A NATIONAL system of registration for doctors is being finalised by federal, state and territory governments, which will help prevent cases such as that of Jayant Patel in Queensland and the “Butcher of Bega” in NSW.Federal Health Minister Nicola Roxon yesterday said the Council of Australian Governments was expected to sign off soon on a national registration system for health professionals.
“It will make a difference to ensure high standards across the whole country,” she said on ABC television. “It’s no solace to the people who are victims of the treatment for now but it needs to be proceeded with.”
The current system for registration of health professionals is done by medical boards in each state and territory. The COAG proposal is to replace this with a national process overseen by nine separate boards for all the different health professions.
Ms Roxon’s comments were made in relation to the so-called Butcher of Bega, deregistered former doctor Graeme Stephen Reeves, who allegedly performed unnecessary and sometimes horrific gynaecological procedures at Bega and Pambula hospitals on the NSW south coast over several months in 2002.
Self-regulation in most professions has been problematic, so it’s beyond time to have an external oversight system properly put in place for the health professions. It’s only shameful that it took a case as full of blatant system failures as that of Dr Reeves to finally get some action.
Interestingly, I hadn’t heard this before in all the recent coverage (emphasis mine):
The board maintains Mr Reeves was able to dodge the restriction because he moved from Sydney to take up a new post in Bega and at the time legislation prevented the board from passing on details of the ban to his new employer.
Really?
Kudos also to the NSW Government for planning to institute a system of mandatory reporting for medical personnel of medical misconduct by their colleagues. Such systems have been recommended by watchdog groups for years (decades?) of course, and who knows how many unnecessary harms could have been avoided if such systems had been in place for all that time, but at least it’s finally happening.
Next: regulating the specialist medical colleges so that they can no longer unreasonably inflate their incomes by maintaining an artificial scarcity of medical specialists. Isn’t competition meant to be healthy?
Crossposted from Hoyden About Town (related post by Lauredhel)
Next: regulating the specialist medical colleges so that they can no longer unreasonably inflate their incomes by maintaining an artificial scarcity of medical specialists.
Dentists should be somewhere near the top of the list.
The science of Dentistry remains appallingly primitive (drills, clamps, and pliers) but the fees are ridiculously inflated. Australians in need of major dental work are now flocking to the Philippines and other countries, sometimes exposing themselves to unaccountable practitioners. The alternative in many cases is that the work does not get done, with potentially fatal consequences.
Dental work should be covered by Medicare. Fees should come down. And there should be enough (affordable) university places to ensure a good supply of dentists across the nation. If we cannot manage that, then we should drop our protective barriers and make it easier for foreign dentists to immigrate, with their skills and qualifications checked in the same manner as this new system for doctors.
Presumably if a doctor gave you a combination of medicines like a flu shot and a pneumonia vaccine (which was the wrong thing to do according to hospital medical staff) which put you in hospital at death’s door a few hours later,for several days, that would be medical malpractice? Its down in my hospital/medical record as an allergy, not a medical mistake. This happened to me some years ago, not with my present doctors. But you can bet that doctor won’t be on records anywhere.
From personal experience, it is also very, VERY difficult to mount legal action against doctors, particularly those working within hospital systems.
First you need to find another doctor to testify against them, then you need to prove that their diagnosis and/or treatment was deficient, which can be nigh impossible post-facto.
There’s a difference between malpractice and misconduct, Paul. Misconduct is always malpractice, but malpractice is not always misconduct if it involves mistakes/negligence rather than intentional harm.
Of course, everyone makes occasional mistakes. But Patel and Reeves were not committers of occasional mistakes. Well designed oversight systems should detect health practitioners who are injuring their patients (whether through incompetence or intent) through auditing expected rates of various procedures/results against the actual results in the operating theatres, pathology labs and mortuaries, and making sure that deviations are properly investigated.
However, hospital oversight systems won’t necessarily catch malpractising GPs giving patients inappropriate injection combinations. This page for the NSW Health Care Complaints Commission offers links for their sister-commissions in other states/territories – you could contact them to find out if you are still within the reporting period for that incident in which you were harmed.
PB,don’t believe everything you are told – I don’t think there are any reasons for not giving pneumococcal and influenza vacccines at the same time – in fact this is a common practice. For more info try the Australian Immunisation Handbook – available on-line. Sorry, don’t know how to link to this.
