Complication in fund study

WITH the Hunter’s public hospital system apparently fraying at the edges, it seems like simple commonsense to cut back on public funding for overseas trips and conference tickets for medical specialists.

But sometimes things that seem simple at first glance conceal unsuspected complications.

For example, it isn’t always easy to get and keep specialists in public hospitals. Often, doctors who agree to be staff specialists do so in the knowledge that they may be depriving themselves of higher earning potential in the private sector.

Many visiting medical officers – most of whose work is private, but who sign on for some public duties – are motivated by a wish to provide their skills to people who wouldn’t be able to afford them from their own pockets. Working in public hospitals on that basis isn’t necessarily an easy job. It can add uncertainty, frustration and conflict to the life of a self-employed professional who might just as easily have elected to do all his or her work in the private sphere.

Also, accreditation bodies insist that doctors provide evidence of ‘‘continuing medical education’’. This is a serious requirement and exists for a good reason. Medical developments come thick and fast, and doctors who remain immersed in daily practice can – if they don’t make an effort to stay abreast of changes – fall behind best practice in their specialities. That’s bad for the doctors, bad for their hospitals and bad for their patients.

None of that is to suggest that some doctors might not sometimes exploit their privileged positions and wrongly gouge money from limited taxpayer resources.

Medical trust funds

Those instances do occur and, when they do, they ought to be punished.

On the other hand, it is a matter of certain public record that many specialists use trust funds under their control to provide equipment and services for public benefit that really ought to be paid for from the health budget. The PET scanner at the Calvary Mater hospital is just one outstanding example of that.

Valuable research is also funded, at times, from doctors’ trust funds, allowing useful studies to proceed even when external funding can’t be obtained.

It is a fact that some specialists volunteer unpaid hours for public benefit, grin and bear it when operating lists are cancelled through no fault of their own and even absorb the costs of treating some public patients from their own pockets – though such generosity is now more scarce than it used to be.

There may be a good case, as the NSW Audit Office has declared, to trim back spending on trips and training for staff specialists in public hospitals.

But this is an area that needs to be approached with care, and in which not every case will be the same.

Hounding scarce specialists who possess precious skills over relatively small sums used to fund legitimate education and training might not be a wise course of action when all sides of the issue are carefully examined.

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