Private care in public hospitals worries doctors

Doctors are "very uneasy" about a proposal to allow private medical care in public hospitals because it could create a two-tier system separating rich and poor patients.

But a spokesman for Health Minister Tony Ryall said yesterday the idea was "worth looking at". The Otago and Southland district health boards have released a consultation document, Bridging the Gap, which suggests patients should be able to pay for treatments in public hospitals that are not government-funded.

"New treatments and medicines are constantly being researched, and there is always a period between when the potentially better or more appropriate treatments and medicines are developed and when they might become available for the general public," it said.

It did not specify which treatments would be made available, but used cancer drugs as an example.

A spokesman for Ryall said the idea came from a senior Dunedin doctor who was concerned about cancer patients having to fly to Auckland or Palmerston North to get private treatment.

"If it can be done without queue-jumping or preferential treatment, is not costing the public health system and makes things easier for the patients, then it's worth looking at."

He said the Otago-Southland plan could become a pilot for the rest of the country.

Christchurch Hospital medical staff association president Dr Ruth Spearing said many doctors would be against the idea, which would create a two-tier system of patients in public hospitals.

"Our facilities are so stretched already trying to fit in patients for funded treatments," she said.

"We often have to delay for lack of facilities, space, chairs for them to sit on  that would just make the whole situation worse."

Spearing said she had experienced a public-private system in Britain, and it did not work well. Fee-paying patients would get better treatment or bumped up lists ahead of non-paying patients, she said.

Association of Senior Medical Specialists president Ian Powell said he was "very uneasy" about the proposal.

Powell believed it was primarily a revenue-gathering exercise to reduce health board deficits.

"Things that introduce and extend a two-tier approach in the same institution, discriminating on the basis of those with money and those without, create a very uncomfortable situation for patients and health professionals," he said.

Powell said user charges had been tried in the 1990s but were stopped because of a combination of "controversy, op-position and administrative costs".

Canterbury District Health Board member Andrew Dickerson said the idea had not been raised in Canterbury.

He would be concerned if it was.

"As soon as people are charged for some treatments in a public hospital it opens the door for the range of care people have to pay for being increased at some time in the future," he said.

"I feel it would be a slippery slope having public and private patients together in the same public hospital."

Labour health spokeswoman Ruth Dyson said people should be able to access services in the public health system on the basis of their medical needs, not their wealth.

The idea that paying patients would not queue-jump or be given preferential treatment was "simply not credible".

Otago board chief operating officer Vivian Blake said any additional services would not compromise the care or volume of what the board was providing in the public sector.

"The decision to have any additional treatment would be entirely the patient's," Blake said.

Submissions on the proposal close on February 2.

- © Fairfax NZ News