Tasmanian Times

The individual has always had to struggle to keep from being overwhelmed by the tribe. If you try it, you will be lonely often, and sometimes frightened. No price is too high for the privilege of owning yourself. ~ Friedrich Nietzsche

The individual has always had to struggle to keep from being overwhelmed by the tribe. If you try it, you will be lonely often, and sometimes frightened. No price is too high for the privilege of owning yourself. ~ Friedrich Nietzsche

Economy

The worst in Australia

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The buck stops here: Health Minister Michelle O’Byrne and Premier Lara Giddings. Picture: Rob Walls, http://robertwalls.wordpress.com/

Access to elective surgery in Tasmanian public hospitals is the worst in the nation by a huge margin, according to a new analysis.

And many patients in need of operations ‒ at least several hundred but more likely to be in the thousands ‒ can never realistically expect to be treated. Many of these patients are in constant pain.

The report, by independent health policy analyst Martyn Goddard ( Martyn Goddard’s TT archive of analyses, here ), draws on the most recent national and state data for 2012 that shows for the first time how Tasmania compared with the rest of Australia. It also shows the first full year under the state government’s 2011 budget cuts to elective surgery.

‘By almost every measure, access to elective surgery for Tasmanian public patients is massively worse than any other state or territory,’ Goddard said. ‘The budget cuts made an already bad situation into one that is plainly unacceptable.

‘The greatest cost is borne by patients in the least-urgent category, whose operations can be deferred even though they may be in constant pain and distress. Of the 105 patients in this category who had already been waiting the longest by the end of 2011, all but seven remained on the waiting list a year later; 93.3% were still waiting. This compares with none in NSW, Victoria, Queensland, South Australia and the ACT.

‘As there are many reasons for dropping off the list ‒ including dying while waiting, moving interstate or giving up ‒ it is entirely likely that none of those patents had in fact been treated.

‘In addition, recent state data show about 11,000 people have been referred to a surgeon but their names have not been added to the official waiting list because they have not even been able to get their first consultation. Some people have been waiting for years just to talk to a specialist.

‘Then there are the people whose GPs know need an operation but who have not been referred to a public hospital because there is no point in doing so. We cannot even guess at the numbers in this situation.

‘But putting the whole picture together, it is probable that the people who are unlikely ever to get clinically necessary operations are in the thousands rather than in the hundreds.

‘These new data give us the most complete picture yet of what is going on. Until now, we have known only anecdotally from doctors that some patients will never be treated. Now the figures prove it.

‘The budget cuts also had a serious effect. Overall admissions for elective surgery fell by 8.9% between 2010-11 and calendar 2012. There was a decrease in admissions of 30.4% for hip replacements and 33.3% for knee replacements.

‘Waiting times are the longest in the nation. In 2011-12, 9.4% of patients had waited for longer than a year for their operations, compared with 2.7% for Australia as a whole.’

Download the full analysis:
elective_performance.pdf

Martyn Goddard’s archive of analyses for Tasmanian Times, here

Paul O’Halloran: Time to move to a single funder model

Paul O’Halloran: Questions surround cost of state’s elective surgery procedures

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10 Comments

10 Comments

  1. A.K.

    March 19, 2013 at 1:28 pm

    #6 Geoff, don’t be sorry, I realised many years ago nothing would be done to change health and hospital approach, to many corporate vested interests controlling the health system worldwide.

    All I try to do in posting is put forward alternatives, all the time knowing it won’t change anything ever. Ideological humans are programmed to complain, but not to do anything themselves, as in change their approach to health, lifestyle and diet.

    Probably 99.9% of humans are simple ideological clones who do exactly as they are told and not what is real, logical, factually supported and has to be done. It’s the same with voting, they babble, complain, threaten, but at voting time, they all line up, their programming takes over and they vote for the controlling ideologies no matter what. Never for the reality. It’s the same with health, all the facts are there, but they are ignored for greed, gluttony and in empty hope it won’t happen to them, but in the end, it always does..

    To change the health and hospital system requires the people to make the changes in their lives first and until they do that and for that matter every aspect of society, nothing will ever change until disaster overwhelms their denial and delusions completely, then it is too late.

  2. Geoff Couser

    March 19, 2013 at 1:12 pm

    I’m trying Andrew, I’m trying. Can only do so much, but to get the right answers you need to ask the right questions….we’re not even at that point. Most doctors are working too hard to be able to think of the big picture, and when they do they frame it in terms of their own experience…we need to step outside that, and it’s hard.

    As for the links, they seem to be ‘lost in translation’, perhaps try highlighting the lot and putting them into your browser. Maybe with all your education and training Andrew you could find them easily on the LegCo Hansard? 🙂

  3. Andrew Ricketts

    March 18, 2013 at 1:41 pm

    Re #8 Links are not working.
    With all that expensive education and training under their belt Prof Couser, perhaps the doctors should take the lead?