Good point, rf. Yes, it’s worth discovering if what you were told at the time about the injection combination is actually correct.
Decided long ago not to worry about it. I’m still alive. Now if I’d died …
Here it is
“Next: regulating the specialist medical colleges so that they can no longer unreasonably inflate their incomes by maintaining an artificial scarcity of medical specialists. Isn’t competition meant to be healthy?”
That one has always been in the too hard basket. Do you reckon Rudd would possibly try and bust them… I mean, they are effectively ‘professionals unions’ aren’t they? You could not flood them with o/s specialists, for instance, because they would fail them for local work. In each little area they are like popes.
Great post Tigtog.
The mess that our so-called health “system” is in requires urgent reform. I agree wholeheartedly with your point about the specialists colleges, these bodies have way too much power over the way our hospitals and health care are managed and delivered.
Let’s not be too kind to Nicola Roxon though. Her new appointment to chair the Government’s health inquiry is none other than a former CEO of a health insurer. This is not likely to be a ccommission that argues for significant health sector reform.
I think I’ve said elswhere: So far I haven’t seen any evidence that Bega made any checks on Reeves at all. I might be wrong.
Actually, the breaking of the colleges is well under way and being eagerly, if unwittingly, participated in by the colleges themselves.
The colleges hold one significant power, accreditation. They have traditionally exercised this in the form of control of numbers of training posts and an examination regime. The actual training was provided by hospitals.
The first college to run into trouble was the newly formed College of General Practice. They attempted to differentiate GPs from being a professional “ground state” into a specialty by introducing a training system and limiting places in the early 2000’s. The Liberal government had a justifiable tantrum about what to do with doctors excluded from all forms of training while their is a GP shortage and set up a series of rival, University run rural training schemes. This was the first time you could qualify in Australia outside of the college system.
The problem the other colleges are about to run into is of their own making. They all appear to be laboring under a collective delusion that they are educational bodies. They are busy developing curricula and continuous assessment regimens without any resources to provide these. They do not negotiate with hospitals or universities, merely pronounce that they must be done. The essential argument is that it is the trainee’s responsibility to arrange their own training. The first example was the College of Paediatrics demanding a rural placement for all trainees when there were two in Victoria; for 40 people. Then being unable to provide a definition of a rural placement. The Physicians have just released a long and complicated document that demands a series of thing that no-one is going to achieve. It essentially reads like a suicide note.
The College of Surgeons keep trying to get themselves sued out of existence by excluding people who have met all of their explicit requirements.
The bottom line is that medical post-graduate education has always been done using the resources of Hospitals and University departments. A peer-run examination system has a great deal of merit but the silly buggers have restricted supply too much and are about to get broken. Probably with parallel programs offered by Universities. Similar to the GPs, initially in rural areas.
The worry is going to be the pool of talent. There are a lot more doctors with the ability to train as a specialist. The problem is that, even if there are places, the training is a huge amount of work. This is a commitment of between 5 and 8 years of your life to a round of examinations, disgusting hours and, compared to our GP colleagues, questionable remuneration. There are currently more training posts for basic physician training in Victoria than applicants. Opening up a large number more physician training posts will simply leave a harder task for the HR managers of minor hospitals. Sure, you can have more Dermatology training spots full tomorrow, the same is not true in Internal Medicine. This is worsened by the older average age of interns since graduate entry became the norm.
The colleges are an anachronism and should be gone tomorrow. My worry is that the bar to qualification as a specialist is currently set very high indeed and yet still the occasional fool manages to clear it. How much lower the leap of logic will need to be under an open, accountable, fair University system remains to be seen.
Oh, and Paul, that was an allergy.
It was often commented on, in many hospitals in which I worked, what an astonishing coincidence it was how many unimpressive registrars in specialist training who succeeded in gaining accreditation on the first try were the offspring/relatives of existing medical specialists, and how many superlatively excellent registrars in specialist training who failed to gain accreditation (despite excellent assessment results and many applications) were of non-European immigrant stock.
Haven’t been to the dentist recently then, have you? CAT scans, computerised tooth replacement sculpting, titanium dental implants including fixed full-denture implants, and state-of-the-art ceramic and acrylic materials are a normal part of dental practice.
