Somewhat socialised medicine

Since Wednesday, Chatterboy has been in Royal North Shore Hospital being treated for pneumonia. On Friday, when he’d turned the corner, the doctors admitted to us that they had been quite worried about him on Thursday, when nothing seemed to be working, and he was lying there, listlessly, on oxygen, not wanting to talk. He’s just come home this afternoon, alternating between wanting to run everywhere, and then sitting down because, “I still feel a bit tired.”

He was a public patient, and received what looked to me like superb care. And I say that even though he spent the first 16 hours of his time there in Emergency because they didn’t have enough beds.

He was in the very new Children’s Ward (new in the last three years at least, since he was last there), which has a school (two teachers who have resources to share out), a play area and a fairy garden attached. It was decorated with children’s paintings, and, while clearly a hospital, there had been an attempt made to cheer it up a bit with small decorative touches around the place. His TV was free, and there was a special entertainment unit available if needed, with DVDs and video games. He was in a four bed ward at first, and then a two bed ward with ensuite bathroom.

Family involvement was enouraged and welcome. Parents could visit any time, and were provided with a cot bed if they wanted to stay overnight (not especially comfortable, but better than a chair in the corner!). There was a special parent’s lounge with free coffee, tea and cereals.

He had two doctors involved in his case the whole time, plus assorted junior ones. They kept him in an extra night just to make sure (although they were pretty convinced) that he could get through the night without needing extra oxygen. The only slightly negative note was that a lot of the nurses seemed to be agency ones – leading to a lack of understanding of hospital routines (only noticeable to me at least, to be fair, on discharge).

And it was entirely free.

A lot of what impressed me about it was not so much the care -notwithstanding that the doctors seemed really thoughtful and interested in what was a slightly puzzling case – but the extra bits and pieces. Chatterboy’s spirits really lifted when he discovered the fairy garden. And he got very excited when the teacher brought some computer games for him to play, even before he was well enough to get out of bed.

I haven’t been a patient in a public hospital, but I imagine that the adults don’t get the same level of small luxuries, or even nice decoration. They’re generally paid for by the various children’s charities, which of course raise money for children, because who wouldn’t give money for sick children? But I’m sure they make a difference to the happiness of patients, and perhaps even their health (the signs in the children’s ward seemed pretty convincing on the importance of psychological health for their pediatric patients). It’s the kind of thing, though, that hospital administrators would find it hard to spend public money on – when the choice is some extra books or video games for the adults, or another of the latest hi-tech diagnostic machines.

I’m glad we look after our sick children so well. But I think (without much direct evidence, admittedly) our sick adults have been becoming second class citizens for some time.

  15 comments for “Somewhat socialised medicine

  1. April 2, 2007 at 6:05 am

    I’m so sorry to hear about your son. You write without emotion but it must have been so frightening!

    When you say free, do you mean the whole visit was free? Or just the perks? I am trying to wrap my head around that. Just read an article in our local newspaper about how three charities working together try to get adequate care to uninsured children in our lovely state. As for insured children… Well, let me tell you this. My neighbor’s 2 kids had RSV and were in the emergency ward for 2 days and it cost her $4000 out of pocket. She has insurance. That’s just the part they wouldn’t cover.

  2. April 2, 2007 at 8:52 am

    Wow, I agree with Jennifer, it must have been very scary. Glad to hear he is doing better and is back home!

    And yes, the concept of ‘free health care’ is just so foreign…I have good insurance (by US standards), and I’m sure I’d still have to pay $1000 or so out of pocket to cover my deductible for a hospital stay of that length.

  3. April 2, 2007 at 4:59 pm

    Good post. I suspect the hospital care really varies for adults, esp in the public system. Might just be the ‘luck of the draw’ within one hospital, too.

  4. April 2, 2007 at 9:17 pm

    It was pretty scary, but I’m not sure I could do the complexity of the emotion justice in a blog post.

    I’m amazed at the level of out of pockets in the US – giving birth, both times, my private hospital cost (which I was $500 out of pocket for) was a total of $5,000, so your actual hospital costs must be a fair bit more than ours also.

    Total costs so far for the week of illness so far: GP visit (net of govt refund) – $20, X-ray (also net) – $30ish, parking $30 ish (plus illegal parking) and prescription drugs on discharge $20. So I’m pretty sure it’s around $100. We’ll have another GP visit before we’re done, but that should be it.

    I’ve seen some research (which I must dig out for another post) that suggests that out-of-pockets don’t lead to more sensible use of the health care system (at least at the primary care level, where patients are making the decisions to use the health care system or not). The general public just doesn’t have enough knowledge to decide sensibly. By asking for money, you eliminate the people who don’t like spending money, not the people who don’t need the care.

