It has been revealed that the New South Wales Government is planning to announce a policy which makes significant changes to the way that patients access public health services through the Accident and emergency Department. It appears that the plan is for certain categories of patients will be diverted to other units to address there needs. For example, so called “frequent flyer” senior patients will be sent to a Medical Assessment Unit, while chronic patients are to be sent to Care Co-ordination Centres. These units are to be co-located alongside Ambulatory Care Units and the Emergency Departments.
While there is a great deal of merit in the idea of providing a range of more tailored streams of treatment apart from simply admitting patients to already overcrowded wards, concerns have been raised about the proposals.
Dr. Tony Joseph of the Australasian College of Emergency Medicine has suggested that the new arrangements will do no more than create another layer of bureaucracy. It is, he believes, just another obstacle between the patient and definitive medical care. He asks who is going to staff it and where will they get the doctors from? In his opinion, a better solution is to simply increase the staff in the Emergency Department so that patients are seen more promptly.
Another concern is that patients referred to the Care Co-ordination Centres will be separated into those with private insurance and those without. Now this is where the plan is really treading dangerous ground. The fundamental underlying principle of out Public Hospital system is that all patients are entitled to the best available care. If we start separating out the patients who arrive at a Public Hospital on the basis of their insurance status then we have put our front foot on the slippery slope leading to a two tier health system where patients are treated according to their insurance rather than according to their medical needs.
That’s just not the Australian way.