Kerryn Williams
A national survey conducted by Roy Morgan Research last August found that 25% of Australians do not believe their local hospital would provide them with adequate treatment if they had an accident.
If a quarter of the population has lost confidence in the public hospitals there must be something seriously wrong. But who is to blame for the deepening crisis? Is it incompetent nurses or greedy doctors? No, the current crisis exists because public hospitals have been utterly deprived of the funds necessary to provide adequate health care, and the blame for this lies squarely with the state and federal governments.
On December 31, David Say, the honorary treasurer of the Children's Hospital at Westmead in Sydney, resigned from his position over the use of public donations to cover the hospital's day-to-day running costs. Due to a major shortfall in the CHW's operating budget, more than $2.5 million in donations was used to cover the wages of cleaners, security staff and surgeons and to pay overdue bills to creditors who were withholding supplies.
"The hospital has never been given a research and development budget", Say stated in his resignation letter, and since 1995 the CHW has "not been given a budget to maintain and replace its capital equipment".
Say also claimed that the hospital was required "to meet ever-increasing targets, but with less funding in real terms than in the previous 12 months, a situation that has been repeated for some years".
It is common practice for public hospitals to rely on donations to meet the shortfall in government funding. The CHW's rigorous fundraising program aims to generate $20 million in donations each year to fund its research programs and to replace essential medical equipment. Staff are even encouraged to donate some of their wages to the fund. The CHW web site currently features its next major event, the Bandaged Bear Day.
All public hospitals are forced to seek donations, whether through cake stalls to raise money for the replacement of life-saving equipment in the emergency department or raffles to fund nurses' participation in training courses.
The January 24 Sydney Morning Herald reported that many NSW hospitals are already over budget, just halfway through the financial year. Sydney Hospital and Sydney Eye Hospital are $1.6 million in the red, and South Eastern Sydney Area Health Service, which covers several hospitals, faces a $2.64 million deficit.
The hospital crisis has produced fatal results. In December, the NSW Health Care Complaints Commission (HCCC) released a report on its investigations into Campbelltown and Camden hospitals in Sydney. The report examined 47 complaints of misconduct between 1999 and 2003 and found that 17 patients who died at the hospitals during that period had not received safe or proper care.
In one case, a 40-year-old woman with symptoms of sepsis who had given birth to her fourth child a week earlier was sent home from the emergency department at Campbelltown hospital after being diagnosed with the flu. The next day she died of septicaemia.
In another case, a 70-year-old man with severe abdominal pain was classified as non-urgent at the Camden emergency department. He was given pain relief, including morphine, but was not seen by a surgeon or visiting medical officer. By the following morning his condition had rapidly deteriorated and later that night he died at Liverpool hospital.
Since the report's release staff at other hospitals have come forward with similar allegations. A nurse working at Liverpool hospital claimed that in 1999 an elderly patient was given a lethal dose of painkillers to free up her hospital bed.
On December 11, NSW health minister Morris Iemma sacked the head of the HCCC after claiming the report into Campbelltown and Camden hospitals "doesn't go far enough in terms of finding anyone accountable for these failures".
However, scapegoating individual staff members for these events and their tragic consequences — or even sacking a few incompetent high-level administrators of the hospitals — does not get to the heart of the problem. The massive pressure on hospitals attempting to provide health care to the public in the face of insufficient staff numbers, beds, equipment and resources will inevitably force errors.
The deteriorating conditions in public hospitals are alarming. A study by NSW area health services of 55 hospitals in the state between 1999 and 2001 found that hospital waiting times were increasing every year. More than a third of all adults admitted suffered "unacceptable delays" in the allocation of a bed, in some cases more than 16 hours. In the emergency departments this delay is resulting in "trolley block", where patients awaiting admission to a ward are left on trolleys clogging up the corridors and aisles.
Similar trends exist across the country, and are contributing to the degeneration of working conditions for hospital staff. Recent studies conducted by the Australian Nursing Journal, for example, revealed that more than 40% of nurses in Western Australia have been physically injured at work.
According to Lisa Macdonald, the Socialist Alliance candidate for the NSW federal electorate of Reid: "Funding a health system that can adequately meet the needs of the whole population must be non-negotiable. The federal government could begin by shifting the $3.7 billion in subsidies to private health insurance companies into improving our public hospitals.
"The events at Campbelltown and Camden hospitals should be heeded as a warning to the state and federal governments, that if the health system is not properly resourced, then they will be responsible for future lives unnecessarily lost."
From Â鶹´«Ã½ Weekly, January 28, 2004.
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