Abstract
Mat Gelman, Dandenong Hospital, Melbourne, Australia:
William Sutton was a notoriously prolific bank robber. A master con-man and impersonator, he was a stickler for stealing only from banks. A massive America-wide manhunt eventually found him. The head detective then asked him why he'd stolen solely from banks. Sutton replied ‘Because that's where the money is’.
This, however, was in an era before managed care and diversions in health dollars.
Professor Larkins College Oration [1] noted health to be a human right ‘and it is a national disgrace to see [it] made less accessible when we gloat about our economic success’.
To cite examples of these disgraces: a colleague's previously well father at 55 had a first episode of angina. He saw an eminent cardiologist who requested a next day angiogram. A clerk at the health insurance fund blocked this. She said payment couldn't be made for what she portrayed as a pre-existing condition. In pleading unsuccessfully for her father the registrar met with stonewalling statements such as that government regulations prevented any leeway.
Further unholy alliances and values have manifested in more systemic contexts. Callous economically driven values were introduced into two hospitals I worked in. One was to be decommissioned, the other shamefully degraded. Both were highly regarded by patients and their families. They had continuity of high quality care, were remarkably humane and effective. In their devolution psychopathic processes were prominent.
In retrospect what's most worrying is that long-standing staff, myself included, took largely philosophical attitudes. From my reading, ‘I'm alright Jack’ isn't listed among the healthiest defences.
Freud wrote of denial in our attitude to personal mortality, of the unconscious never accepting the reality of one's death.
By extension are we denying the death of the highest quality public health system? Not to mention the emerging stealth victory of a callous and destructive ethos and its duplicitous practitioners.
It wasn't so long ago I was a medical student. A proud excellent health system seemed as safe as banks.