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Hidden costs of private hospitals

Written By: - Date published: 2:39 pm, May 26th, 2008 - 13 comments
Categories: health - Tags: , , , ,

If you’re paying for your health care you’d expect good service wouldn’t you? The release of four health commissioner decisions over the weekend and covered by the Sunday Star Times, focused attention on private hospitals and the potential for catastrophic outcomes from relatively minor operations.

According the report, Health Commissioner Ron Paterson says the cluster of cases “tells us that sometimes people go in for relatively minor surgery in private hospitals and things go very badly wrong there” and that patients should be aware of the lack of a “safety net” of the public hospital team when they are in the hands of just one private specialist who has ultimate responsibility for their care.

Those who suggest the private health system is the answer to our heavily committed public hospitals may have to think again. Currently about 3 per cent of publicly funded elective surgery is done in the private sector.

13 comments on “Hidden costs of private hospitals”

  1. Daveski 1

    Is that it – 4 cases in nearly 10 years??

    Obviously, it’s 4 cases too many but this is a media beat up.

  2. Stephen 2

    As Rodney suggests, perhaps MORE than 3 per cent should be done then, if rather large waiting lists are any indication of how many people are…waiting. That is based on the assumption that private hospitals have more spare capacity than public ones. By the looks of it, some public ones have none!

    What I find interesting is the concept of the “safety net’ – many would recall Roger Douglas’s proposal to let surgeons hire hospital facilities, such as is the case with Wakefield here. It seems to me that it’s very difficult/impossible to call on other staff for help in a private hospital when something goes wrong, as opposed to pressing the panic button in a public hospital…

  3. Stephen 3

    Yes, perhaps a beat-up…I don’t think the quality of the surgery is much different, it’s the ability to carry out operations as soon as possible that seems to be the private sector’s advantage. They probably provide better post-op care (e.g. not leaving people to sleep in corridors due to lack of space) too, even in the face of this incident.

  4. erikter 4

    You’re obviously averse to the notion of private hospitals, but other people like the idea and, given a chance, would prefer it to a state-funded health system.

    What about rebating taxes to those who choose private health insurance? Extend the approach to education and you’ll find the whole proposition very attractive.

    Of course, it means less power exerted by the state and more reliance on personal responsibility, both concepts abhorred by the Left.

  5. Stephen 5

    erikter, if you’re going to answer for him, why bother asking at all?

  6. mondograss 6

    One of the problems is that many people only access private healthcare via insurance, which allows the private hospitals to cherry pick the things they do so they’re only doing the profitable work. Other less profitable work gets dropped back on the public system, as do all their screwups (See Michael Moores ‘Sicko’ for examples of how they do this).

    I am aware of many people who have had operations go wrong in the private sector and have had to get the public system to fix them up. Luckily none were fatal but several could have been. So this isn’t a beat up. It’s just that private hospitals don’t need to provide the data to evaluate their effectiveness.

    If you allow rebating of taxes you get into arguments about whose responsibility a particular condition is. The private hospital will (and do) say, sorry not covered for that. If the public hospital disagrees, what happens? Does the patient die waiting for the court case to sort it out? Or does the public hospital have to take the case anyway and try to reclaim costs (which then get chewed up in lawyers fees). A dual system doesn’t work unless the public system accepts ultimate liability for everything and tax payers fund it accordingly.

  7. MacDoctor 7

    There is absolutely no evidence that you are more at risk in a private hospital as opposed to a public one. Quite the opposite. The vast majority of serious hospital-based complaints on the HDC website involve junior, inexperienced doctors and poorly executed handovers. Both of these are entirely public hospital problems.
    In addition, the resuscitation facilities at private hospitals are, in my experience, usually top-of-the-line.
    The credentialling issue is hardly one in which the public hospital system can claim superiority, given their track record so far.

  8. MikeE 8

    As opposed to the Public hospital that nearly killed my mother, and killed numerous others….at National Womens

    With the right to sue being removed by ACC..

    http://www.womens-health.org.nz/cartwright/unfortunate.htm

    Or the last time I went to a public hospital having them lose my records at Auckland Hospital?

    Or my father having his cancer spread to his lymph nodes resulting in his death due to shitty treatment at Greenlane?

    Need I go on?

  9. higherstandard 9

    Can I suggest that one’s outcomes in either the private or public system have more to do with the competence of the senior physician than whether it is public or private hospital.

    Although Ron Patterson makes a fair point that

    “There is a symbiotic relationship between the private hospitals and the specialists the people they are credentialling are the people who provide their business,” ….. Given that potential conflict, it seems particularly important there is a rigorous process.”

  10. mondograss 10

    OK, so there are always plenty of examples on both sides. Doesn’t change the fact that the public system has to remain the safety net and the more you stretch it, the more holes it’s going to have. Private hospitals may well ease the load, but rebating taxes on the basis of having private health insurance just stretches the system further.

    The second point I would make is that if you have private hospitals regularly contracted to do public work, then you’re strengthening the competition for already scarce human resources. Many surgeons work across both sectors, often simultaneously, and the more that can be done privately, the less they’re available for the public work.

  11. burt 11

    I expect quality service from the public system I’m amply funding. So where do I go… which is higher risk, waiting list and public or private? How urgent am I, will I survive the wait and consume the services I paid for many many times over or will I pay some more and get on with it allowing the scare public resource I’ve paid amply for to be used by somebody else?

    This is the choices after 9 years of Labour-led govt. You cannot call this entire situation anything other than a complete failure if you are saying private is not an sensible option for people who can afford it when we have such long waiting lists. Remember who the systems are here to serve, it’s not the polls and it’s not themselves, it’s the patients.

  12. burt 12

    An ACT style ‘operation voucher’ would solve this problem. The voucher would entitle you to a place on the waiting list or (x) thousand dollars toward a private facility.

    Presented with a $20,000 voucher (or whatever it costs) for a hip replacement, people would have a choice of joining the waiting list (status quo), or redeeming the voucher with a certified third party provider. Many people given the choice of waiting 2 years or paying an additional $5,000 (for example) would take the private option. Taking their investment in their own health as a ‘citisen provided for by the public system they fund’ and using it to get the job done.

    What’s so repugnant about this?

    How would you feel about a missionary eye surgeon who had worked in Africa setting up shop in Akl taking the public health vouchers for cataract surgery. Delivering the service and having enough change to give a $1,000 donation to his mission and a free widescreen tv to every patient.

  13. burt 13

    Dancer

    It appears the govt is extending the program of using the DHB’s to manage third party providers. Can’t see them going for it, that got the Hawke’s Bay DHB board sacked.

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