19 August 2008

Stories related to the current health crisis in Canberra

| scootergal
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I’m sure this topic has come up a number of times, so sorry if I’m posting something old news. Since moving to Canberra from Queensland five years ago, I have been constantly amazed at problems with the public health system here.

Having a chronic illness, I often have to see GP’s at a moments notice, or fly in and out of hospital for treatment. Yesterday whilst attending my local medical practice, I was told that my doctor would not be on until 11am, and asked to come back at 10:30 to register to see him. I arrived back at that time and was told that there were four people in front of me. I then watched eight people go in before me, then I had to go back to reception and ask how much longer it would be. (I should point out that, with my illness, a rising temperature, dehydration and nausea are danger signs, which is what I presented with at the time). The receptionist told me there was one person ahead of me, and I demanded to go to the treatment room. Anoother 40 minutes and I was seen, with the time taking around four hours from the moment I got there.

I understand it is a busy period with coughs and colds, that there aren’t enough doctors and the medical centre did their best. It just frustrates me that waiting times are so long when my only option was to join another long line of sick people at the hospital.

Another point – I have a friend who has both a husband, and a three year old son with a brain injury. Her son had to go to Sydney to have both brain and spinal surgery at the age of two, because there is no peadiatric neurosurgeon in Canberra. He has not learnt to swallow properly and needs help learning how to feed, and whislt there is a feeding clinic in TCH, it has no actual office and is horrendously difficult ot get into. He has rehibilitation through TherapyACT, but only occassionally, due to the fact the workers are overworked and only work part time. Why is this happening in the nation’s capital?

My final point is the juvenille mental health facilities in Canberra – totally appalling. Working in an area where I see children and young people with severe mental health issues, as well as ADHD, Drug and alcohol and homelessness, most of these kids end up in either an adult facility (depending on their age), juvenille dentention or a refuge, which are terribly overcrowded.

I am just interested in hearing other people’s views on the state of the territory in terms of health issues, as it is an area of which I am a strong advocate.

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gun street girl9:51 am 24 Aug 08

teepee said :

Sepi is right. In our lifetime there could be some pretty serious deterioration in access and quality of assessments (because of the sausage-factory model by some GP surgeries), ironically despite improving science, technology and training.

The one silver lining is that a lot of med schools were established in the last decade and the benefits of that will start to flow soon.

I believe the “breakdown” described by Sepi is already here.

Just a word on the new med schools – many are still to graduate their first cohort, so you will not see a benefit for quite some time (remember, it takes nearly a decade – sometimes more – after graduation to produce a fully independent consultant level doctor). Ironically, the Government has made a meal of that issue too – too many med schools have been opened, too fast. As such, we will potentially have the same problem as the UK – an oversupply of junior doctors, and a dearth of specialists/infrastructure to train them into consultants –> potential unemployment for those graduates who miss out completely.

peterh said :

sorry, the ADF offers them good money, good lifestyle, a chance to serve OS and excellent conditions in retirement?? what about working on a messed up soldier who has been hit with shrapnel from a frag grenade??

excellent conditions in retirement? which force are we talking about here?

I always suspected you were an idiot. You just confirmed it.

ah, yes. but an ex adf idiot, none the less. several of my cannon fodder mates and I love a particular medic. great drinker and someone who always had our backs. He wasn’t there for the money. far from it.

and the RAAF does have cannon fodder. we were called ADG’s.

sorry, the ADF offers them good money, good lifestyle, a chance to serve OS and excellent conditions in retirement?? what about working on a messed up soldier who has been hit with shrapnel from a frag grenade??

excellent conditions in retirement? which force are we talking about here?

I always suspected you were an idiot. You just confirmed it.

ah, yes. but an ex adf idiot, none the less. several of my cannon fodder mates and I love a particular medic. great drinker and someone who always had our backs. He wasn’t there for the money. far from it.

That was my experience too, PeraPHon. Made umpteen phone calls, and was quite amazed. Closed books everywhere. The one I ended up getting was the best Dr I’ve ever encountered, and luckily for me, she was between health services and had vacancies on her schedule. But it was pretty amazing.

