Given that the productivity commission estimates that spending on health care will increase from 5.7% of GDP currently to 10% in 2044, I welcome the discussion on Australia's health care policy.

I would like to know that health care is delivered effectively, that patients are treated with dignity, that health care workers are treated fairly.

Philosophically I would hope the system is equitable. On a more pressing issue, I am opposed to Medibank Private being fire-sold to the for-profit sector.

Ms Gillard states'While the measure of a good health care system is the health of the population and the outcomes achieved when people pass through the system, it is also imperative that we operate on sound economic principles, and ensure that public dollars are invested wisely. The two are not incompatible.' However she does little to pose any new ideas and continues to harp on the costs rather than the delivery of good health care. Her closing statement signals her obsession with funding - that, as far as I am concerned is the root cause of most of out health system inefficiencies( not economic ones either)the ones that lead to patients needless anxiety and suffering and burnout by over worked staff. I don't have any qualifications in economics but I have been nursing for over 30 years and I have seen more problems created by applying the profit and loss argument than I ever did from incompetent staff. Health care professionals are the saints in patients eyes and yet health professionals are the first ones to be shot down by the system if something goes wrong. They are told continuously to 'be accountable for their own scope of practice' - 'take responsibility for their own education' - when I trained we supported our nurses and doctors till they knew enough to practice confidently and competently alone, patients benefitted from the hospital based apprentice training because there was more staff - patients often need other care besides professional expertise ie. an ear to listen, a kind word. It is a sign of gross inefficiency in my books that health care systems do more to employ administrative staff than hands on health care workers. Until these fundamental 'mistakes' are addressed NO party is going to get it right.

Geez, Billie, you sure change with the wind. A few days ago you were writing about how the sick old people, the wrinklies, should have the plug pulled on 'em. Now you're hoping they're treated with "dignity". What - pull the plug with dignity?

Anyway, Guillard, this all NEW exciting health reform you've got here, it sounds a lot like that OLD health reform we had to have under that Keating chap. And it was only today that I was reading, in another place, that Labor was coming up with some fabulous new directions. Frankly, I don't know, it's beginning to sound like the old mutton dressed and served up as lamb story.

Minister

Thank you for your article.

I have two penetrating questions.

1. What is the Labor Government going to do about child protection? Why isn't there a commonwealth mandatory reporting system? Children must be our priority.

Most politicians ignore this "tender" area.

Most politicians have no understanding of mandatory reporting. This is a national issue - not a state issue. Our children are national.

Most politicians have no understanding of the role of DoCS. It's role is not punitive. It's role is meant to assist. As a mental health professional I have used DoCS on several occasions. It is the responsibility of the professional reporter to develop a positive and sustainable relationship with DoCS.

2. What is the Labor Government going to do about people who have a mental illness and who are homeless? Why are mentally ill people treated as second class citizens when it comes to accommodation?

Cheers
Kay
RGN RPN
Dip Teach Nursing
B.Ed Nursing
Master of Education

2.

Maximus, I see no contradiction in my observation that today nursing home inmates are often starved, often left to sit in their urine, and the recipients of slip shod or scrimped medical treatment, irrespective of their ability to pay - unless they have the resources of Kerry Packer to throw at their health provision.

I am appalled at the crappy nursing care provided by agency nurses in our most presitious private hospitals but I understand the pressures the agency nurses are under trying to get enough shifts to pay their rent and I see how patient care suffers as they have to protect their own backs first [literally] on the chronically understaffed wards.

If I was in that situation, alert and aware, in pain and only able to escape into the glory days of my dim and distant legendary past I would much rather be dead that kept alive "come what may". That's my idea of personal "dignity".

I thought that this forum might have provoked discussion of how to spend less than 10.3% of GDP in 2044 on health care. Or perhaps posters might have wanted to discuss the efficacy of private health provision in aged care but I guess every one knows that its very hard to glean a profit out of aged care and provide a decent level of care to your patients. Is this an example of 'tacit consent'?

Well billie,this is the result of a totally socialised health system.It is fast approaching the point of being totally dysfunctional.Make anything free and people will abuse it.

Everyone should pay something to see a doctor.This vastly decreases over servicing and whimsical visits to the doctor.

Society cannot afford to pay for all the whizz bang new drugs or operations,since our taxes would eventually be greater than our incomes.That is the reality we must all face.Each one of must eventually face mortality and we should not expect the rest of society to live in poverty so we can squeeze a few more years out of our lives.That notion is very selfish.