Two medical system in Australia bad? (1 Viewer)

[Medman]

http://www.smh.com.au/national/heal...-just-helps-to-jump-queue-20140420-36yoj.html

Found this article an interesting read. I know for a fact that private hospitals have much shorter waiting lists because there is significantly less people going through the private system as opposed to the public system. People are using their own money to pay their way out of the public situation which I think is fair enough.

If you go public you will not have the same team of doctors. Consultants don't generally perform operations unless they are complex or think the reg is unable to do it. On the most part if you go through the public system you will be in contact with a generally less experienced doctor.

Another problem is consultants often share their time between private and public. They generally spend more time in private because that's where they make the most money. Hospitals should put in place restrictions for public consultants who also working privately, one to open more jobs for junior doctors who are stuck in the bottle neck training system and two decrease waiting times as they will be able to be in the hospital seeing patients instead of just relying on their regs who needs to consult them anyway.

The ineffectiveness of the public system astounds me as it took 3 hours to sort out a patient for an salphingectomy from an ectopic pregnancy after the reg consulted with 4 different doctors with waiting in between. Ridiculous, if you want to know where our money is going to this is one of the few places.

 

[Havox]

Shouldn't surprise anyone really. The private system is necessary for relieving pressure on the public system by taking care of a large number of non-urgent cases so having it around is definitely a good thing.

 

[flashyGoldFish]

How exactly do you limit private hours? Completely unfair to stunt the income of people who have spent ages getting to where they are.

 

[Medman]

How exactly do you limit private hours? Completely unfair to stunt the income of people who have spent ages getting to where they are.

It is also unfair to those that can't get a job as a public consultant having to resort to doing PHDs. I was in fact referring to VMOs sorry to get that mixed up. Not sure how VMO's get paid but the public system needs to find a way to hire public consultants that will actually be in the hospital. Then it comes to the argument of we don't have enough money etc.

Another thing that seems to bug at me is the fact that many overseas doctors are beginning to receive public consult positions. I'm not saying it's a bad thing but given the fact that no additional positions are being made available in public hospitals and the number of doctors in the future is increasing. As a medical student you now will be not only competing with your peers for a job but also with overseas doctors.

The many surgeries moved to private hospitals means it will not only save money but increase the cost and waiting time for patients. Unless the article writer is suggesting we either increase funding or find more effective spending strategies we are pretty much screwed in terms of public health given the aging population and increasing population.

 

[Schmeag]

If you go public you will not have the same team of doctors. Consultants don't generally perform operations unless they are complex or think the reg is unable to do it. On the most part if you go through the public system you will be in contact with a generally less experienced doctor.

In my opinion, we have a decent system--its not like the today's blame-and-shame NHS, but we still have universal health coverage. If people can afford it, they can choose to have an increase in the standard of non-medical care (ie single room, choice of consultant). Not being able to see a consultant of your choice is a first-world problem, as is getting a room to yourself. Our system mandates a good standard of care and keeps costs down by allow those with the means to spend on the extra perks.

If you go public you will not have the same team of doctors. Consultants don't generally perform operations unless they are complex or think the reg is unable to do it. On the most part if you go through the public system you will be in contact with a generally less experienced doctor.

There is a certain necessity for public hospitals to employ trainees and junior doctors. Apart from needing paper pushers to keep the cogs of hospital bureaucracy well-oiled, public hospitals can also be teaching hospitals. Registrars and JMOs need to have patient-contact and responsibility in order to be adequately-trained. Increasing the number of public or full-time consultants may not necessarily help with this.

Another problem is consultants often share their time between private and public. They generally spend more time in private because that's where they make the most money. Hospitals should put in place restrictions for public consultants who also working privately, one to open more jobs for junior doctors who are stuck in the bottle neck training system and two decrease waiting times as they will be able to be in the hospital seeing patients instead of just relying on their regs who needs to consult them anyway.

Separating public and private healthcare may have more harm than benefit. The opportunity to go into private practice also applies to new consultants who are not employed a public hospital. Additionally, private practice allows those VMOs with experience to contribute to the public health system without working full-time and allowing more positions for junior consultants. Public hospitals also allow those in private practice to keep in touch which current practice, as whereas practice practice often works on an "anything goes" principle as it is more profit and consumer-driven.

The ineffectiveness of the public system astounds me as it took 3 hours to sort out a patient for an salphingectomy from an ectopic pregnancy after the reg consulted with 4 different doctors with waiting in between. Ridiculous, if you want to know where our money is going to this is one of the few places.

I thought public hospitals don't receive funding from public consultations--isn't funding more diagnosis and procedure-based? Rising healthcare costs are probably more a by-product of increasingly widespread use of newer technology. Private practice might be more at fault in this regard as more unnecessary procedures may be performed due to the profit and consumer factors, whereas the incentive is there for public hospitals to try to rationalise treatment according to best practice due to limits on cost.

Regarding the example provided, I assume your registrar was either in ED getting abused by O+G or they were O+G and the patient had other medical/surgical problems? What were the issues requiring consultation and were they necessary? How emergent was the procedure (could it wait minutes/hours/days)? What was the outcome for the patient? Ultimately, was this flagged as an issue, or was the waiting time necessary?

Public hospitals tend to have stronger and more transparent auditing processes than private hospitals (ie M&M, risk management, departmental meetings), and it is helpful for those in more isolated private practice to keep in the loop with what their colleagues are getting up to.

In short, our system is not perfect and we could be doing more to keep costs down (ie probably spending more on primary care), but we do have it pretty good.