November 5, 2008 11:36am by David Farrar

Ideology kills

MacDoctor blogs on how Labour is placing ideology above patient care. He explains:

There is excess capacity in the private health system. There is also an ability in the private health system to provide even more excess capacity at relatively short notice. Most surgical clinics have been constructed to allow rapid expansion of wards and theatres, particularly if resource consents are streamlined.

There are thousands of people on elective surgical waiting lists who are waiting many months to years for operations. Most of them could have already had their operations if the private sector was allowed to properly partner with DHBs. Currently, most private sector “public” operations are done under limited contract – often 1 or 2 surgical sessions at a time. There is absolutely no incentive for the private hospital system to “flex up” as the huge demand is being dealt with in a piecemeal fashion.

This is bad enough for Mrs. Smith who has waited three years for her hip operation and can barely walk. It is life-threatening to those who need cardiac surgery or radiotherapy. I am certain that, if Saturday sees the return of a Labour government, the brand new radiotherapy clinic in Auckland will have a few patients sent to it by the DHBs – the ones who have waited well beyond a safe waiting time. There will, however, be no concerted plan negotiated between the DHBs and the new clinic to maximise this new resource, because Mr. Cunliffe is apparently nearly out of his comfort zone.

This means, to put it baldly, people will die because of his ideology.

He also dispels the myths around using the private sector more:

I hear objections to using private health care occasionally from my colleagues. Their objection is that, if you move these patients out of the public system, hospital doctors will eventually have insufficient variety of work to maintain their skill sets (”I’m in charge” Cunliffe puts it as “sucking capacity out of the public system – a nonsense phrase, if I have ever heard one). Apart from the dubious ethics of essentially denying people timely care in order to maintain a doctor’s skills (or non-existent theoretical hospital capacity), this objection does not hold water. Most of the surgery dealt with by the private clinics is low complexity. Private clinics usually lack ICU beds and so cannot deal with the very complex. What maintains your skills better – 10 routine hip replacements or three complex revisions? Removing a dozen easy appendixes or a couple of complex appendix masses?

He concludes:

So let’s stop this whining about privatising medicine and use all of our resources, both private and public, to get the medical care that people need. National’s thoughts on this are very promising, particularly the multiyear funding guarantee which will enable both public and private resources to expand capacity with confidence. Yet another reason to vote for the three-headed hydra.

I note that the Herald uses the word “Elite” meaning “private”. I realise this is probably due to space constraints in their headline, but it is hugely insulting to those people who are having to mortgage or sell their homes in order to get the surgery they desperately need. I think we need to get past the place where we see private medicine as the domain of the wealthy and see it as a normal and valuable part of the entire health system.