Monday 7 September 2009

NSW public hospitals once more becoming thought of as a place you go to die?


When I was a nipper a hospital was considered a place you went to die.
By the time I became an adult hospitals had become places where you went to be treated and maybe if you were lucky, cured.
Now as I get even older and read the growing litany of medical errors, I begin to wonder if perceptions are swinging back again and we're once more becoming afraid of hospitals?
Take this old man left on a bedpan for so long in a public hospital that he had to have surgery for the ulcers this disgusting neglect created.
NSW Health Care Commission media releases over the last twelve months don't instill a lot of confidence either. Neither does the growing list of doctors, nurses, pharmacists, psychologists etc. who are either reprimanded, suspended or deregistered in this state.
If you want a real scare - just read this May 2009 Medical Journal of Australia article which looked at the chances of survival if a baby is born in a public hospital:
"After adjusting for the same maternal variables, serious adverse neonatal outcomes showed similar differences between the two hospital groups.
Term babies born in public hospitals were more likely to require high levels of resuscitation, to have an Apgar score < 7 at 5 minutes, and to require admission to a neonatal intensive care facility or special care nursery (Box 3).
Perinatal death was twice as likely for babies born in public hospitals.
Even using a composite for adverse perinatal outcome (patients with at least one adverse outcome), the unadjusted OR was 1.30 (95% CI, 1.28–1.33) for public hospital deliveries.
When the adverse perinatal outcomes were compared individually by method of birth, the differences between public and private hospital sectors persisted for all the adverse outcomes studied (data not shown).
For example, for spontaneous vaginal births, the rate of Apgar score < 7 at 5 minutes was 0.9% in the public group compared with 0.6% in the private group.
The differences for forceps deliveries (1.6% v 1.1%), ventouse deliveries (2.1% v 1.4%), and caesarean sections (1.3% v 0.5%) showed a similar pattern.
The rates of perinatal death were similarly lower in private hospitals for each method of birth: spontaneous vaginal birth (0.2% v 0.1%); forceps delivery (0.5% v 0.2%); ventouse delivery (0.2% v 0.1%); and caesarean section (0.3% v 0.1%)...
Conclusion: For women delivering a single baby at term in Australia, the prevalence of adverse perinatal outcomes is higher in public hospitals than in private hospitals."

So Prime Minister Rudd - when are you going to fix this appalling state of affairs?

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