A little birdie contacted therenalunit.com today, suggesting that a major public hospital in an Australian capital city is in the process of inking a deal with a large (think multinational) private dialysis supplier, to send somewhere in the vicinity of twenty public patients to dialyse in a center run by the private dialysis supplier.

No only will these publicly funded patients be dialysing in a private unit, but they will be transported from their homes to the unit before dialysis, and home from the unit after dialysis, in taxpayer funded taxis.

This raises numerous interesting questions:

Why are taxpayers footing the bill for patients to dialyse in the private system? With recently published evidence that the number of Australians requiring dialysis treatment for kidney failure has increased dramatically, and will continue to increase dramatically in the foreseeable future, why is the Government allowing this short-term solution to be implemented? Could it possibly be that the introduction of more “chairs” for patients in the public system requires infrastructure investment that Governments, with an eye to the next election, rather than the long term health and fiscal benefit of their constituents, see as a way of delaying the long term cost of caring for these people?

Will patients with private health insurance be turned away, and forced into the public system, as a result of these “chairs” being taken by publicly funded patients? Surely no-one can guarantee that, as the private dialysis provider has a guaranteed twenty (public) patients, they would not turn away privately insured patients looking for somewhere to dialyse. It would be nothing short of a laughable situation to find publicly funded patients in the private system, whilst privately insured patients are forced into the public system, thus doubling the burden on the taxpayer.

Why are these public patients being afforded the luxury of taxpayer funded taxis to and from dialysis? One can be sure that any public patient who was told that they were from now on going to be dialysing in a private facility, and that they would be ferried to and from that facility at public expense, would be thinking that someone was having a lend of them. Surely this is overkill? It is difficult to understand how, if a patient was previously managing to find his or her own way to dialysis, they now need a taxpayer funded chariot to acheive this purpose.

A thought must also be spared for the patients who currently hold private health insurance. There is no doubt that a large percentage of patients dialysing in private units, pay for their health insurance through great sacrifice and toil. Logic says that very few people undergoing dialysis treatment have the capacity to undertake high-paying employment, therefore must give up a great deal to retain their cover. This move by the public health system could well be taken as a slap in the face by these people. What is the point of sacrificing and saving at every turn, when there is no perceived benefit? Will this facilitate a drop in privately insured dialysis patients, hoping that their “number will come up”, an they’ll be able to dialyse in a private unit anyway? This could possibly be to the long term detriment of the private dialysis industry in Australia, as if more patients drop their cover to be dialysed publicly, there may not be enough patients for the private providers to operate profitably.

All in all this is very poor form by our public health system. One cannot point the finger at the private provider. They are a business which has shareholders to answer to, and are not concerned from where their income is derived, be it private health funds, private citizens, or short-sighted government health departments. I believe that the decision makers who have implemented this plan should consider its long term ramifications, and build the infrastructure required.