Counting down ...

One week to go - and still a few things I would like to do to assist with the hospital functioning before I go.   But let me have a little rant first ... we at Babinda have 100% ward occupancy ( I hear that is good ) - all with long stay patients.  Cairns "has a responsibility to the community" and has been encouraging us to take as many as possible to help relieve their bed stress ( they don't have the luxury of going on bypass like the Melbourne hospitals ... they "ramp" their patients until the can be seen in the ED ).   Interesting dilemma facing us here in Babinda though - those who I might otherwise be able to admit here as acute care patients can't be as I have no bed for them, and have no bed now for a few days in a row.  Funding here is also dependent on bed occupancy but there is a fine line between what should be done to support the extended Cairns Health Services area and what is expected to be an acute care facility for the local community.  I hope the locals keep a finger on the political pulse, or they will lose their Babinda Hospital like so many other small rural communities around Australia and the facility here will be officially renamed Babinda Nursing Home to reflect the increasingly long-stay care role for the hospital.   The locals and the people working here at Babinda are beautiful people ... don't screw with them, and above all be honest.

 

The local electioneering has taken Cairns Base Hospital as a political baby and run with it ... and running not very carefully either mind you, that baby is going to be dropped in the scramble for votes and in being dropped hurt badly.  The local Cairns newspaper makes interesting reading at the moment with extravagant promises being made without apparent thought to resourcing any new or improved facility.  As usual, might be good for votes as long as the voter never has to use the facility and discover that it does not come up to pre-election promise expectations.  No, this is not unique to Cairns ... you have all heard the same bullshit from your own local politicians in times of ( their own political ) need.  There is even talk here about a "24hr Super Clinic" here in Cairns to "ease" the problems of Cairns Base.  Dunno what the policy makers are smokin' ... the Australian ethos ..er. disease should I say ... is "what does not work anywhere we can make work, I'm sure we can" ... and its been got bad here.  Who is going to be seen at the "Super Clinic" ?  GP level care patients of course ... and yes this might appear to help the numbers in ED by reducing the triage category 4 and 5 patients, but its not them who are causing the "ramping" ... or the 90+ day stay patients bed-blocking the ward beds for acute care patients because there are not enough nursing home beds anywhere in the community or because the small rural hospitals like Babinda are full of long stay care patients and can't take anymore "waiting for placement" patients.   The whole system is constipated.  And who is going to staff the "Super Clinic" ... overseas trained doctors?  ... I am not even going to go there.

 

I speak from experience .. I have been there, done that .. 25 years of GP experience in more places of differing repute that you would care to know about.  Believe me, after hours clinics don't work and are not sustainable long term.  Just tell me how many privately owned 24 hour clinics are currently running in Australia - does anyone even care to know?  As a public health system mutation they are an awful waste of limited health budget resource.   You need to support the local GPs to do their job better, not open up a fancy new clinic down the road from their clinic.  Pay local GPs a retainer to be available after hours?  Actually employ GPs inside the Cairns Base ED ? ... heaven forbid !  If you health policy makers want to talk to me for more on my opinionated opinion you know where to find me.   I have said it for a long time now, but never in such a public forum ... you don't need more doctors you need less patients ... there I've said it for all the world to see.  If you don't understand what I just said there, go sit in the corner with a light ale and a glass of water and have a long think.   For the sake of all the gods you believe in, don't throw potentially good money after bad ... be long term smart, not short term stupid.

 

Well actually that wasn't just a little rant was it ...  oh well, get me onto health care politics, patient advocacy and health service provision equity and you are going to have to pull on the bit real hard to keep me under control.   Lets leave the rest for another time maybe.

 

Today has been a good day .. its amazing how much relief is provided with one gets paid for the job being done.  Today payment for my first three weeks and the airfare reimbursement was deposited to our account and cleared for use today.   I repaid the lines of credit to stop any further interest at credit card rates simply used for family living expenses.  Have enough in reserve from the remainder for our family to live on until I start getting my salary back in Melbourne in a couple of weeks time.  I expect a significant majority of the remaining two week or so's income will be set aside for tax and GST, the smaller of the rest will be set aside for future reserve ... I have been a little isolated from the "world economic crisis" here in Babinda but at least the money earned extra here will be a welcome financial cushion for the family.  I don't want to even think about how much less that "superannuation guarantee" I have been getting as an employee for the last two years is worth.

 

I will keep in touch ... maybe a couple more posts before I say my final goodbyes to Babinda.