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Issue # 1426      2 September 2009

Mr Prime Minister are you listening?

“G’day and welcome to www.pm.gov.au!” A chatty Kevin Rudd greets visitors to his blog on health reform. “Today I want to speak with you about Australia’s hospital and health care system and the challenges it faces in the 21st century….

“Without fundamental change Australia’s health system will buckle under the pressure of demographic change, rising costs and modern diseases,” the PM says inviting comments on recent reviews of the health and hospital system (see www.yourhealth.gov.au and Guardian August 12, 2009).

“We must consult the people with the greatest stake in the future of our health system... our local doctors, our local nurses, health care workers, you and your families. Your views will directly influence the changes we will make to improve the system.”

“So get involved, send me your suggestions, participate in the blog and together let’s improve the Australian Health System.”

Over the five days that the blog remained open the people gave the PM their personal experiences and views – plenty to think and act on:

Andrew S says: “In 1990 (during Mr Bob Hawke’s government) I could ring my GP in the middle of the night and get a doctor to attend to my baby daughter within an hour. What has happened to that level of service?”

Mental health

TracyS says: “Just today I came across a case of a middle aged man with a significant psychotic illness and co-occuring drug use. His elderly mother is his sole carer.

“His erratic and some times violent behaviour is making it more and more difficult to cope. When she requested assistance from the local mental health service, and told them about her concerns about her own wellbeing due to her son’s erratic behaviour, she was told to ‘either move or get a restraining order out on him’.

“This is not an uncommon example. A comprehensive approach to care is needed; and the buck passing has to stop.”

Rural & regional

Alison says: “I am in a rural area and we have a largish hospital nearby. The wait times at this hospital are very poor. I have a young son and one morning at 4.30 I waited three hours before seeing a doctor. I was the only one in the waiting room this whole time. This may seem small compared to the city but it is a big deal. There are many stories of people waiting up to seven hours during the day to be seen.”

Barbelle says: “Massive growth in management structures over the past five years must be a drain on the resources of this health service, which runs several large hospitals and numerous small hospitals and other health services in regional areas.

“At the same time, services to the community have been withdrawn and equipment, paid for by community fundraising for their hospital has been taken away. A case in point is a hospital in a town serving a community of some 6,000 people – their maternity ward was incrementally closed down by the health service – when medical and nursing staff and community leaders objected, they were told that only half a dozen babies are born in this locality each year – last year’s stats (the rest of the babies, several dozen, had been born in hospitals 100-200 kilometres away – many had been born in the ambulance on the way to these locations).”

Janice says: “I think it might be a good idea if some thought was given to the problem of getting doctors out into rural and remote areas... If the government changed the doctor provider number system to one where the provider numbers were allocated to districts/towns/cities rather than to doctors individually, then doctors would have to go where provider numbers are available.”

Nurses

ozkate62 says: “Please take the time to consult with Community Nurses. We are paid less than acute care, yet expected to take on more and more to save acute beds. Why do you continue to say nurses can do more, when we are already stretched now? Doing more is just not possible most of the time. We are not funded for most of the work we do now… Please talk to us.”

Private profits

JoeSmith says: “We have seen, read and heard all the excuses on why the hospital system is falling apart. I will put it concisely why Australia’s essential infrastructure is failing; politicians on all sides simply don’t give a toss about anything if it can’t make a quick short-term profit.”

NimbusWeb says: “Mate, now how to move forward: First, dismantle the 30 percent uncapped private insurance rebate…. what other inefficient industry gets such a subsidy these days.”

Andrew S says: “Private insurers by definition are not in the business of serving sick patients. Their only responsibility is to their shareholders. Therefore basic medical needs of the community should be funded through the tax system…

“Public Healthcare professionals should be paid competitive rates so that new graduates can be attracted to public service.”

Training & income

RachH says: “Fund more uni places. Pay students for clinical prac and put more training back into hospitals. Increase staffing to reduce patient load. Develop and implement models of care that increase continuity of care; this is more satisfying for staff and leads to improved patient outcomes – people heal or birth better when they are comfortable and feel safe! Support staff education – it should be more than just the odd half hour at handover when everyone is busy and distracted. Put more money into primary health – an ounce of prevention is worth a pound of cure. It’s not brain surgery!”

deidrejay says: “I’m training in the health field and the HECS debt I am accumulating as a woman in my mid 40’s who’s needing to build up superannuation horrifies me. Also the practicals are 26 weeks in total and as a self-supporting woman not earning for 26 weeks is impossible so I’m still trying to figure out how to do the practicals and continue to earn an income. A block period of seven to eight weeks is in the country meaning I probably have to pay two sets of living costs on no income.”

Craig Rowley says: “It seems reasonable to me that citizens putting their shoulder to the wheel, studying and learning to become competent health professionals and completing a clinical placement to translate learning of theory into practical learning should indeed receive payments at least equivalent to NewStart for the duration of the clinical placement.”

The Cannulator says: “As both a Paramedic and a Critical Care RN I have seen the ‘system’ change over 20 years. To improve the shortage of professionals like nurses and paramedics, salaries need to reflect the responsibility they carry. If I work on a cardiac arrest patient, I receive about 20 percent of the wage of a fully qualified anaesthetist or emergency doctor.

“To allow more useful care outside of hospital and reduce hospital attendances, bulk billing 24-hour medical centres with adequate complete pathology and radiology services for non emergencies; so that EDs [hospital emergency departments] aren’t full of those seeking free health care.

“Similarly pathology and radiology services need to be reined in so they aren’t charging twice the scheduled fee after the fact. We just can’t afford to pay big business for health-care, even if we aren’t on pensions.”

Kevin, mate, are you listening?

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