Healthcare system in Australia - just how bad have things got?

[Bushdid911]

The hospital system was pretty much running at capacity even before the pandemic. That's how it's designed. In government's mind there's no use paying for beds to sit empty for years, nor having loads of doctors/nurses on standby.

Obviously you can have plans in place to ramp up if required, but you can't train doctors/nurses overnight. You can try and get them from overseas which we are doing, but we are competing in a global market there too.

 

[GreyWind]

The norm in Qld, unless you sign a 10 hr shift break form.
Which.
Management rarely offer,and are pissed when staff sign.

Then, there is bullying by roster.

I have a friend, who just seems to have mostly ND......Strange that.

Rarely gets what she requests.
She has been told, she is a hastle, because she wont do late/early.

and dont get me started on the oncall/ recall bullying that happens.

Rostering a nurse to be on 3 ams, with oncall/ recall, then get called on, work 5 hours on an interhospital transfer, then abused, when you say you are not due back, for 10 hrs. That bullying is due to bad managers.

* me that's deplorable. At least we've got a rock solid EBA and strong union backing when it comes to our shift management. Although we're now having huge issues of crews being split to work with the surge workforce.

Our management bullying doesn't relate to that aspect of the job.

 

[hamohawk1]

The hospital system was pretty much running at capacity even before the pandemic. That's how it's designed. In government's mind there's no use paying for beds to sit empty for years, nor having loads of doctors/nurses on standby.

Obviously you can have plans in place to ramp up if required, but you can't train doctors/nurses overnight. You can try and get them from overseas which we are doing, but we are competing in a global market there too.

The issue when everything is run through the lens of the $$. Even though most countries had similar issues, it seemed like the healthcare system had very little scope to scale up when needed.

 

[Crankyhawk]

The issue when everything is run through the lens of the $$. Even though most countries had similar issues, it seemed like the healthcare system had very little scope to scale up when needed.

We relied on overseas trained nurses. This pipeline dried up in the pandemic

 

[Northalives]

Take it from me, the healthcare system in Australia is the worst it has ever been.

 

[Ned_Flanders]

Take it from me, the healthcare system in Australia is the worst it has ever been.

You think pre Medicare was better than this? How??

 

[Gough]

If you get sick, raid your super, that seems to be all the all purpose solution for the Libs these days anyway. After you've used it to buy a house, escape an abusive spouse and then get you through covid there should be plenty left.

 

[Taylor]

If you get sick, raid your super, that seems to be all the all purpose solution for the Libs these days anyway. After you've used it to buy a house, escape an abusive spouse and then get you through covid there should be plenty left.

If we work on the assumption that governments should pay for everything then super isn't needed is it? Raise the pension enough. Give everyone a 10% payrise right now without impacting business costs.

But I suspect this topic, hospital capability, will only get serious coverage after the elections.

 

[Gough]

If we work on the assumption that governments should pay for everything then super isn't needed is it? Raise the pension enough. Give everyone a 10% payrise right now without impacting business costs.

But I suspect this topic, hospital capability, will only get serious coverage after the elections.

It arguably won SA Labor the election. Is this one of those media is to blame things you're so fond of?

 

[Taylor]

It arguably won SA Labor the election. Is this one of those media is to blame things you're so fond of?

The selective story telling? It's an example of media manipulation yes. Unfortunately our journalist cohort should dislike, distrust and hold to account all of the political class but that profession has become partisan and when that happened the people lost their most valuable service.

Now if the politican is liked by the journalist they don't run the story that might hurt the team at the upcoming election. If most of the journalists are on one side and the rest are kept in pockets on other networks you can keep a story away from almost everyone and only those who were never on "the team" will hear it anyway

 

[Gough]

The selective story telling? It's an example of media manipulation yes. Unfortunately our journalist cohort should dislike, distrust and hold to account all of the political class but that profession has become partisan and when that happened the people lost their most valuable service.

Now if the politican is liked by the journalist they don't run the story that might hurt the team at the upcoming election.

Stop reading stuff that tells you white nationalists are Marxists then.

 

[Taylor]

Stop reading stuff that tells you white nationalists are Marxists then.

Journalistic integrity extends to reporting that guy claiming to be authoritarian left and a former communist too.

 

[hamohawk1]

No one has the cajones or intellect in the media but f*ck we could really strip back a bit of our defence spending as i think its played up how much of a threat we are at. While they could also stop p*ssing China off with the crazy geopolictial stuff we could really divert even a 5-10% of defence spending into healthcare.

It will never happen because this country loves the history and notion of warfare but i can dream.

 

[Northalives]

You think pre Medicare was better than this? How??

I need to correct my statement: Take it from me, the healthcare system under Medibank/Medicare in Australia is the worst it has ever been.