  4. Geoff Couser

    March 17, 2013 at 9:34 pm

    More detail in these links if folk are interested, but I just know this important article about an issue which costs hundreds of millions of dollars more a year than it should in Tasmania alone will get fewer than 1% of any posts about foxes…just sayin’…! It drives me nuts…

    By the way, my purpose of making submissions to parliament used to be to contribute to informed and constructive debate, but now it’s to create a paper trail to one day prove that folk can’t claim they didn’t know…

    http://www.parliament.tas.gov.au/ctee/Council/Submissions/Govt Admin A_Health_Submission from Prof Geoff Couser.pdf

    http://www.parliament.tas.gov.au/ctee/Council/Transcripts/9 March 2012 – Health and Human Services.pdf

  5. Mike Bolan

    March 17, 2013 at 5:09 pm

    Well it’s not so bad because at least we pay for our politicians and senior bureaucrats to have private health cover so that they don’t need to experience the health system that they provide to the rest of us!

  6. Geoff Couser

    March 17, 2013 at 5:03 pm

    Not so sure AnnoyingO in #2…you’re thinking in a very narrow model. Medical graduates are very expensive to train and a broader view is required…why not train other folk to do appropriate tasks? Why not have a serious discussion about what health really means? Tasmania could lead the way here, but most of our politicians seem to think that if you throw some money at a problem (usually capital works – hey, does anyone really think when the current works at RHH are finished the health system will be any better??) that will fix it.

    No, a new way of thinking is called for, but no-one has the guts (I tried to talk about it once…). Tasmania could lead the way, but there’s little chance of that. Basil seems to be the only one in state parliament (or any parliament for that matter) who gets it.

    #4 – all true, but will take generations for the effects to manifest themselves. I agree with you, but it won’t happen for a while. We’re going to be a reactive health system focussed on curing sickness, rather than being the proactive one focussed on maintaining wellness we ought to be, for quite some time yet. Not that we shouldn’t work towards it. Sorry.

  7. John Biggs

    March 17, 2013 at 2:44 pm

    #2. Agreed. Our UTAS medical graduates and nurses should work in Tas on graduation. Unfortunately, though,the Govt cut the health budget and the numbers working front line, doctors and nurses, but increased the numbers of nonmedical staff and bureaucrats. But as Health Minister O’Byrne said in today’s Mercury, “The Government is continuing to make the health system more efficient and to reduce costs.” You see, that’s more important than reducing the worst waiting times in the country. What an outrageous, insensitive and stupid thing to say. Michelle O’B simply doesn’t understand what her job should be. How did a person of that limited calibre become appointed to one of our most important portfolioS?

  8. A.K.

    March 17, 2013 at 11:52 am

    The majority of elective surgery would be unwarranted if a decent approach to preventive medicine were undertaken. The need for elective surgery comes from medical complaints easily overcome by dietary and life style changes when treated early.

    The current approach to health is seeing an increase in elective surgeries and most other forms of medical intervention, whilst useful funds and resources are drying up. If it were the right approach, there would be a decrease as knowledge of the causes and how to avoid them were implemented.

    The facts prove beyond doubt the direction and application of health measures is not improving health outcomes, but exasperating them.

    Another example of the reality of having an ideology and not logical sanity controlling the health systems worldwide. Tas has the opportunity to change that situation and head down a 21st century path of preventative medicine, not economic vested interest long term subtle, palliative medicine.

    The only way to reduce elective surgery waiting times, is to remove the need for surgery in the majority of cases. This would free up resources for more important aspects of medicine, traumatic, research and development of methods to improve the lives of those unlucky to suffer from defects, accidents or real illness and not lifestyle. It would also free up funds for the care of the aged and disabled, a win win all round. Except for sections of the medical profession and their vested interests.

  9. Karl Stevens

    March 17, 2013 at 11:33 am

    Isn’t it true that corrupt societies are also economically poor societies? Little Tassie’s half a million is too small to support massive corporate welfare schemes and a functioning healthcare system. You chose this outcome voters remember? Obviously living in pain is what most Tasmanians want.

  10. AnnoyingO

    March 16, 2013 at 11:04 pm

    Given the high cost of medical treatment, perhaps the problem needs to be tackled from another angle, by training more medical students and providing incentive for them to work in Australia after graduating, before working overseas.

    Scarcity of medical specialists means they can charge high prices. The availability of more medical specialists should mean fees go down. If fees go down, more can be done per dollar.

    Perhaps the requirements for people to enter medical training should be reviewed. Scoring highly in academic exams does not necessarily make someone a great doctor or surgeon. A more all-round appraisal of potential students of medicine, with less emphasis on the academic result, might make more people eligible. It might even increase the standard of graduates.

    The medical profession will of course resist such proposals, citing lower standards and nurturing the fear factor.

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