I’d hate to see the state of your teeth, if indeed you still have any.
Like most of us, Gandhi probably has to pawn his mother and sell his soul to Satan every time he visits the dentist for even routine procedures.
Dr.S – I’d say take away the protectionist influence of some, not all, colleges and there is a lot of good in the colleges.
One f’rinstance ANZCA (Australian and New Zealand College of Anaesthetists) has possibly done more than anyone to advance EBM, protocols and standards and safety.
Indeed, sorcerer.
Most interesting is how GregM, scouts away from the gist and most important part of Gandhi’ comment…”but the fees are ridiculously inflated.”
Don’t forget it’s the
social Darwinism“free market” which guaranteesa closed shop“competition” on the philosphy that thesucker“user pays”.Actually it is cheaper to go to the Philippines/Malaysia/India on a low-season cheap fare and take your chances if you need a complex job.
As for standards, my Indian doctor goes to India for her dentistry. Says Australia is way too expensive.
Then perhaps he should do what his dentist will tell him he should do, at every routine visit: floss once a day, brush twice a day and use a mouthwash with every brushing. Then he’d hardly ever need to visit a dentist.
No I didn’t scout away from it. I was just waiting until some clown, and that is you joe2, would pick up that point. On what basis do you assert that dentists’ fees are ridiculously inflated? Have you been through their books? Do you know what capital costs they have to cover with their fees? Or their operating costs, including the cost of employing their staff?
Or, as is usual for you and sorcerer, do you just think your clueless assertions should be taken as fact without the slightest evidence of brain activity on your part to justify them? Sorcerer (impressive authority as he has already proved himself on the rules of evidence on another thread) has made the assertion and you have agreed with it so put up the evidence you have to support it.
Yeah I weep for them. So sad.
My dentist has a holiday home to match the one in the Eastern Suburbs. Am I supposed to be proud of that?
I actually would like to go through some of their books. Would make an interesting exercise for the inquisitive forensically minded.
Not bad was I
The thing is the more someone annoys you the more combative your posts become. Fun to watch. Sort of like Windschuttle, but with a smiley stamp instead of a PhD.
You got the gender wrong too Mr Moylan. I’m a she.
I was waiting for that Windschuttle comparison, sorcerer. It seems to come out whenever someone calls you on an unsubstantiated assertion.
The thing that annoys me is how you can post whatever ignorant twaddle comes into your mind without any regard for the facts and expect it to be taken seriously.
Ignorance is your watchword.
Greg M and sorcerer, thanks for your thoughtful comments about the topic at hand. Seriously, it’s your professionalism that I respect!
Such as? And when was this?
So how is a comment on over-inflated dentist fees “ignorant twaddle”? or should we simply cop them uncomplainingly?
Sorry, that link is broken – try this. Should keep you entertained for a while – you can even leave comments there!
Here’s one:
http://larvatusprodeo.net/2008/02/27/non-violence/#comment-444058
One thing I find curious; you write:
I have been commenting at LP for three years under the moniker GregM. It is a convenient abbreviation for me, it conforms with the LP comments policy, and I have never posted under any other. If the LP comments policy required me to post under my full name I would have been happy to comply.
On the other hand the great majority of commenters at LP choose anonymous monikers and I respect that. I judge them, and comment on them, on the quality of their arguments. That is all.
But you have taken the time to find out, and have thought it important enough, to fins out my surname and have published it on this site as if there is some point for doing so. Why is that?
And having thought it so important and having made the effort of doing so do you not think it incumbent on you, as a matter of integrity, to post under your full first name and surname, rather than hiding behind the assumed name of “sorcerer”, from now on?
Or don’t you have any integrity?
I strongly second GregM’s comment above.
A certain self-organising netiquette has emerged, initally on chat sites and usenet, and now on blogs (now this is when and how libertarianism should work) whereby people of genuine good will do not:
- use others’ net handles;
- alter the substance of comments posted on sites they control(disemvowelling or sooning should be the creative responses of choice here); or
- set out to dismantle a net de plume that has been consistently employed in good faith.
To do any of the above makes it clear you’ve given up trying to argue your point on its merits or your native wit and are just aiming below the belt now.
