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08 Jul 2014

By Dr Ludomyr Mykyta AM, Consultant Geriatrician

Life just got a lot worse in the compassionate society with the best health care system in the world. I need to share my dismay.

I have always more than suspected that the concept of political ethics is an oxymoron. In the period prior to the election of this Government, propaganda had replaced reasoned debate, appealing to our fears and basest instincts. I cannot envisage that anyone who practices such deception can be an ethical and moral person.

Political parties may be able to justify their actions to each other on the principle that the end justifies the means. But parties are made up of individuals, many of whom are practitioners of a profession or trade that is guided by a code of ethics. I wonder how they live with their consciences.

I only vote for people and parties that I respect. That leaves me voting for independents and minor parties in the forlorn hope that the winner will have to form a genuine coalition that will “keep the bastards honest”.

Professional ethics is very important to me, and I lose sleep over decisions that may potentially cause harm to other people. I hope that that is true of all people who aspire to act as ethical professionals.

There has been much talk of “pain” before and since the recent Budget. It has been expounded on and by experts in macroeconomics. There has been talk of the political and electoral pain that may be experienced by some Coalition politicians.

If we look at harm, rather than pain, how much suffering will be a direct outcome of the changes in this Budget?

As a consultant geriatrician, I specialise in the care of people suffering from dementia and their families. I have bulk billed everyone I see for years.

Most of the patients that I see are very reluctant to seek medical advice for a variety of reasons, including their inability to perceive that they have a problem. Many have to be persuaded that such consultation will not cost them anything.

I have seen millionaires who believe that they are living in abject poverty. I have also seen many, many people for whom a co-payment would be a very significant burden. I will not stop bulk billing, and the co-payment will erode my already relatively modest income.

The Government talks of taking hard and courageous decisions for the sake of future generations. This Budget has dealt the health and aged care systems a lethal blow. Future generations will have nothing to be grateful for.

The ageing of the population is no surprise. It has been more than highly predictable for over a generation.

We had models to study. I, like many people interested in gerontology, made the pilgrimage to Western Europe and Scandinavia, where similar prosperous countries were already coping with the ageing of their populations. Our models of aged care were superficially based on what we saw. No effort was made to understand how these services were organised and funded in these societies.

In retrospect, the introduction of what is now Medicare was a miracle. It could not happen now in the polarised, populist atmosphere that prevails.

We need another miracle. We already fail to meet the needs of our most vulnerable people, the true measure of a compassionate society.

The health and aged care systems are fatally flawed. Tinkering with obsolete and dysfunctional structures and systems can never do anything but fail to meet the needs of more and more people.

Successive governments of both persuasions have failed to make the hard and courageous decisions needed for the benefit of the nation and oblivious of self-interest.

Their only discernible goal is winning an election. They do not risk alienating powerful interest groups and individuals and their idealistic fellow-travellers.

As a profession we must examine our consciences and become more visible and true advocates for our patients.


Published: 08 Jul 2014