 

[Achy Blakey Heart]

I’ll post some experiences on the ground later as a specialist MH nurse in a broken regional health service. But this basically sums it up. Recent service redesign brought in new exec who instilled allied health at the top of the operational tree with no experience doing the job on the ground. New agenda is to fill the service with allied health at expense of the nurses. Mass exodus of experienced nursing staff due to woke culture change. Coverups of sentinel events. Rife nepetism. Awful bullying from the top. No transparency. No leadership. No accountability. We have hugely inexperienced staff in senior clinical roles. It’s actually scary.

Imho. The Andrews government is responsible for all of this. It’s a similar story throughout the dept and the gov. The vast vast majority of MH staff got no surge payment which was a huge * you from him despite being redeployed and treated like s**t by the org. Andrews slow played the recent EBA negotiations meaning we haven’t had a pay rise for 2 years.

Recently heard that the vic health minister told a senior and very valuable nurse in my org that there would be no $$ for new hospital because there is no votes for Andrews in building NSW infrastructure even if they are paid to run it.

It’s disgusting. I’m totally and utterly burnt out.

 

[Seeds]

Gp shortage is due to Medicare cuts.Totally unacceptable.

Yeah gp shortage aint the problem. The problem is the hospitals. Not enough of them. Not enough workers.

no one waits months and months to see a gp like they do to get into a hospital for elective surgery. Hell some waits are over a year.

 

[Seeds]

So people are starting to wake up to the fact we have a hospital problem and we should of been investing in hospitals during a pandemic and not friggin quarantine prisons.

ive only been banging on about this for two whole years.

 

[Seeds]

private health is responsible

No it isnt. Lack of government funding is the problem. If there was no private health the problem would be even bigger.

 

[Achy Blakey Heart]

When you said you were involved in mental health I always figured you you meant as a patient.

Nice stigma. Well done.

 

[Seeds]

Need more nurses. Not so much doctors.

Nah we need way more consultant doctors. You should not have to wait more then 24 hours to see a consultant and yet you often have to wait months, even though you have a gps referrel. Thats a lack of supply issue that should not exist in a modern society.

plus we also have a massive lack of supply of both hospital beds and doctors to manage those beds. Hospitals and doctors are far too focused on turning over patients because they lack both beds and staff. insufficient treatment results when the priority is to turnover patients and not solely to treat them. Oh and doctors should never have to work more then 8 hour shifts. A lack of supply results in the ridiculous hours doctors work. you dont want to see a tired doctor. Its the most important job in the country.

A modern society should have so many doctors and hospital beds that most of the time doctors are sitting around idly waiting for a surge in patients that may come if we have a bad flu season or you know, a major pandemic. We should always have extra unused capacity for something as important as health.

 

[Crankyhawk]

I’ll post some experiences on the ground later as a specialist MH nurse in a broken regional health service. But this basically sums it up. Recent service redesign brought in new exec who instilled allied health at the top of the operational tree with no experience doing the job on the ground. New agenda is to fill the service with allied health at expense of the nurses. Mass exodus of experienced nursing staff due to woke culture change. Coverups of sentinel events. Rife nepetism. Awful bullying from the top. No transparency. No leadership. No accountability. We have hugely inexperienced staff in senior clinical roles. It’s actually scary.

Imho. The Andrews government is responsible for all of this. It’s a similar story throughout the dept and the gov. The vast vast majority of MH staff got no surge payment which was a huge duck you from him despite being redeployed and treated like s**t by the org. Andrews slow played the recent EBA negotiations meaning we haven’t had a pay rise for 2 years.

Recently heard that the vic health minister told a senior and very valuable nurse in my org that there would be no $$ for new hospital because there is no votes for Andrews in building NSW infrastructure even if they are paid to run it.

It’s disgusting. I’m totally and utterly burnt out.

Can I ask what type of allied health? I would think some disciplines more useful than others. Eg social work more than OT. Or is it “peer support workers”? I think there was pressure from the royal commission to increase lived experience/ peer support types (not that there’s actually many of these outside the cities)
Mind I don’t find nursing leaders necessarily good- find those that stop visiting frontline regularly lose touch.
Aren’t sentinel events reported via riskman and so significant (isr 1 and 2) get externally reported/ reviewed?

 

[Crankyhawk]

Nah we need way more consultant doctors. You should not have to wait more then 24 hours to see a consultant and yet you often have to wait months, even though you have a gps referrel. Thats a lack of supply issue that should not exist in a modern society.

plus we also have a massive lack of supply of both hospital beds and doctors to manage those beds. Hospitals and doctors are far too focused on turning over patients because they lack both beds and staff. insufficient treatment results when the priority is to turnover patients and not solely to treat them. Oh and doctors should never have to work more then 8 hour shifts. A lack of supply results in the ridiculous hours doctors work. you dont want to see a tired doctor. Its the most important job in the country.

A modern society should have so many doctors and hospital beds that most of the time doctors are sitting around idly waiting for a surge in patients that may come if we have a bad flu season or you know, a major pandemic. We should always have extra unused capacity for something as important as health.

