Red News Readers,
After 30 years of rationalisation and restructuring of health services what a success it has all been!! Here we are - a third all ED admissions are not seen within recommended times. Union pleas of the past that too many beds were being closed were ignored. Union demands that governments take more applicants in to universities to train as registered nurses were ignored, and now we are struggling with a huge shortage of nurses. Even if governments wanted to open more beds to clear access block they can't as they can't find sufficient numbers of nursing staff and the staff they can get are inexperienced. I hear we are back to recruiting from overseas with the current union officials crying crocodile tears over taking nurses from countries that need them. Their concerns that we are depleting those countries are weakened by their acceptance of a wage and conditions package that does very little to attract and retain local nurses.
There are alternatives to ED visits - co located GP services and nurse phone triage. WA has done well in establising co located GP services and NSW has dabbled in experiments with this idea but we still haven't moved to the more progressive arrangments that exist and seem to work so well in WA.
I work for a nurse phone triage company and what astounds me is how poorly many citizens are educated about their health and how to look after themselves when they are sick. Many families with young children in the house often have nothing in their medicine cabinet or their first aid kit and the parents have to rush out to find a chemist at all hours of the day and night just to buy the basics. It seems to me that there is no education within families and between generations as perhaps there was in the past about the basics of health care. Then there is the responsiblity of the education system and government to educate citizens, and it seems that both are failing in their role. Certainly among many of the callers that I speak to, going to ED is something to be avoided at all costs due to waiting times.
But if a caller does need to go to ED, there is often hesitancy if there is a need to call an ambulance. To get a trip in an ambulance in the States of Australia now may cost between $200 and $300 . Often callers just don't have the money and they will take terrible risks in their cars, hopefully with someone else driving to avoid this cost. Some callers demand advice for a home treatment for something that requires a hospital visit to avoid the costs of travelling to hospital. So perhaps the waiting times for ED are only the tip of the iceberg of real need for emergency health services. A sobering thought!
The other costs that are driving citizens towards EDs, is the cost of going to the GP. Callers advise this can cost anywhere between $50 and $400 a visit. Why does a GP need to charge $400 a visit, but that is the cost that a WA caller told me they were asked to pay!! After hours locum services that visit the sick at home can charge $100 to $200 a visit to a home. Is this cost price or is this profit making? Again callers often don't have that amount of money. Being a child of the Whitlam generation it enrages me that basic health care is becoming beyond all citizens reach due to cost.
Some thoughts from me about the current health system, the mistakes of the past and their effect on the current generation,
Hospitals choked with admissions
Natasha Wallace Health Reporter, smh
July 1, 2008
PUBLIC hospitals are under "severe strain" with the rate of admissions increasing by 3 per cent - twice that of population growth, the federal Health Minister, Nicola Roxon, says.
The State of Our Public Hospitals June 2008 report - a snapshot released yesterday of activity and performance in the 2006-07 financial year - shows that almost a third of emergency patients were not seen within the recommended time.
The number of patients presenting to emergency departments between 1998-99 and 2006-07 increased by more than 34 per cent.
Across Australia in 2006-07, there were 6.7 million presentations to emergency departments.
Of the emergency patients, 70 per cent were seen within the time recommended for their triage category and half were seen within 24 minutes.
NSW had the lowest median waiting time in emergency - 20 minutes - and the highest percentage - at 76 per cent - of patients seen within their recommended time. The worst was the ACT, which had a median waiting time of 44 minutes and 54 per cent of patients seen within time.
In 2006-07 the number of available beds nationally was 82,662, with 55,904 (68 per cent) public hospital beds, or about 2.6 per 1000 weighted population. NSW and South Australia had 2.8 beds per 1000 weighted population.
Ms Roxon took the opportunity to push her public hospital report card agenda, which NSW has resisted. She argued that hospitals are under "severe strain" and nationally consistent data will help improve performance.
"The [report] … highlights how much work lies ahead of us to deliver a better health and hospital system," Ms Roxon said.
Indigenous Australians represented 5 per cent of public hospital admissions - despite being only 2.5 per cent of the population.
The longest waits for elective surgery were for knee replacements (median 162 days).
The president of the Australian Medical Association, Dr Rosanna Capolingua, said the report showed the system was at "breaking point".