Regardless of how strongly I agree or disagree with your or GregM’s points, I reckon you’re exhibiting very bad manners here sorcerer.
OK this LP thread is (again) going nowhere useful. More’s the pity – it’s an important subject.
Why don’t you all go spend the night somewhere else chatting about Nelson’s new low – 7%!
Incidentally, speaking of gumsmiths and ivory merchants, I patronise D-Spa, which aside from being just around the corner at work, strikes me as being pretty reasonable priced.
And it has a great “On Her Majesty’s Secret Service” vibe about it. A sleek clinic apparently only staffed by charming young ladies in white designer smocks deftly handling hi-tech equipment. Not quite sure though about their kind offer to install wifi GPS in my back molars as they replace my old amalgam fillings.
And here’s an interesting observation about advances in dentistry.
Our grandparents went to the dentist to have their teeth pulled.
Or parents went to the dentist to have their teeth filled.
We go to the dentist to have our teeth cleaned.
Well you can blame your friend sorcerer for that.
And we still await her fronting up and answering the questions asked of her about her attempts at derailing this thread.
To you I apologise then Nabbers.
But in doing so I often wonder why some people come here and to similar sites when they know full well that it is primarily a place for discussion of issues and viewpoints which are not going to suit their particular political slant. That’s why I wouldn’t go to Catallaxy, and certainly not to Bore and Bolt’s.
It’s more pleasant to be able to discuss matters with people whose world view is much like yours, even if you may disagree on the detail and the emphasis (Liam?
) A bit of an extension to one’s real world relationships. After all you do not seek in real life to associate with those whose views are anathema.
It’s no secret I used to post at Webdiary. Some people from there like Jack Robertson are over here, and it’s good to see them. But part of Webdiary’s problem was that it suffered ultimately from trying a little too hard to be inclusive, thus leaving itself open to abuse. And when you get a few years under the belt and realistic pessimism where human nature is involved, you start drawing lines in the sand.
Enough on that.
Now Gandhi – can you perhaps see dentistry included under medicare with a raised Medicare levy as perhaps providing a solution to the dental fee problem?
sorcerer, LP has always sought to be open to people of different political views. The only caveat is that people don’t sledge others (longer form = comments policy). There’s no need whatever for people who have views opposed to mine, yours, or anyone else’s to feel they need to go elsewhere.
A smiley face won’t make me agree with you, sorcerer. I’m pretty badly behaved most places I go, I’ll admit, but trying to out people from their handles is pretty low.
And who made you the arbiter of inclusion or exclusion anywhere, anyway?
Going back to the original post – a national registration system is long overdue – the current system is a bit like having different gauge railway tracks in each state. But if you think that it will solve anything much, you’re deluded. The simple problem is that with a few altruistic exceptions, highly qualified doctors just don’t want to work in places like Bega. It takes a decade and a huge amount of money and personal sacrifice to qualify as a specialist. How many of these “Masters of the Universe” (thank you Tom Wolfe) are then going to practice as generalist physicians and surgeons in small towns? No thanks, everyone else is getting into super specialised medical niches.
So you end up with regional hospitals and small town GP practices being served by overseas trained doctors and nurse practitioners.
Something like two thirds of doctors outside the capitals are within ten years of retirement. Kevin Rudd better come up with some good ideas at his 2020 sumit because by 2020 there’s going to be no rural obstetricians, surgeons, nephrologists, dermatologists, gasteroenterologists etc etc.
Never mind the Flying Doctors, we’ll need a Flying Patient Service to deliver sick people from places like Bega to the super specialists working in the corporate run city clinics.
Just a quick ps to my earlier comment. Everyone – including sorcerer – should remind themselves that discussing others’ actually stated views and arguments – not some pre-judgement about what they might think based on their politics or what their politics is perceived to be – is a precondition of civilised debate, and indeed a requirement of participating in this forum.
I’ve read over the thread now, and it does seem to me that the dentistry discussion has sent the thread off its original topic. I’d ask everyone to follow Michael’s lead and discuss the topic of the post.
Thanks very much.
“the dentistry discussion has sent the thread off its original topic.”
Perhaps the thread needs braces?
