Thursday, November 01, 2007

Read My Lips...

"Your mission, Kevin, should you decide to accept it, is to radically cut elective surgical waiting lists. Your target is to ensure that no patient is waiting beyond their waiting list category time. As usual, should you or any member of your I.M. Force be captured or killed, the secretary will disavow any knowledge of your existence. This tape will self-destruct in five seconds. Good luck, Kevin."

OK, team. This is going to be a tough one. It's going to take all of our espionage skills of misdirection, camouflage, trickery, deceipt, and social engineering to carry it off. Here is our 10 point strike plan:
  1. Spend some money to give the appearance that we are doing something that might work, even if it won't. For example, let's take, say, $100 million and give it to private hospitals, because public hospitals are crap. They can take care of a few thousand patients in the short term to buy us some time. We all know the patients will keep being added to the waiting lists faster than we can operate on them, but at least we'll look good.

  2. Let's ring up as many waiting patients as possible and try to convince them that they don't really need or want the operation. Even better, if they don't answer the phone or we lose their phone number, we'll say that we tried our best but have no choice but to take them off the waiting list.

  3. We can starve the public hospitals of funds to buy or maintain essential equipment to do operations. If the hospital is physically incapable of doing the operation we can justify delaying these operations and classify the patients as "Not Ready For Care".

  4. Ring up some more patients and tell them that they can have their operation at another hospital more quickly, as long as they agree to be done by a surgeon that they've never met, who won't talk to the surgeon that they have met and who may or may not be as good as the original surgeon. Then they will have to repeat all the tests again only to decide on the day of the operation that maybe they didn't need the operation in the first place. If the patient refuses we can take them off the waiting list, or say that it's the patient's fault that they are waiting.

  5. Fine hospitals even more for having patients waiting beyond their projected waiting time, so that hospital administration pressures the doctors to clinically reclassify patients to a less urgent category. It won't be our fault, because we'll just provide the incentive to perform better, as long as hospital executives don't tell us what they are up to.

  6. Redefine the waiting list categories so that the projected waiting periods are longer than before. That way it will be harder to run over time.

  7. Define the official date that a patient goes onto the waiting list as the date that the clerks type the form details into the computer system, not the date that the doctor filled out the form. That way we can have an extra month of physical waiting that doesn't count towards the statistics.

  8. Give the clerks in the waiting list office more tea breaks, and put them in a small, dark, cramped, noisy office to minimise their productivity. Therefore it will take longer before a waiting list form is physically processed, and the official waiting period will start later.

  9. Refuse to add patients to the waiting list unless they have their operation physically booked before entering it into the computer. That way, not only do we stay within the official target times, but we look fantastic because the patient can be physically waiting 3 months, and officially waiting one week.

  10. Stop these bloody doctors from putting patients onto waiting lists in the first place - let's block entry into outpatients by creating a waiting list to see a doctor, and then offer to let them see a nurse practitioner who will tell everyone that they don't need an operation. We can trust nurse practitioners to do what they are told.

The detailed operational plan can be reviewed here.



Labor pledges $600m to cut surgery waiting lists

ABC News Website
Posted Wed Oct 31, 2007 3:15pm AEDT
Updated Wed Oct 31, 2007 5:28pm AEDT


Federal Opposition Leader Kevin Rudd has unveiled details of Labor's $600 million commitment to slash elective surgery waiting lists across Australian public hospitals.

The money forms part of Labor's previously announced $2 billion health commitment.

Under the scheme, a federal Labor government would hand $100 million to the states and territories to enable public hospitals to purchase operations from private facilities.

Mr Rudd says there are 25,000 Australians on elective waiting lists who have passed the recommended time for surgery.

"The 25,000 people we are talking about, they are there now OK," he said.

"We've got an election due in November. If we win that election what I want to see is money flowing as of January 2008, out to the states and territories in order to make payments to get that 25,000 number down to zero by year's end."

But in return for the funding boost, the states would be expected to report back on their progress.

"As we speak, we will not be extending to the states a blank cheque for any of these amounts of money," Mr Rudd said.

"We will be insisting with the states that report cards be produced."

1 comment:

Milk & Two Sugars said...

Ha! As if the problem was empty, unused theatres, or surgeons not operating! If they really performed 25,000 operations next year - and clearly it will never, ever, ever happen - I foresee a year in which I'm required to be a surgical assistant all day and every day.

Honestly, I'm a bit relieved! But I feel for our patients when we tell them it'll be 2 years til their knee replacement, 6 weeks til we cut out their cancer, and so on.