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All assessment and no action Top health bureaucrat wants‘ less reviewing, more doing’ from Mark Butler after 70 reviews in three
years
Seventy reviews is essentially two reviews a month every month for Mark Butler’ s entire tenure as health minister.
That a bureaucrat feels there are too many reviews and not enough actions tells us everything we need
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consensus on this expert panel, which cut through the hysteria and tragedy to see the difficult position the private psychiatrist was in— a position we could all be in.
Dr Bradley Ng Psychiatrist, Gold Coast, Qld
As tragic as this case is, no doctor can legally force treatment on patients who have capacity and choose to disengage with care.
It would be great if we could turn back time, but if Cher couldn’ t do it, I’ m really not convinced any of us mortals have much hope.
Dr Penny Wood GP, Perth, WA
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to know about the worst health |
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minister in living memory.
Dr Joe Kosterich GP, Perth, WA
Maybe there should be a limit on the number of reviews done. The limit being roughly the number of reviews that can be implemented within the term of government.
Dr Michelle Porter GP, Gympie, Qld
The only surprise here is not that Mr Butler is prepared to spend healthcare dollars on reviews that, at best, remove money from direct healthcare; it is that someone in the upper echelons is prepared to talk about it.
Dr Louis Fenelon GP, Gold Coast, Qld
The ABCs of health service administration were often touted as Accuse, Blame, Criticise, Deny, Excuse.
In reference to the endless reviews and the absence of implementation of any new initiatives, we could also add Defer, Delay, Dawdle, Derail. Dr Simon Langdon Retired doctor, Perth, WA
Reality bytes and virtual success Hospital ED accused of
‘ cooking the books’ to hit government targets
The four-hour idea itself has merit, but its blunderbuss implementation led to widespread game playing and rushed care, with the predictable dire consequences for some patients.
I was‘ lucky’ enough to have been on shift in both the UK and Australia for the first day of the four-hour rule in both countries.
In the UK, I saw cardboard signs stuck onto corridor walls with the hastily scrawled new name of that‘ ward’. There were wheels taken off
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trolleys to turn them into‘ beds’. I witnessed the( harried-looking) hospital chief executive do his first ward round in decades to clear inpatient beds. All this was done so that the ED could meet its target time to disposal.
Australia, by contrast, was far more advanced. We‘ shuffled’ the patient into a‘ new ward’ on our computer screen, all the while looking directly at said patient staring right back at us from their ED bay.
Associate Professor Jonathan Levy GP, Melbourne, Vic
High-handed or high standards?’ If you identify me, I’ m finished’: The IMG surgeons surviving life under RACS
This article is excellent and too long coming.
The discriminatory behaviour towards IMGs is our national shame. They are not mentored, supported and progressed through a clear, simple and effective pathway.
The impact of chronic employment and visa insecurity on their lives is a disgrace. I feel very ashamed as a practising doctor in Australia.
The example of Dr Jayant Patel being used to increase scrutiny over every IMG is emblematic of cultural and institutionalised racism in Australia.
We did not do the same to Australian university graduates when other Australian practitioners were before the courts or were disgraced in some way. Think of the so-called‘ Butcher of Bega’ case.
Even when IMGs progress
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successfully through pathways and examinations devised by Australians, they are still called IMGs. Our lack of embarrassment over this reeks of ignorance, and arrogance.
Dr David McKeag Ophthalmologist, Newcastle, NSW
It seems AusDoc likes to repetitively recycle the same article, reposting it from different angles with the hope it will finally achieve its determined agenda.
I agree with the Royal Australasian College of Surgeons( RACS): it is not in the Australian community’ s interests to accredit more surgeons like Jayant Patel; therefore, the accreditation process needs to be demanding and vigorous.
Australia has got plenty of great surgeons. The ones who want to join this community need to be the best of the best.
RACS is doing a great job to get the best surgeons working at Australian hospitals. I hope it will not cave into this diversity, equity and inclusion pressure and the beat-up, which is repetitively applied by the media.
Dr Vytauras Kuzinkovas Surgeon, Sydney, NSW
As an Australian-trained hand surgeon, I would( and should) struggle with a current RACS orthopaedic exam, not having seen anything proximal to the wrist in 35 years.
The same would be true of a Singaporean hand surgeon wanting to work here.
Other than through a professorial appointment, there is no way to recognise mainstream sub-specialty practice.
The real irony is, for those of us who practise in esoteric areas, like major hand trauma reconstruction or paediatric spinal surgery, most of us have gone overseas to renowned units for further training. But under the RACS IMG pathway, most of
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those who trained us would not be recognised here.
Dr Ian Hargreaves Surgeon, Sydney, NSW
‘ If we could turn back time’ The Westfield attacker’ s psychiatrist has been savaged over her care— this is what five expert witnesses actually think
I would argue that a patient with diagnosed schizophrenia significant enough to have been on clozapine should have ongoing secondary care follow-up— whether that is a private, public, nurse practitioner or outreach model.
If the patient is seen privately and then cannot be seen because of financial or geographical reasons, there should be the ability to be discharged to a public psychiatry service with GP shared care responsibilities.
Dr James Courts GP, Gold Coast, Qld
I agree with you about ongoing secondary care follow-up.
But from the information available, Joel Cauchi was having appropriate follow-up and he decided— for reasons not disclosed but that might have been because of the side effects of medication— he wanted to cease clozapine.
At that point, he was not showing signs of psychosis and it seems his psychiatrist then made changes to his medication. The psychiatrist had a good ongoing professional relationship with Mr Cauchi, and her treatment was appropriate.
It seems that the difficulty arose when he moved away.
Dr Yvonne Skinner Psychiatrist, Sydney, NSW
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Can we get PSR for plebs, please Can you bill Medicare for group consults? This is what the federal Health Department says
At least there is consistency here.
No, you cannot do group consults and charge professional attendance item numbers to each of the group members. Yes, it makes sense to have group appointments and share the time between the attendees, but it has never been allowable with Medicare rebates.
Dr April Armstrong GP, Greenfields, WA
The Professional Services Review( PSR) says it cannot provide advice or a general position on billing Medicare without getting in trouble. That response is a huge joke.
I understand it is not a judicial organ, but it is not as if the ethical principles that underlie the judiciary are irrelevant to the operation of the PSR.
Is it too much to expect that the PSR decides cases by reference to established, published rules? And is it too much to expect it to publish its case law so that we plebeians might have some guidance, please?
For all we know, it decides cases by rolling dice. Totally unacceptable.
Dr James Cronshaw Medical practitioner, Geelong, Vic
AskMBS advice is also incredibly grey and mostly borders on useless.
Each time I’ ve asked for clarification on one of the many unclear points of the MBS, I’ m informed there are some vague MBS notes that can be interpreted in a number of different ways but that it is ultimately my responsibility to ensure I interpret them correctly.
I’ m more often than not none the wiser as to whether my interpretation is correct.
Dr Tom Morley GP, Melbourne, Vic
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