious Caboolture patients to Redcliffe and Brisbane may also breach Queensland's commitment to provide "equitable access to public hospital services regardless of geography".

She said the agreement provided for a "compliance payment" which would amount to around $67 million if Queensland failed to meet its obligations. "We're extremely concerned that the Queensland Government appears to be breaching its responsibilities under the Australian Health Care Agreement," Ms Bishop said. "We've provided very substantial funding - $8 billion over five years - and, clearly, this should be used to better maintain the public health system."

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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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