One thing, of course, to remember is that despite there being a “General” in the title of GP, GPs are specialists. Long years of training, followed by more training.

ant said :

Getting in to see a GP as a new patient here in Canberra is very hard.

Yup I can vouch for this one too. As a _reasonably_ recent arrival, trying to find a GP with open books was a nightmare. I sent a bulk email to friends asking which GPs they use, and some phone calls and much angst later I finally found a doctor.

The number of times I got “have you been to see Dr Whatever before?” “No” “Sorry” was just astonishing.

I think the more germane point is that the Defence Force poach some Canberra-based doctors by offering pretty nice pacakages – superannuation etc

Yes it does happen. But they still undergo basic military training so that in the case of the shirt hitting the fan, they are tooled up to fight.

And what is the problem with this? If the ADF offers them good money, good lifestyle, a chance to serve OS and excellent conditions in retirement, why shouldn’t they take it?

Having said that, I would guess the amount of doctors we are talking about here is very small.

sorry, the ADF offers them good money, good lifestyle, a chance to serve OS and excellent conditions in retirement?? what about working on a messed up soldier who has been hit with shrapnel from a frag grenade??

excellent conditions in retirement? which force are we talking about here?

Army: They are trained to fight, because they do. doctor or grunt, they all end up in the thick of it.

Navy: same deal. if a ship is under aerial attack, the doctor may well be the one to step up and take on the cannon duty. Sub doctors can assist with all facets of the normal operation of a sub.

Airforce: small misconception re the RAAF, not everyone flies into battle. there are ground troops, and maintenance personnel. The doctors (sorry medics) are in each sector of the RAAF environment.

most of the doctors poached by the ADF go in as civvies, not as regs.

and they make far more money in private practice than they do in the ADF.

BerraBoy68 said :

Overheard said :

** Can I stress that with one very notable exception (and he’s not related to this case), every medical person, specialist, oncology doctor/nurse I’ve ever had any dealings with has been an absolute champion. **

Similar experience but without any exceptions in my case.

The exception was very notable at the time, and if I ever run into this *****, I fear what my reaction might be. I nearly decked the ******. No names, no pack drill. But some time later, my brother’s widow was very philosophical* about the whole thing and summed it up this way, which has become a much-used saying of mine: ‘It’s karma; he’ll come back in the next life as a centipede with a limp’.

* I so needed dictionary.com to check that one. Long day, long night, many beers.

Sepi is right. In our lifetime there could be some pretty serious deterioration in access and quality of assessments (because of the sausage-factory model by some GP surgeries), ironically despite improving science, technology and training.

The one silver lining is that a lot of med schools were established in the last decade and the benefits of that will start to flow soon.

An article in the paper by a local doctor also pointed out that the more the ‘sit and wait’ Medical Centres take over all the ‘easy 5 minute dr certificate for work/antibiotics’ appointments, this just leaves the complex work for the already too busy GPs.

So the poor GPs are left trying to see all the nervous pregnant girls, the oldies with cancer/other ongoing illnesses and the mentally fragile.

The system is on the edge of breakdown I reckon.

swamiOFswank10:50 pm 19 Aug 08

Okay…to all of those who say ‘there is no crisis here’…

On 12 August I called my GP to make an appointment. The only one available was on 22 August.

I’ve twice been to the medical certificate centre at Belconnen, queued up with all of the other germ-ridden folks and been prescribed antibios for what ailed me. I’m glad they’re there – I needed to see someone.

What I want though, is to be able to see my own GP when I’m sick, not have to see some random at the medical certificate centre. I want health care that documents and records my history and takes into account my overall health picture.

I don’t want a 5 minute walk-in with some random who doesn’t give a shit. Is it too much to ask?

I feel as though I’m living in a third world country, having to wait 10 days to see my usual family doctor.

The airforce analogy is interesting. I think the more germane point is that the Defence Force poach some Canberra-based doctors by offering pretty nice pacakages – superannuation etc. I don’t blame the GPs really. Presumably they get a fancy officer rank equivalence too.

