Dr Trevor Mudge, AMA Vice President, with Howard Sattler, Radio 2SM
SATTLER: The New South Wales Health Minister, Craig Knowles, said he was surprised that the level of dissatisfaction with our public health services was so low. And he was talking about a survey that has been done, an international survey that found Australians are fed up with the state of the health care system. That's okay. But it appears that only a minority of people are. The survey was of 1400 people. It found one in five low income Australians admit not going to a doctor or specialist or failing to fill a drug prescription because they can't afford it. 40% put off a visit to the dentist. And the Health Minister in New South Wales thinks the figures of dissatisfaction are low. Joining me now is Australian Medical Association Vice President, Trevor Mudge. Good morning, doctor. How are you going?
MUDGE: Good, Howard, thanks.
SATTLER: Your response to this survey. I mean it's been done by Harris Interactive / Harvard School of Public Health. I don't know who they are, but they've done a pretty big survey. Are they the sort of people you take notice of?
MUDGE: They sound like it, don't they?
SATTLER: I don't know who they are.
MUDGE: I don't have any more information than you. But they certainly sound reputable. And the survey, as you say, looks big enough to produce some sort of results you could depend on.
SATTLER: You're quoted in respect to the story saying that the system has now reached a point of being unsustainable. What do you mean by that?
MUDGE: I think it's only surviving on the goodwill of the people who work within it, as your listeners would know. One of the problems is it's probably an average of five years between most families' experiences of the hospital system, I mean fortunately it doesn't happen to many of us very often, that we have to go to hospital. And so I think it takes a while before there's enough perception in the public consciousness of the problems that are happening.
As the chief medical officer, Professor Smallwood, said in London, the system is fraying at the edges.
SATTLER: Does it worry you, too, a lot of people are actually ill but not going to the doctor, not going and getting the drugs they need because they can't afford it. I mean what's that going to say to the overall health of the community if that's going in?
MUDGE: That is a real concern. I think if society is and should be judged by its capacity to look after its weakest members, and if there are people who are not getting medical treatment that they need because they can't afford it, then I think we would be all judged by it.
SATTLER: Or there's no room, no bed for them, I mean at the end of the day they're all going to finish up in the back of ambulances as emergency cases, aren't they?
MUDGE: Yeah, being driven around and around hospitals until they can find somewhere that will take them. That's another issue, isn't it?
SATTLER: You've got, as you said, the Chief Medical Officer of Australia is saying the system is not well. You've got the New South Wales Health Minister saying he's surprised that the level of dissatisfaction is so low. I mean where are we headed here and how quickly?
MUDGE: The first thing we need is an honest debate about the situation. Our politicians should be being honest with the populace that health care is rationed, it's rationed around the world. It's rationed either by waiting list or by costs, or a combination of both.
The real question is what health services should we provide free to those who can't afford it. And what health services should people have to contribute some of the costs to because no society in the world can provide free health to everybody.
SATTLER: I can see because I do talk to people in the medical field a fair bit, that one of these days there is going to be mass numbers of people working in hospitals who are just going to say I can't come to work today, I've had it. I'm just too tired and I'm worn out.
MUDGE: I think it is already happening. You ask nursing staff in public accident emergency departments, they burn out terribly quickly. You know it's got to the point where it really is just surviving on the goodwill of those who work there. That can't happen forever.
SATTLER: Can I just tell you the other day a close relative was trying to find a doctor to administer a drug to a patient in the hospital, and when she finally found the doctor who could do it, she said he appears to be a bit off the planet, he's a bit spaced out, I'm worried about that, and then she found out he'd been on duty for 72 hours non-stop. Is that unusual?
MUDGE: No, but it's becoming a bit more unusual. The AMA has had what we call a Safe Hours Program that has been running for about five years to try and raise the level of awareness in the hospital system that this is quite unsafe.
SATTLER: Quite unsafe. No wonder they make mistakes.
MUDGE: That's right. All of the studies show that that is unsafe practice. But of course it's much cheaper to get people to work long shifts than to employ more people.
SATTLER: I couldn't work 72 hours straight without making major mistakes I can tell you but I'm not into lifesaving stuff. Thanks for your time today, Trevor Mudge.
Ends