  5. April 2, 2007 at 10:39 pm

    Well, I’m just pleased chatterboy is on the mend – that must have been really, really terrifying. We had the high level of agency nurses on dudelet’s ward as well and witnessed one utterly terrifying misreading of medication notes that was thankfully spotted by the mother involved. Hope the overnight beds are a teeny bit more comfortable in Australia.

  6. April 2, 2007 at 10:58 pm

    I’m glad all is better now. Wilder was hospitalized for pneumonia last March, and spent 12 hours in emergency because there were no beds on the pediatric ward, and then spent overnight sharing a bed with Elba (who never did test positive for pneumonia, but was not getting enough oxygen when first admitted) in the observation wing of the ER.

    It’s just plain scary when your kid’s lungs aren’t breathing.

    I was struck, too, by how very, very serious doctors take that. They do not mess around, there is no waiting, the whole arsenal comes out. It makes an impact.

    For comparison, we paid $150 per kid for hospital admit copay, plus $15 per kid for the doctor’s visit that morning that led to the admission. Their antibiotics afterward were about $15 a prescription, because they’re all generics. (Wilder’s allergy meds are still under patent and so max-out the prescription plan co-pay at $35 a month.)

    Of course, we also pay $325 a month for the privilege of the insurance.

    Anyway, I’m really glad Chatterboy is on the mend. May he stay healthy through the upcoming autumn and winter….

  7. April 3, 2007 at 5:28 am

    Sorry to hear of what you have been through, but I am pleased to hear he’s out and on the mend. It’s plain awful when kids are sick, so it’s a relief to know that the care you are getting is of the best kind.

  8. April 4, 2007 at 2:32 pm

    That must have been very scary. I’m glad to hear he’s better.
    I have been a public in-patient twice here. The food wasn’t great but the care was very good and after an emergency birth I was given a private room.
    The agency nurses scenario is a big problem though – not for me, but for my elderly father who spent weeks in the San. The nurses seemed uncommitted and unorganised and I have to say, uncaring. No one seemed to be in charge or to know what was going on.

  9. April 6, 2007 at 10:03 am

    I’m glad to hear Chatterboy is mending nicely. It does make me grateful for the level of free care in our public health system, and furious at the ideological attempts to dismantle it.

  10. April 6, 2007 at 7:19 pm

    I wonder why your post is headed “Somewhat socialised medicine”? If the care for Chatterbox [glad to hear he is OK] was free for you it was subsidised, minus your contribution to Medicare, and socialised.

    Is that a bad thing? Imagine the same situation with your not knowing what the final out of pocket expenses might be.

    It’s a pity children can’t vote – grey power outvotes them at present on the rationing of scarce medical resources; but even so the pickings are thin on the ground for oldies. Maybe Phil Nitschke and his followers need some kind of acceptance – then a lot more money would be available for kids, and oldies with a chance.

    Either way, our local practice of Medicine needs a philosophical / religious shake up.

    I don’t see either of the main political parties looking at that issue. What kind of country do we live in when the hawkish Defence Minister is a Medical Doctor who wears/wore a diamond earring in his left ear???

    Signed: Grumpy Old GP

  11. April 6, 2007 at 9:20 pm

    Suzoz, my experience of agency nurses is actually worse in a private hospital (and they do tend to be foreigners also, which probably makes the routines more different). Nursing seems to be inching closer and closer to some seriously difficult resource issues, but I don’t get the sense that anyone cares enough to think hard about it. Paying them more might help, but I doubt if that’s the whole answer.

    Tjilpi, probably my shorthand was too short. Lest there is any doubt, I think the care I got (being socialised) is a good thing; the point of my heading was that for children (but not necessarily adults) in Australia, socialised medicine means an excellent standard of care. Socialised medicine seems to be a term of abuse (in the US) hurled at anyone who thinks that there should be universal health coverage – in the assumption that socialised medicine must equate to terrible care.

  12. April 7, 2007 at 10:49 am

    Xactly! Most persons in the US seem to think that they know what they are doing about each and every thing on Earth. God gave them the country between those borders to the north and south, no more, no less; plus the land grabs of Alaska and Hawaii, so that the poor should suffer and serve as a example of what happens to people who are not White Anglo Saxon Protestants.

    The whole thing leaves me bushed.

    [I wonder if my outlandish comments on the web might be the explanation for my incoming email being held up by two days or more?]

    Signed: I have a US 12th Grade High School Diploma. Year of ’65.

  13. April 22, 2007 at 12:52 am

    I hope Chatterboy is feeling much better. What a scary experience. Kiko’s (then) three-year-old friend came down with pneumonia last year. With all the vaccinations and medicines around nowadays, it was a nasty shock to me to see pneumonia floor her for more than a month.

    Westmead Children’s Hospital is excellent too – the staff are amazing.

Comments are closed.