The NSW North Coast Area Health Service took the region by surprise this week when it announced that it would be withholding some hospital beds from normal use and instituting a policy of 'treatment in the home'.
No mention was made of how such home treatment would be implemented by community nursing already stretched by the North Coast's increasing population and changing demographics.
Nor was there any indication of whether it was expected that local GPs and their practice nurses would play a part. Which given the limited number of bulk-billing medical practices in certain areas, would involve patients in additional costs.
No consultation with local communities was advertised. I'm left wondering exactly which chronically ill patients the NCAHS chief allegedly consulted with, and whether those consulted happen to fall within a socio-economic band which allows them greater facility to draw on other home assistance which would make home treatment an attractive personal option.
Certainly the frail-aged pensioners of my acquaintance, with no family living close by, would not be clamouring to receive home treatment during episodes of illness normally requiring hospital admission.
It is distressing to see North Coast residents short-changed in this way.
According to ABC News yesterday.
"The nurses' association is meeting the North Coast Area Health Service executive this afternoon over a plan to slash bed and nurse numbers across New South Wales north coast hospitals.
The plan would see more than 80 beds at 14 north coast public hospitals converted into 'surge' beds for seriously ill patients at times of high demand.
Less ill patients would be treated at home or at outpatient clinics.
Union organiser Susan Pearce says the initiative was to have come into play today, but is on hold because health management failed to consult nurses.
"We're just amazed that they would seek to introduce such a change today without any consultation with our members whatsoever. It doesn't set us off on a good track for discussion about this particular issue," she said.
The chief executive of the North Coast Area Health Service, Chris Crawford, is defending the surge-bed plan.
He says the strategy is the result of consultations held with medical staff and chronically ill patients.
"Particularly patients have given us feedback that they'd prefer to be treated in their homes if they could be in a familiar environment rather than having to go to hospital," he said.
But the chairman of the Port Macquarie Base Hospital medical staff council says the move has taken it by surprise.
Dr Steven Begbie says it has been working with the area health executive to try and solve the bed crisis at Port Macquarie Base Hospital.
"There is a vision to increase the footprint of the hospital so that we can have more beds, an increase in services, and yet this plan comes out of left field as an option that reduces the beds in our hospital on a day-to-day basis," he said."
4 comments:
Could this be a surrogate sign of something much more extensive. Some lateral thinking will link this with a reported activity:
In the Tweed News...
http://www.tweednews.com.au/localnews/storydisplay.cfm?storyid=3763209&thesection=localnews&thesubsection=&thesecondsubsection=
or
http://www.tweednews.com.au/localnews/storydisplay.cfm?storyid=3762190
or
http://www.smh.com.au/news/national/anaesthetists-set-for-walkout/2005/10/14/1128796712313.html
(I wonder whether some executives take a cut from the locum fees)
or
http://www.cansdell.com/pages/showspeech.php?recnum=66
or
http://www.echonews.com/1151/index.html
(the guy earned $250K per year declared)
Can removing beds also cover up for the disappearance of funds?
Unknown (or not widely known):
Cost shifting happens like no one's business. How many hospitals iin the North Coast have privatised clinics and have Staff Specialists work full (and over) time) in them?
In 2006, there was a Staff Specialist whose Medicare Provider number was used in irregular claims. He was put in a privatised clinic full time without his knowledge when appointed.
When he inquired of management after Medicare cautioned him on cost shifting, he was suspended and fabricated allegations (by the CNC) on a NSW Health Level 2 risk rating, when in truth it was 4, at best 3 (managed internally).
A level 1 or 2 risk is like a Dr Patel affair and is automatically referred to the NSW Medical Board
He was put through a tawdry investigation and then dismissed from his post despite the fact that the investigation did not lead to the NSW Medical Board Disciplinary Action.
Since, he has left the country to seek employment elsewhere with great difficulty.
The Commonwealth Dept of Health and Ageing is now investigating the NCAHS for cost shifting and 'incorrect claims'
Several of this specialist's patients have come forward with Stat Decs to indicate that that their names had been used falsely in these allegations.
Shocking indeed.....it is said that Geoff Provest knows the story and will use this as another example of alleged corrupt practices.
Guess what? No prizes for guessing that Crawford is various signatory of the Trust Fund Medicare claims (Staff Specialists receive salaries from Commonwealth to State budgets) go into! The question now is who else is involved in the plot?
Trish Hogan may wish to be perceived to be at loggerheads with Crawford but in reality they are thick as twin siblings in this scheme.
Treatment in the home via a privatised outpatient facility in cahoots with GPs (or by itself) attracts Medicare Australia benefit claims.
You can imagine how this can shift state budgets awarded by the Commonwealth on the Australian Healthcare Agreements back to the Commonwealth.
The 2003-2008 agreement which NSW signed was different from the rest of the Australian states and it had special conditions which disallowed what other states could legally do.
By this, NSW received more money and yet, NSW Health has been biting a larger share of the Commonwealth cake by cost shifting.
Meanwhile, it is emerging that Crawford (and cronies) is a master of 'consultation' as his idea of consultation and communication with others seem to involve “I, myself, and me”, i.e. he consults himself and makes the rules up as he goes along.
The same pattern appears for 'Assoc Prof' Trish Hogan. She is a part timer AP at Griffith Uni in Qld but conveniently applies the title in NSW at Tweed (it is inappropriate as she does not hold a personal title)1
Try this!
$250000 of funds unaccounted for at Murwillumbah!
http://www.tweednews.com.au/localnews/storydisplay.cfm?storyid=3763209&thesection=localnews&thesubsection=&thesecondsubsection=
Someone should alert ICAC
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