“But in doing so I often wonder why some people come here and to similar sites when they know full well that it is primarily a place for discussion of issues and viewpoints which are not going to suit their particular political slant.”
But that’s a big part of the fun. Provided you follow the Queensbury rules of stoush.
Root canal work, I’d say.
Sorcerer, I’ve noticed you taking an aggressive tone with a lot of people who disagree with you. As Liam says, smileys don’t make that any better. GregM and I have had a lot of disagreements, but he deserves better than some snide remark about being a free marketeer, which is probably inaccurate anyway.
LP was established as a place where people of all persuasions could chat and occasionally stoush, but in a good humoured way. Key to that is not making unwarranted assumptions or personalising comments in a bad way. You don’t get some free pass because you call yourself a leftie. Please take heed.
Fun!! After about 12 detailed posts on my own in the Naomi Parry thread trying to chase off some Windschuttle troll tragic, then coming back to this?
Anyway, we’ll be in trouble if we get off-topic…
Ahem…
so what do you think about Government initiatives to dismantle the current cosy little doctor’s cartel? Any ideas?
The points michael raises are quite pertinent to this.
And maybe the changes in University education are a step in the right direction, or maybe they are adding to the shortage. I am not sure, maybe michael or Dr S can comment.
With an eight-ten year qualifying period, plus internship plus additional years if they wish to train as specialists, we’ll be seeing 60 year old first year doctors in about 2030, with none in between.
Ah well there’s always Google Scholar, a first-aid kit and my trusty Merck’s
Now this is what a good blog stoushing thread should sound and look like.
Kim, the remark actually was not directed at him. It was directed at the comments made by Gandhi and joe2, at the bulk of the dentistry profession in response to both joe2 and Gandhi, in the context of exorbitant fees.
I make no apology for stating that dentists charge too much.
Fair enough, sorcerer. And I wasn’t asking you to apologise for saying stuff about dentists. It might be helpful if you could provide us with something about dental cost structures that’s more than assertion or anecdote. But as has been said, that discussion isn’t on topic.
Thanks for your informed comments Dr S. & Tigtog.
I was reading an old essay – ‘Health Wars’ by Race Mathews, and was staggered to discover just how many decades of concerted effort it took, to finally introduce a universal or even national health systems.
For example: “in 1947, a new Pharmaceuticals Benefits Act was passed but the Medical Union advised its members to return to the Dept of Health the prescription forms and formulary supplied to them under the Act, and all but 155 of Australia’s 8000 doctors complied with this advice.” It went to the High Court, was upheld over some ‘civil conscription’ meaning madness, and then a change of Govt – and on it went. Delaying was the most effective tactic over the decades. And this was after the original Act passed by Curtin in 1944, which was also challenged successfully in the High Court, and a subsequent a referendum in 1946 won, to make laws which covered pharmaceuticals amongst other provisions. Sheesh!
Compared to yesteryear (and I’m older enough to remember a very belligerent Bruce Shepherd – the head of the NSW branch of the AMA screaming blue murder on the nightly news if the Govt didn’t toe the line) you would think (or rather hope) a Federal Labor Govt, finally without this sort of highly organised opposition, would take whatever bold steps necessary, to bed down a national health system worthy of the name.
That is, in respect of training, registration, accreditation, research, remote/rural postings, hospital & community health funding, modernising medical records & medication data with digital technologies, cracking down on over-servicing, introducing basic dental to Medicare (beyond the yoof) and so on. Compared to introducing medibank/care it should be a doddle!
And with input from the specialist Colleges…or not.
Though as michael points out – the rural/regional problem is gunna take something special in terms of GP’s and other specialists. But isn’t the ‘Flying Patient Service’ exactly what is happening already – people are airlifted to major city hospitals from regional centres for trauma/transplants/acute major surgery etc? I’d be asking for the chopper straight to the Alfred, or RPA or wherever, rather than the District Base option, if some dumbass had run me off the road.
The Mersey Hospital was all about downgrading it to a day hospital with one specialty – dialysis (?), and concentrating specialist services in Launceston. Maybe subsidising rural/regional folks for travel/accommodation costs might be one option?
And as many have pointed out – getting cracking on Aged Care Beds – a significant burden on the public hospital system, with many beds used by the frail elderly who could be cared for in low-care facilities, if they existed, or in upgraded facilities etc.