There are a lot in private system. And plenty in inner city; outpatients (which is part of your complaint) has limited physical space. This limits the number of vmo which can do a clinic.
On the inpatient side we need 7 day a week senior decision makers to facilitate appropriate discharge (junior docs default to keep patient for consultant review). Beds though are a function of nursing (due to ratios) more than doctors; though I admit there are bottlenecks from inefficient inpatient processes to getting patients out when they are ready in a timely (hours) fashion

 

[Cyber_punk]

I've worked in the system, especially ED departments. Has been s**t for years. Staff and resource shortages have always been an issue and staff morale has been low whether it be doctors, nurses, psas or cleaners. Toss in more funding cuts and it's just a clusterf. A lot of people in management are completely unapproachable. Purely there for the power trip and wouldn't spit on their workers if they were on fire.

 

[Seeds]

There are a lot in private system. And plenty in inner city; outpatients (which is part of your complaint) has limited physical space. This limits the number of vmo which can do a clinic.
On the inpatient side we need 7 day a week senior decision makers to facilitate appropriate discharge (junior docs default to keep patient for consultant review). Beds though are a function of nursing (due to ratios) more than doctors; though I admit there are bottlenecks from inefficient inpatient processes to getting patients out when they are ready in a timely (hours) fashion

Im not saying the problem is constrained to a lack of consultant doctors. Nurses, beds, junior doctors are insufficient as well.

the entire health system should be double the size it currently is. and the rational taxpayer would be happy to pay for it knowing that if they get ill they can get treatment straight away and not just when its an emergency. We also can avoid lockdowns the next time a pandemic happens.

it might also change doctors attitudes about treatment. Not focused enough on preventative treatment (as they dont have time). Too focused on making decisions based on the most probable outcomes rather than the worst case outcome (the most probable outcome doesnt always occur). The former approach is fine for every industry except health. Too focused on sending patients home and marking it off as successful treatment rather then taking the risk averse approach. The KPIs used by some medical teams within hospitals are not only wrong but grossly immoral. lack of resources is the cause.

queues are shorter in the private system because there are more doctors per private patient supply. it should be like that in the public system too. But even in the private system their are major bottlenecks that are caused by lack of supply which push out wait times for too long. They just arent as extreme as the public wait times. And yes there are some doctors with little to do And earning little in pay as a result. Thats not an oversupply problem though. Its a problem created by a poorly operating health system that cant properly allocate its resources.

 

[Crankyhawk]

Im not saying the problem is constrained to a lack of consultant doctors. Nurses, beds, junior doctors are insufficient as well.

the entire health system should be double the size it currently is. and the rational taxpayer would be happy to pay for it knowing that if they get ill they can get treatment straight away and not just when its an emergency. We also can avoid lockdowns the next time a pandemic happens.

it might also change doctors attitudes about treatment. Not focused enough on preventative treatment (as they dont have time). Too focused on making decisions based on the most probable outcomes rather than the worst case outcome (the most probable outcome doesnt always occur). The former approach is fine for every industry except health. Too focused on sending patients home and marking it off as successful treatment rather then taking the risk averse approach. The KPIs used by some medical teams within hospitals are not only wrong but grossly immoral. lack of resources is the cause.

queues are shorter in the private system because there are more doctors per private patient supply. it should be like that in the public system too. But even in the private system their are major bottlenecks that are caused by lack of supply which push out wait times for too long. They just arent as extreme as the public wait times. And yes there are some doctors with little to do And earning little in pay as a result. Thats not an oversupply problem though. Its a problem created by a poorly operating health system that cant properly allocate its resources.

Part of the preventative issue a lot of the specialties (surgical, emergency, ICU) are not geared/ trained in preventative medicine. For example my reaction when someone (often sent in by GP or pharmacy) comes in with asymptomatic hypertension (BP say 180 or even 200 +) my reaction is "wtf are you doing in my ED, theres nothing I'm gonna do and if I increase your medication I could drop your blood pressure too fast and cause dizziness and collapse. And if you were admitted (even in the setting of beds galore) I would likely be doing harm (risk of nosocomial infection, DVT etc)"

Last night we had a 96 yr old from residential care with painless urinary bleeding. Had a histroy of prostate cancer, which unsurprisngly causes... painless urinary bleeding. The patient had been sent in pretty much against the better judgement of family (after the 4th time the facility called them; this is a family who do visit the patient every day and didn't think he was distressed or needed to go to hospital). WHen I spoke to the nursing home it appeared that this issue was that the GP wanted an ultrasound and one wasn't going to be available until early JUne, so the facility people thought "the ED will make it happen faster"

Which I did not, I told them there was no way I was going to start the path of investigation on a 96 year old man

And even in the relatively short time he was in ED (3 hours) he arked up multiple times due to dementia, wanting to climb out of bed, sometimes able to be reassured by the fantastically attentive staff member, but it eventually got too dangerous and we had to chemically sedate him. As in get a bunch of security, hold him down and jab him with droperidol.

The ED would be a s**t tonne better off if there was some recognition in the aged care community about when transfer is actually pointless. And risky.