Overheard said :

** Can I stress that with one very notable exception (and he’s not related to this case), every medical person, specialist, oncology doctor/nurse I’ve ever had any dealings with has been an absolute champion. **

Similar experience but without any exceptions in my case. My dad died of cancer/brain tumor 3 years ago this week.. He wanted to die at home so me and my brother spent 12 hour shifts injecting him with morphene to keep him comfortable. The community services staff were excellent to deal with and they turned up on time each day to bath my dad, do medical procedures etc.. when he passed away the GP was also there within 20 min’s to make out a cietificate. They made a difficult time less difficult.

On a happier note, whenever my kids get sick at night now I take them to CALMS at Canberra hospital. There’s no waiting in queue’s at Emergency and we’re typically back home within an hour. The GPs that work at CALMS are absolute GOLD and great with kids. They often give out free antibiotics too!

Getting in to see a GP as a new patient here in Canberra is very hard. Our GP in Fyshwick retired some years back, and when I had a nasty emergency (torn achilles tendon) I discovered we had a health system that was all closed down. Oddly enough, I found a GP new to town still taking patients who as luck would have it, was a fantastic GP. She’s moved to Canberra Uni now but I can still see her.

Our system is overloaded. We have (we meaning all of us, not just Canberra) a desperate need for GPs, hospital doctors, specialists, that can only be met from overseas. So we’re bleeding third world countries of their doctors to feed our need. Anyone who’s visited a hospital in the region in past years knows this. It’s quite immoral. We need to train more doctors. More than we’re training now.

As the economists urge us to breed and increase, it means strain on all the things we’re experiencing shortage of: housing, water, food, space, doctors, roads, petrol, etc, etc, etcetera.

Wouldn’t it be a nice world where instead of spending $12b on 100 brand new jets for our airforce to look good in while still basically being the transport arm of the army that we actually spent $12b on health and gave australians free universal health care and cheap medication subsidised by the taxpayer. $12b is $600 roughly per person in australia for those interested. Maybe we could give nurses their much needed payrises which they fight tooth and nail for. Imagine the actual benefit to hundreds of thousands of australians… (cue The Beatles hahahhaha)

Yeah it would be a nice world.

Here’s my prediction those jets will never be used ever in a major conflict in fact they will just depreciate and cost us an ever increasing amount to support.

Maybe I’m just a dreamer… I tell you what though like Granny said it’s great to be young and fit…touch wood

sepi said :

We are the youngest and wealthiest society in Australia – that probably has more to do with our life expectancy than our superb health system.

Agreed, and also more aware of health and fitness than in many other places.

We are the youngest and wealthiest society in Australia – that probably has more to do with our life expectancy than our superb health system.

Woody Mann-Caruso7:13 pm 19 Aug 08

WMC I am not the only person having this difficulty

The system can’t please all of the people all of the time, but it seems to be pleasing most of them most of the time (hence us having the healthiest population in Australia), and that’s good enough for me.

Population – Townsville – 143,000, Canberra, 340,000. Why make that comparison?

Because we’re both large regional centres built around administration and defence? To draw a contrast between towns with low hundreds of thousands of people and services available in cities with close to two million (Brisbane) or over four million (Sydney) people? I could’ve said Woollongong / Newcastle, the Gold / Sunshine Coasts or Geelong but they’re all right next door to a city with millions of people. Townsville is the next largest city with a comparable population that isn’t on the doorstep on a state capital.

AUrelius I don’t think paying is the entire answer.

REmote areas of NT have better numbers of GPs and bulk billing than us.

For some reason the Fed Govt refuses to see the problem in Canberra.

You get the medical system you’re prepared to pay for.

An interesting issue on the shortage of therapists in the ACT is that there’s not enough to meet the prvivate demand and they are having to close their books too.

WMC I am not the only person having this difficulty. I also work in an industry that has alot to do with the health system, and yes I am totally aware that this is not a new or local issue, as I did actually state at the beginning of my post.