And revisiting some of the Medicare Gold proposals as I’ve posted before, such as immediately utilising unused private beds for the above purpose, and for the Govt to just pay the fee. It apparently worked out as a ‘zero cost’ or even saving, compared to keeping the elderly in costly public beds, with not required specialisations on tap etc. (According to John Deeble, the architect of Medicare, and that’s good enough for me.) Actually, the AMA and private insurance mob (those old hands) did a pretty job demonising all of Medicare Gold, come to think of it..
It will be v. interesting to see what Federal Labor brings to the health table during this term.
Re: Dentists – I gave in about 10 years ago, after much neglect, and now just bung dentistry on the never-never with everything else. My man in Macquarie Street charges by the hour, and is excellent value in terms of having restored my teeth to v. good working order, painlessly. He also turns the gas and music to 10, when required. (The only time I’m ever completely off my scone these days, is in his chair. Root canal tripping – who would have thunk it.)
The funny thing is that most of my comments on LP seem to be ignored. I just MENTION dentistry as an example, and BANG! the whole thread goes up in smoke! Lucky I didn’t mention the Nazis.
I do appreciate that dentistry has some modern gadgets available these days, but 90% of the work is still pretty basic. I have read that stem cells implanted in gums might make it possible to regrow teeth, which would surely bring some big changes to the industry. Meanwhile, it’s over-priced and over-protected.
Which brings us back to the topic…
“Meanwhile, it’s over-priced and over-protected.”
The government estimates that one in three avoid the dentist because of the cost involved and plans to offer 150 dollars towards the 300 dollar cost of a comprehensive check up for teenagers. Get that, $300… for a check up, for gods sake. Not quite sure what the parents are supposed to do if their kids actually need work.
http://www.news.com.au/couriermail/story/0,23739,23306100-953,00.html
Kev’s talking about bringing tradies from overseas to help cover a shortage of builders etc – why not bring in dentists too? Oh, and doctors, while we’re at it…
.
One thing I have noticed over many years is the number of teenagers whose parents I know to be on less than average weekly earnings who are wearing braces. The treatment takes about two years and their parents wouldn’t see much change out of 5 to 6 thousand dollars. Still the parents consider it a worthwhile investment in their kid’s future both in terms of appearance and dental health.
The stem cells thing sounded familiar, so I dug a bit. Gandhi, prepare to be amazed and repulsed at the same time.
Wow, maybe they could isolate some testicular tissue, implant it within Brendan Nelson’s tongue… and see what happens!?!
“Still the parents consider it a worthwhile investment in their kid’s future both in terms of appearance and dental health.”
Yeh right Greg. Too bad about living on the bake beans for the rest of the family for two years. More seriously, necessary treatment of the medical variety, dentistry included, should be a right for all and not a matter of sacrifice for the poor.
There is no earthly reason why many more specialists cannot be trained up to meet community needs rather than many professionals, excessive, personal cash flow requirements.
Let’s start thinking about practical solutions here.
If we can give rebates to people with private health insurance, surely it isn’t too much to ask that we start to grow our own replacement lower and upper jaws in our abdomens early in life. Perhaps children could be encouraged to grow pieces of skulls in their stomachs in school, as biology projects, say, that also serve as insurance against fistfights and sporting injury. Who *wouldn’t* want a second set of adult teeth?
I mean, that’s until we can start farming our own clones for universal aftermarket body parts. I’ve got a homebrew kit and space in the garage, and though I’ve no training in medicine, biology or genetics, I’m willing to learn on the job.
Get back to me, CSIRO.
Sit quiet or go about normal home brewing business for a bit longer, Liam.
When you see the smiley men and women in the nice white suits, at the gate, do not fear. They will be your new colleagues from the CSIRO coming to pick you up. I mean, “escort you” , to work on growing teeth inside an arshole.
In making that comment I was not making a judgement about whether or not it is desirable that the parents don’t have any financial support for those expenses.
Still I’m not sure the parents have been reduced to baked beans. Probably had to cut back on junk food takeaways, ciggies and booze though.
