I’ve heard that health bureaucrats are tearing their hair out – so many reports, so much reading, so many briefings – how to make sense of it all??!! Believe me, I feel genuine sympathy, struggling as I am to stay on top of the reading pile and having not yet made much sense of any of it.
For those in need of some brief relief in these times of overwhelming health reform, we have retired GP Dr Peter Arnold to the rescue. Asked for his thoughts on the recent reforming reports, he has offered the following advice. It may annoy some, but no doubt it will entertain others.
It is impossible to have any system (or systems) of health care which is/are efficient, quick and cheap. Simple economics dictate that any two of the three can co-exist, but not all three. If the goal is an efficient and quick system, then it must be expensive. To think otherwise is wishful thinking par excellence.
Our health professional workforce can never be large enough to cope with the demand. When he was UK Minister for Health, Enoch Powell put it succinctly: “There is virtually no limit to the amount of health care an individual is capable of absorbing.” I am incapable of elaborating on that simple truth – the implications are obvious.
While there is probably plenty of evidence that competition lowers price (which is what the ACCC is all about), I am not aware of evidence that competition raises standards in an area where the consumer (patient) is necessarily and inevitably less knowledgeable than the provider (doctor).
The very notion of competition in an area of endeavour where, in the interests of patients, co-operation is of the essence, is imbecilic. If no one but a registered veterinary surgeon is allowed by law to treat animals*, why are people other than registered medical practitioners allowed to treat human beings? That is the stupid situation where ‘competition is King’ leads a society. If nurses and others want to ‘play doctor’, let them enrol at medical school.
While health care providers should always strive to be responsive to the rational and reasonable demands of their patients, simply doing what the patient wants or asks for does not necessarily make medical, scientific or economic sense. I’m all in favour of improvements – but they need to be incremental. As GK Chesterton put it, “”The reformer is always right about what is wrong. He is generally wrong about what is right.””
To which I would add one of my favourite aphorisms, dating back to 1711, “The most ingenious way of becoming foolish is by a system.” Anthony Ashley Cooper, the Third Earl of Shaftesbury.
With our vast land mass, with our diversity of population and cultures, we need many systems, each appropriate to local need and overall affordability.
* other than people treating their own animals (for which they don’t pay a fee to themselves!)
VETERINARY PRACTICE ACT NSW 2003 – SECT 9
Offence for unregistered person to do restricted acts of veterinary science
(1) A person must not do any restricted act of veterinary science unless the person is a veterinary practitioner.
Maximum penalty: 50 penalty units or imprisonment for 12 months, or both.
“veterinary science” includes any branch of the science or art of veterinary medicine or of veterinary surgery and, without limiting the generality of the foregoing, includes the following:
(a) the examination of or attendance on any animal for the purpose of diagnosing the physiological or pathological condition of the animal,
(b) the giving of any anaesthetic to, or the performance of any operation on, any animal,
(c) without limiting the generality of paragraph (a), the diagnosing of pregnancy in an animal,
(d) without limiting the generality of paragraph (b):
(i) the carrying out of any artificial breeding procedure involving surgery, and
(ii) the de-antlering of deer,
(e) the doing of any act that is prescribed by the regulations as forming part of the practice of veterinary science.