Comments on: Agnostics need faith in private hospital sector

By: Jenny Haines

Jenny Haines — Thu, 01 Jan 1970 10:00:00 +0000

Having worked as a registered nurse in public and private hospitals, I prefer the public sector. My work in the private sector was as an agency nurse but I think that gives you a unique perspective. Private hospitals do work that is going to generate profit for the hospital. If anything goes wrong, they move the patient out to the public sector (take note those collecting statistics). While there may be full medical and nursing teams during “working hours” 7am to 6pm, after hours, wards and intensive care units can be staffed by GP Locums in private hospitals. Just as well the nursing staff were experienced! But, a few years ago, private hospitals changed their skill mix, so that many of them now have minimal numbers of registered nurses supervising a team of Endorsed Enrolled Nurses and Assistants in Nursing. This was to achieve cost modelling targets, not improve the quality of care. I am disappointed to hear Nicola Roxon say that the huge fortune that is being given to private hospital and private funds will remain as is, while the public sector that does all the work that the private sector won’t touch, faces a huge funding problem. If people choose the private sector they and their fund should pay for it. Mind you from my observation, if you want quality and safety or you need a complicated procedure done or you have a chronic illness, choose the public sector.

By: Cathy

Cathy — Thu, 01 Jan 1970 10:00:00 +0000

A brief and hurried response to the input from Jenny Haines who certainly offers good insight into the divide between public and private aged care. Between them they still fail to meet the demands of average ageing Australians. Our elderly and age-affected remain desperately in need of medical, allied health, welfare and advocacy services not yet available in a co-ordinated package. As do our children, ageing Australians have specific needs tied into their living environments. As a nation we’re failing critical human needs at a time when family, network and government support is least accessible . Why we assume older people need or deserve less care than those who follow in their footsteps I’ve no idea. No one human life is more important than another as our medical fraternity will tell you.

By: Marcus Dabner

Marcus Dabner — Thu, 01 Jan 1970 10:00:00 +0000

It depends on how you define "best". If you regard the primary role of a hospital to provide elective surgery, then certainly they do this more efficiently. This is for a wide variety of reasons, almost all of which relate to a lower demand when compared to the public sector, as well as increased financial incentives in the private sector. However, "best" in health care doesn't mean "fastest". Nor can it or should it be measured in terms of elective surgery waiting lists, but in overall service provision. Private hospitals take a much lower burden of seriously ill patients and in my experience prioritise surgical cases over medical cases. This of course influences how "efficient" they are.

Also, bear in mind the fact that a major cause for waiting list blow outs is the cancellation of elective procedures due to lack of bed space. If this situation was reversed the medical staff who currently sit around doing very little due to lack of surgical patients would be more productively employed, rather than the ridiculous but common scenario of having surgeons with no operating time in one public hospital, while the (public) patient is being operated on under a fee for service arrangement in a private hospital, thanks to the "waiting list blitz". Surely the system becomes more efficient if we restore capacity, rather than just shifting to the private sector.

Finally, there is a factor that is often forgotten in the equation which is the training role of public hospitals. If we look at hosptials purely in terms of service provision we will rapidly lose all capacity due to a skill shortage worse than the one we already experience. Although the share of undergraduate and postgraduate training that occurs in the private sector is increasing, this is one of the essential roles of the public sector and increases it's "inefficiency" from a cost point of view, but results in better care in the long term (and arguably the short term).