I left UK in 1959 though I have visited in 66 76 86. The system here has
been chopped about by politicians who later regretted what they did but they
by then had retired with money and "honour".
We cannot afford our 'free' at point of service system - waiting lists
control some of the demand
but they are politically unpopular. The States who, with Federal extra
funding, have to foot most of the secondary and tertiary care are doing this
by closing beds which again increases lists.
Reducing bed stay times and using day surgery helps but there is a limit
before the demand overwhelms the system.
In GP the majority accept the Federal rebate on their fee about 10UKP for
6-20 min consult-called 'bulk-billing. This leads to rapid turnover of
patients. Who are not tied to a practice. Many GPs have
now joined clinics which are owned by businessmen who also run pathology
and extra services( paid for by the Federal (central government) which are
fed by the bulk-billing GPs who are paid a % of their gross turnover.
The figures seem to indicate that about 25% of GP see more than 10 000
consultation/year.
So far no controls have worked. One of the side effects is that it is no
longer profitable to work
in the rural areas - the legal ramifications of a series of legal cases
also is a major problem.
No one, not even newly trained obstetricians, seems to want to deliver babes
- I wonder why?
However no politician who wishes to be re-elected can do anything sensible
but tinker with
the system. The remedies are some linkage of patients to a GP, co-payment
so they think
twice before demanding 'free' instant care.
Each GP has a number that is linked to their prescribing/ funding but up
to now if you qualified you were issued one. The Federal government cannot
control the supply, deployment or movement of doctors thus the rural lack
goes unchecked.
I have enjoyed being a GP for 37 years and still work half time. Our group
has always charged
a upfront fee. We have had manageable load, high patient loyalty and clear
consciouses.
I have saved enough to retire on if I do not live to long.
Sorry - complex and long.
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Gerard Flaherty FRACGP 67 Hopkins Street Moonah Tasmania 7009 AUSTRALIA
(The less sad Island south of Australia)
email : [log in to unmask]
Fax 61-03 62781257(new 1996)
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