I also know of many health professionals who are suffering ‘burn out’ from a system that is under a great deal of stress throughout the country.

But although there is a national issue, for GPs and specialists Canberra is worse off than almost everywhere else.

Surely something can be done.

Population – Townsville – 143,000, Canberra, 340,000. Why make that comparison?

Is more money for health the answer? Or is it a lack of supply of staff and facilities? From what little I know we need to make nursing more attractive for young people, and train more doctors (this has already started, but it the greater numbers won’t feed into the system for another 5 years).

I believe ACT healthcare is in crisis.

We have the second least number of GPs per capita in the entire nation.

We have the lowest amount of bulk billing doctors in the country.

Paediatric services are so unavailable patients are advised to try Goulburn, or other small rural towns.

Our only private hospitals are run by religious groups.

Our hospitals are under funded and understaffed.

We have an aging population.

It is increasingly difficult to get into a GP – each person’s story is just an anecdote, but added togather the picture is grim. We rang on Monday for an appointment, and got one on Thursday – is it hopeless.

Woody Mann-Caruso2:09 pm 19 Aug 08

You not being able to see a particular GP at ‘a moment’s notice’ is not the same as ‘problems with the health system’. Further, I doubt many population centres with fewer than a half million people have a paediatric neurosurgeon. The fact that we live near the National Library doesn’t change the fact that we’re about the same size as Townsville. Mental health facilities, the treatment of juvenilles in adult facilities (and even aged care facilities) is not a new or local issue.

This comes across as you having a bit of a tanty about one appointment for one person with one GP and looking for support by claiming the entire system is somehow in crisis.

dodgybranchopolous1:25 pm 19 Aug 08

“If I was ever going to get into pollitics (no way I would now!) I would strongly advocate for health to be a top priority.”

I’m no Stanhope lover, but it should be noted that:

1. They put an extra $300 million into health in the latest budget;
2. ACT has the highest life expectancy in Australia and one of the highest of any city in the world.
3. The allocation of GPs is a federal, not local matter.

dodgybranchopolous said :

I was sorry to read about your experiences Scootergal, but I was a bit surprised. I’ve recently moved back to Canberra after 9 years in QLD and have found the ACT Health system to be far, far better than that of QLD, or Sydney and Adelaide for that matter.

I haven’t been in Queensland’s health system for five years, and I know since Anna Bligh coming into power, there has been issues, and scandals.

The Royal Brisbane Hospital is the biggest hospital in the southern hemisphere, where as Canberra is so small by comparison. When visiting GP’s up there, I’d get straight in, they were extremely proactive with me and I actually had a ‘team’, who were interested in assisting me with my health issues. I haven’t has that experience here.

It is more upsetting to know that my friend’s son gets such little asistance. My friend is exhausted trying to sort out both his issues, and dealing with her husband, who has just recently been diagnosed as having a disability due to his brain injury.

If I was ever going to get into pollitics (no way I would now!) I would strongly advocate for health to be a top priority.

Overheard said :

My father was a relatively healthy 77 year-old when in December 2007…

Sigh! Another time-travelling story. Make that: ‘My father was a relatively healthy 77 year-old when in December 2005…’

I don’t have any first-hand experience of cancer treatment services in the ACT at the current time, but for the sake of anyone currently requiring treatment, I hope we never see a repeat of the situation from about 2-2.5 years ago that resulted in so much upheaval for so many.

My father was a relatively healthy 77 year-old when in December 2007, a minor procedure later revealed that he had oesophogeal cancer, and soon afterwards, he was diagnosed with prostate cancer. As the ACT’s radiotherapy machine had broken and was taking some months to repair or replace, he had to up stumps with my mother (who requires 24-hour care) and relocate to Sydney for a number of months in mid 2006. Luckily, they were able to rely on a good family support network in Sydney, but that was purely good luck and partly reflective of the fact that they both previously lived in Sydney.

Dad always said there was only one way they’d get him out of his beloved inner north Canberra house: in a box. He was almost correct. After six weeks of treatment (including his first ever overnight stay in a hospital (Westmead)), he was discharged to a nearby nursing home and lasted another three weeks.