I actually think there is a good case to expand at least subsidised dental care to children, especially orthodontics because if a kid can get to about 15 with a sound set of teeth and then have any straightening issues (which go to such things as proper occlusion and are of much more than of cosmetic importance) sorted out then it’s very likely that with sticking to a basic dental hygeine regime, their teeth will last them into their sixties and beyond.
However, unlike you who seem to think that money grows on trees, I am conscious of the fact that medical treatment and dental treatment is extremely expensive to provide and that someone, either the user or the taxpayer, has to pay for it.
The same goes for training more dentists, including as specialists. As I understand it the number of students studying dentistry hasn’t increased much over what it was twenty years ago. One of the reasons for this was that it was thought that with fluoridation there’d be less dental caries and hence less need for dentists. In fact the number of children making it into their teens with basically sound sets of teeth created a new demand for orthodontics and with increased affluence and better knowledge of dental hygeine a lot more people are getting into their fifties with essentially intact teeth as well meaning that other specialties, such as periodontics have become more important.
So yes we should be training a lot more dentists. Still dentistry, like medicine, is one of the very expensive university courses and if you want more of them then you as a taxpayer will have to pay for them.
Then after that, if you see dentistry as a what should be a free public good you, as a taxpayer, will have to pony up the money for new dental practices and with modern dental equipment, such as CAT scans (vastly superior to the old X-rays) and that equipment is extremely expensive. On top of that you’ll be paying for the dental practice’s operating costs such as the salaries of the dentist’s professional support staff such as dental nurses, hygienists and technicians as well as the costs of the advanced materials that dentists now use.
Of course paying for all that will be at the expense of some other thing that your taxes would have been spent on.
Gandhi, 51, Wouldn’t that result in Nelson choking to death?
Paul B @ [56] do you make any value judgement on that choking death? And if he fell suddenly silent, how long might it take for anyone to notice?
After this morning’s story on RN: “the digital rapist dermatologist of Victoria” {I kid you not, I am NOT making this up} – national registration is LONG overdue, and from the Patel case one might hazard a guess that swapping lists of dodgy doctors internationally should occur more regularly.
GregM,
My teeth are all over the place. I’m not a fashion model by any means. When people take photos, I smile with my lips (teeth hidden).
I’m not talking about cosmetic shit. I’m talking about basic health standards.
Fidel was right about one thing at least: we should all demand universal free health care and universal free education as a basic right in return for our taxes. Not just basic stuff either, but top quality! Dammit, we pay a huge percentage of our wages in tax – tell me where else does it go that is more worthwhile? Iraq?
“Of course paying for all that will be at the expense of some other thing that your taxes would have been spent on.”
GregM, I went to drop off my computer for a service the other day and the middle aged women who took down the details held her hand over her mouth because of the embarrassment about her obvious rotting teeth. One of the first acts of the Howard government was to kill funding for dental care to the poor. That is over ten tears of neglect, while happily budgeting 22 billion dollars for defense in their last year.
I would prefer fellow citizens, without means or whatever, not living a life of pain and shame for the price of a few war machines, for instance.
If you re-read my last post you’ll see that I come at this issue from the same perspective as you do. Having a properly aligned set of teeth is not just a cosmetic issue; it involves ensuring that there is proper occlusion and a stable set of teeth and ultimately whether the person will keep a full set of functioning teeth into old age.
The point I make is that providing top quality dental care is exceedingly expensive and has to compete with a lot of other priorities such as affordable housing, aged care, social security payments, other forms of medical care, public education including tertiary education etc etc if it to be publicly funded. And yes, it’s got to compete with the defence budget and I think you’ll find that the ALP is just as committed to that as their predecessors were.
I doubt that you’ll find that Fidel is actually providing top quality universal dental care to Cubans. He could not afford to no matter how many graduates are churned out of Cuba’s dental schools.
Still having had the experience of top quality Thai dental work a few years ago when I was living in Asia, at a quarter of the cost of having the same work done in Australia I can see the case for outsourcing dental work to appropriately credentialled dentists in Asia, rather than having them migrate here. You could probably fill up a plane load of people with dental problems, fly them to some luxury South East Asian resort and give them a week’s holiday there while their dental needs are attended to then fly them back and find that the cost of the whole exercise was less than half the cost of providing them with dental treatment in Australia.