Published Letters

Published in SMH on Monday, March 17, 2008

When financial rewards are given to large organisations such as hospitals for achieving performance targets that can’t be met, because the hospitals don’t have the resources, we should not be surprised that “gaming” occurs. Falsification of records, invention of virtual wards in order to get patients out of the real ward, and any other means of achieving those targets are likely to be used by bureaucrats who need every resource available.

It is wrong, but it happens everywhere. Audits may diminish such behaviour, but they do not address the real problem: unrealistic performance measures and inadequate resources.

Dr Tim Woodruff
President
Doctors Reform Society

Published in The Age on Wednesday, March 12, 2008

Our emergency departments are struggling to attract and retain staff. Specialists are leaving the public system for the private system. There are four main reasons. Firstly, there is underfunding of the States from the Federal Government. Secondly, there are patients in hospitals who should be in Aged Care facilities. Thirdly, there are patients requiring admission to hospital because they haven’t received adequate care in the community. Fourthly, the promotion of private health and hospital care through the Private Health Insurance rebate makes private practice more attractive to public hospital doctors and other health professions, contributing to public hospital workforce shortages. All of these are Federal Government responsibilities. Could the result be just what it has planned since 1996, the Americanisation or privatization of our health system? In emergencies most of us rely on public hospitals, irrespective of our capacity to afford private health. This is perilous policy for all.

Dr Tim Woodruff
President
Doctors Reform Society

Published in SMH on Wednesday, September 26, 2007

Medical devices are like drugs, they save lives. They also make large profits for their manufacturers. This is big business, and shareholders require profits. Marketing is crucial. Health outcomes are important but are definitely not foremost in the minds of those who control these businesses. We doctors interact with them at great peril, because they are masters of marketing, having sustained huge profits for decades through their skills.

We doctors are susceptible to marketing pressures despite claims by some doctors of a god-like capacity to remain unaffected. Whilst such companies can wine and dine us, take us on overseas trips to conferences at 5 star venues, and generally attempt to woo us in perfectly legitimate ways, there is a problem. Codes of conduct guidelines and self regulation are no match for the power of the marketer.
We need to keep these businesses at arms length, and for that to happen we need a combination of funding to fill the holes in education, training, and research which these businesses currently fill, and regulation to control our interactions with them.

Dr Tim Woodruff
President
Doctors Reform Society

Published in The Age on Monday, August 13, 2007

Paul McMurrick is looking for a solution to the issue of the underfunding of the public health system and the taxpayer funding of the “private” taxpayer-supported system (Letters 10/8).

It’s so simple. Remove taxpayer support for the private system, starting off with removing it from the private health insurance rebate. Spend the savings in the public system. That way, the public system could gradually take most of the “good” things Cabrini Medical Centre and other publicly funded private hospitals have started to do, and which the public system used to do before. That way the credit card would not determine access to care.

Dr Tim Woodruff
President Doctors Reform Society

Published in The Age on Wednesday, May 16, 2007

The Opposition’s rejection of changes to the Private Health Insurance (PHI) rebate is a sad confirmation that neither of the major political parties accept that this $3 billion per year subsidy of the private health industry is both inequitable and inefficient. The rich are being asked by the Rudd Government to pay for the luxury of a short waiting time for surgery or for their private maternity services. How can Mr Turnbull object to that when over half of all Australians must wait for the underfunded public system for their care?

But whilst the Rudd Government has announced changes to the PHI rebate, it will do little more than save $500 million per year. It will not affect the growth of the private hospital sector which is dragging specialists out of the under-resourced public sector. Nor will these savings be earmarked to rebuild and properly finance the struggling public sector.

The 56% majority of Australians who can’t afford PHI will continue to be ignored by both major parties as both parties commit to private affluence and public squalor. Who cares about those who can’t afford private health insurance?

Dr Tim Woodruff
President
Doctors Reform Society

Published in SMH on Tuesday, May 1, 2007

Despite the evidence that the $2.5 billion private health insurance rebate has minimal effect on public hospital waiting times (“Insurance rebates fail to ease pressure on public hospitals”, May 1), the continuing evidence that out-of-pocket costs, including payments for pharmaceuticals, are a serious burden for many patients, and the previous evidence that the Medicare safety net funding is going mainly to people in the wealthiest electorates, there is nothing yet from either major political party to address these issues.

It would seem that so far people on waiting lists and people who struggle to afford proper health care are invisible in the lead-up to this year’s federal election.

Dr Tim Woodruff

President

Doctors Reform Society

Published in The Age on Saturday, January 6, 2007

That private health insurance premiums may not rise as much this year might seem to be good news, but a reality check is worthwhile. For the last five years premiums have risen at twice the rate of inflation, making private health cover less affordable every year for those Australians rich or desperate enough to have such cover. This year the news is that the premiums will still be higher than inflation, just not quite as bad.

Meanwhile, public health insurance premiums – taxes and the Medicare levy – used to fund public health care, have fortunately missed out on such huge increases. Income tax rates have decreased and the Medicare levy has risen only if one’s income has increased. The big winner: private health funds’ profits; the big losers: all Australians, because every increase in premiums means more taxes into the private funds through the rebate, leaving less to spend on our ailing public system.

Dr Tim Woodruff
President
Doctors Reform Society

Published in The Age on Saturday, August 5, 2006

RE DOCTORS and the drug industry ( The Age, 4/8). Yesterday, I received an unsolicited gift of a large chocolate cake from a drug company, decorated with its name and product. I presumed the company wished me to share it with my staff, and perhaps my favourite patients of the morning. It’s called marketing.

Despite the Australian Medical Association’s insistence that doctors are superhuman and unaffected by marketing, the evidence points the opposite way. Self-regulation for the drug industry is a farce. Yesterday’s reports demonstrate that self-regulation of doctors doesn’t work. Detailing gifts and perks to doctors on the internet as proposed by the Australian Competition and Consumer Commission is good but tinkering at the edges. It’s time the Federal Government regulated the industry and doctors and/or vastly expanded its paltry $20 million a year spending on drug education for doctors.

How can this compete with the industry’s $1 billion marketing budget?

Dr Tim Woodruff, president, Doctors Reform Society, Richmond