He died at the age of 78 on 19 August 2006.

** Can I stress that with one very notable exception (and he’s not related to this case), every medical person, specialist, oncology doctor/nurse I’ve ever had any dealings with has been an absolute champion. **

dodgybranchopolous12:33 pm 19 Aug 08

^ Although I should mention that I’ve not had to see any specialists apart from a neurologist, whom i had to wait 3 weeks to see. That was annoying (and expensive!), but not entirely unreasonable IMO.

dodgybranchopolous12:28 pm 19 Aug 08

I was sorry to read about your experiences Scootergal, but I was a bit surprised. I’ve recently moved back to Canberra after 9 years in QLD and have found the ACT Health system to be far, far better than that of QLD, or Sydney and Adelaide for that matter.

Thinking about it logically, it would end up costing the health system and other systems more if developmental delays in kids could have been avoided by faster treatment.

Oops meant to hit preview. Excuse the spelling and lack of formatting. This is how it should read:

Ant – thanks for the tip, Ill try and get someone via the two other specialist I need to go there to see.

As for your claim that your kids take precedence over adults: no, they do not.
Not “my kids”, kids in general. A certain amount of service set aside for kids, so adults and kids are not competing against each other for services. Effectively two separate lines. IMO kids should have access to health services of equal standard irrespective of where they live. Adults can travel, kids dont have a choice.

Ant – thanks for the tip, Ill try and get someone via the two other specialist I need to go there to see.
As for your claim that your kids take precedence over adults: no, they do not.
Not “my kids”, kids in general. A certain amount of service set aside for kids, so adults and kids are not competing against each other for services. Effectively two separate lines. IMO kids should have access to helath services of equal standard irresepective of where they live. Adults can travel, kids dont have a choice.

madocci, yes we do have a desperate shortage of dermatologists in Canberra. I saw a local one yesterday for the first time. However! After encountering the waiting lists a few years back, I scouted around. SW Sydney (Campbelltown) has several with a few days waiting time. I opted for one in Bowral, however, as it’s closer. If you go to the Dermatologists official website, you’ll see them all listed there. I hope that helps.

As for your claim that your kids take precedence over adults: no, they do not.

In my experience, any health care in relation to children is absolutely appalling. The lack of paediatric specialists as well as the horrendously long list to see a normal specialist mean that I do not even bother trying to get into anyone in Canberra anymore, i go straight to Sydney. I had a referral for a dermatologist yesterday, but was told the wait would be six months long at least for my 3 year old. Best off going to Sydney, but I need to find someone myself and get an open referral cause there’s no easy way for a GP to find a specialist in Sydney. Couple that with the fact that it is almost impossible to get into a GP when you need to and you have a difficult time if you have a sick kid. I wrote on this subject earlier. I would be keen to see some good policy thinking in this area to overcome some of the issues that Canberra presents due to its size and population.

I often think maybe there should be pools of the services that are set aside for kids as a priority, I mean adults I think should take second place after kids. The number of times I have been in a waiting room and waited behind the line of old people to get treatment for my child is unbelievable. With an aging population putting strain on the health system I can only think it will get worse over time. Take a look into any Medicare office, private health shopfront, medical centre or pharmacy and there they all are, lined up with plenty of time to fill waiting for subsidised medical treatment!

Harsh I know, but fair I think!

I have a condition that requires expensive treatment through a product that is in short supply in australia, and can be donated. It can also be purchased in the states, and as a result, I have purchased significant quantities, at a great cost to me. This is a required substance for me. It isn’t illegal, and there are cheaper alternative versions of it, but I have shown a reaction to these alternatives.

I have had recent jabs of this substance, and am now due for some more. I will wait patiently for a doctor to administer the jab, as the treatment rooms are just too long a wait.

what I feel is the inherent problem with the Australian health industry is that there is not enough emphasis for kids to become nurses, doctors or specialists. perhaps the problems of funding can be sorted by the next generation, if there are more health workers pushing back on the government, they might start to take notice and act.

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