Tuesday, January 17, 2006


Post lifted from NHS Blogdoctor -- written by a British GP. He notes some of the things that the NHS will NOT pay for

Reported in the Times today, the sad case of John Pilley, currently a long term guest of Her Majesty in Holloway Prison. He is serving life imprisonment for kidnapping and attempted murder. Those of you who are alert will have noticed that John is in a female prison. Has there been a mistake?

John thought so. The mistake being that he was not a "he" but a she. Not to worry, though, the good old NHS stepped in, and at a cost of some œ15,000 he had a sex change operation and so was, appropriately enough, moved from a male prison to a female prison. Anyway, she doesn't like it there, or maybe she was a bit hasty, because she now thinks she was wrong and is really "he".

So the good old NHS is going to put her back to status quo. Dr Crippen does not know how much that will cost. Phalloplasty is somewhat more technically challenging than vaginoplasty. To put that in simple terms, it is cheaper to chop a willy off than it is to it put back on again.

Dr Crippen currently has three patients with angina waiting to have a CABG. Last year he had four, but one died. And he has two female patients in their late thirties who have blocked fallopian tubes and cannot afford to pay for IVF. And then there is the fifteen year old girl who had her ears pierced not once but four times, and ended up with a seriously damaged ear lobe. Silly girl, but she is a teenager. Dr Crippen referred her for plastic surgery. They will not do it. This sort of Surgery is "not available on the NHS". And this month, and every month, Dr Crippen writes out prescriptions for hundreds of pounds worth of groceries for fit people who have coeliac disease. And then the heavy smokers, who spend œ100 a week on cigarettes, demand NHS prescriptions for nicotine patches. And I cannot get radiotherapy within a reasonable length of time for patients with lung cancer. Last year, one of them died before she had even seen the radiotherapist. And some of my breast cancer patients are not on the optimum treatment. My old English teacher said I should not begin a sentence with "and". I have just done it seven times in succession. The list is endless.

Where am I headed? Some get too much, many get too little. The NHS is under-resourced of course. We all know that. But it is grossly abused by some patents who, frankly, are taking the piss. I know that is rude. Sorry. I can't think of a better way to convey the precise nuance of meaning I wish to acheive.

The only way to solve this is to put a charge on the front end. I have said it before. I am saying it again, and I will keep on saying it. The last time I said it I got over two hundred e-mails from people, most of whom remain wedded to this nonsense of "free at the point of entry."

The NHS is only "free at the point of entry" when it is not closed. It is closed to infertile women. It is closed to middle aged men who need urgent cardiac surgery. It is closed to teenage girls with scarred ears. It is closed to some women who want breast cancer medication.

At least it is fair, you may say. It is the same for everyone. No it is not. Full healthcare is not available for the poor. But the hospital door swings open if you turn up with a wallet full of cash. Go privately, (or be a prime minister) and you get anything you want.

It is like the "The Ritz" hotel. That is free at the point of entry too. But see how far you get without your wallet.

In the meantime, the taxpayers who are reading this article can only hope that JanesoontobeJohnagain Pilley finally settles on an acceptable gender.

How many more goes shall we allow her/him?

John Pilley story from The Times

The downward spiral in the Queensland public hospital system continues

Emergency services at Ipswich and Maryborough hospitals are facing similar problems to Caboolture Hospital's accident and emergency department, which is closed from today due to doctor shortages. Both hospitals have been forced to divert medical staff from other areas to prop up understaffed accident and emergency departments, Queensland Health has confirmed. The department yesterday warned there was "potentially an increased wait for non-urgent matters" at both hospitals. "Queensland Health is exhausting every avenue to find solutions to addressing the staffing shortages," a spokesman said yesterday.

Although triage nurses will be on duty today at Caboolture Hospital, patients will be diverted to Redcliffe Hospital. Queensland Health is urging people to call triple-0 in the case of urgent matters and its hotline - 1300 557 514 - for non-urgent matters. Health Minister Stephen Robertson has insisted the reduction in services is a downgrade, but this was cast into doubt yesterday by Caboolture Hospital acting emergency department director Chris Johnstone. In an interview on ABC Radio, Dr Johnstone said "the emergency department at Caboolture Hospital will be closed". "In other words, there will be no doctors available to provide any medical service," he said.

Opposition health spokesman Bruce Flegg said Queensland Health staff had been threatened with disciplinary action just for using the word "closure". "The situation at the Ipswich Hospital is in a critical state, and locals in yet another huge Queensland community face the prospect of being forced to travel to the Princess Alexandra Hospital in Brisbane," Dr Flegg said.

More here

Severe danger to kids from the Queensland public hospital meltdown

"When three-year-old Zachary began swelling in front of Bronny Chetham's eyes last year, the terrified mother rushed her son to the emergency ward at Caboolture Hospital. He was playing with an egg he had broken open. It took only seconds for a severe allergic reaction to take hold. "When he turned around his eyes were swollen shut, his feet and hands were all swelling," she said. "By the time I got him into the shower, he had a rash from head to toe . . . and I raced him to the hospital." In the worst-case scenario, Mrs Chetham said her son would have suffered an anaphylactic fit, which could have led to death if they had been unable to access medical help immediately. So having the Caboolture Hospital's emergency department only five minutes away has always been a source of comfort to her.

But today, with the closure of the department, that comfort has been replaced by fear. With three children under the age of four suffering from allergies and asthma, Mrs Chetham said she was "terrified" by the prospect. Over the past couple of years she has rushed her children to the emergency department more than half a dozen times. The family, who place their eggs on top of the fridge and go to extreme lengths to keep Zachary out of danger, are now looking to move to Brisbane or to Redcliffe".

More here


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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