Ninja wrote:

"John, I was unaware that what I wrote about regarding the system of ‘wellness’ which operated in rural China had been discussed here in Oz. So thank you for that piece of info.

I was not proposing that we should adopt a similar system – it would be unworkable given the prevailing social environment."

I think you'll find a system incorporating some of that logic already exists in the UK, where GPs are paid more if their patients meet a range of "wellness" measures... don't know the exact details but it came up in "Sicko." It is a great idea anyway, putting the emphasis on the opposite metric to what happens here, ie, more consults = more $$. I think their system involves a set allocated number of patients per GP and the healthier that group is, the more the GP is paid.

This has been a fascinating read, thank you all!

Could we agree from the views expressed that our public hospitals could have smoothly run EDs if they ran at lower bed capacity and were prepared to effectively shift the problem to elective surgery waiting lists /times and possibly reduce the range of services, eg, no PET scanner or similar high tech equipment ?

Would that be a better way for health managers to manage the problem ? The politicians would then be left dealing with public rage at why granny is waiting 5 years for a new knee ?