Elective surgery in Canberra – the games they play

A crafty piece of smoke and mirrors was published in our local Canberra times today:


At face value it would appear to be great news in a City where one can wait nearly three years for an elective ENT procedure as a public patient. What the Public however does not see is how this is managed behind the scenes.

The underlying problem is firstly a lack of available theatre time and this is compounded by a relative lack of available doctors and other theatre staff. This creates for an election losing headache and our ACT Government decided to deal with the issue.

One would have assumed that the logical way to do this would be to create more theatre time within the Public Hospitals and get the staff needed to perform the surgery – this would create a long term solution to the problem.

To a degree this has happened – a large portion of the reduction in waiting times is however due to a less sensible process. A range of surgical procedures are being outsourced to private surgeons in private hospitals.

Our tax money is being used to fund joint replacements and varicose vein operations, amongst other types of surgery, being performed on public patients at AMA rates (or even significantly higher rates) at private hospitals. A single surgeon sometimes run two adjacent joint replacement theatres with public patient lists and can do ten or more joint replacements a day – a very profitable day at AMA or higher rates.

The obvious impact of this process is that the waiting lists in the public hospitals are shorter but at what cost to the Taxpayer? One also wonders what has been done to avoid the waiting lists simply stretching out again once this batch of cases have been dealt with.

The cynic in me cannot but help to wonder about a process where waiting lists form in the public system because there are not enough time or doctors to do the procedures yet the very same doctors can do this work so efficiently in a private facility.Two theatres can be run at the same time and cases can be done within weeks that would take months or years to be done in a public hospital.

It says a lot about the bureaucratic processes in our public hospitals that allows Unions and Managers to set up systems that are so inefficient and slow compared to the efficiency at a private facility

Lets not forget to mention the possible conflict of interest that the treating doctors have – why would one put a lot of energy into fixing the issue within the public system when it can be done much easier and for a much more lucrative income at a private facility?

Lastly one should reflect on how unfair this is on the punter who has paid his private insurance premiums and attends the same hospital to have the same procedure done by the same surgeons. He is very likely going to be charged a hefty out of pocket fee as well and one cannot help but understand his anger and frustration when the guy in the bed next to him does not pay a cent for his operation and may have spent his money on booze and gambling instead of buying private health insurance yet get the same benefits at the end of the day.

It all boils down to buying votes, nothing in it about what is fair and what is just

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