What should our public health care system do?
Being a passenger on the journey of public health care from trauma to overnight hospitalisation, I had a front row seat of experiencing what our national health system has to offer.
This was a snapshot but it was clear that we have some things nailed and others need a little more than grease.
Can we imagine a public health care system which takes us from any sort of traumatic event to full rehabilitation? Would we want that for everyone?
Would we want someone who has a baby to have full pre and post natal care for up to 1 year after giving birth?
Would we want someone who broke a wrist to be rehabbed over and beyond what’s necessary to return to work?
If someone is sick and has complicated dietary needs, should we be able to support them with regular visits to a nutritionist to help them manage their condition?
If a person is lazy and unmotivated, overweight and unhealthy, should our public healthcare system be able to fund a coach, weekly to help them and guide them for 1 year, 2 years, the rest of their life?
Let’s imagine two very distinct scenarios and it will be clear that NZ’s public health care system sits somewhere in between, at times on the higher end of care and others, drags its feet. If we call an ambulance, it almost always arrives and particularly in Wellington, it’s free. If your injury requires immediate hospital treatment you generally get a ride to A&E. Once you arrive depending on the severity of your injury you could be waiting for a few minutes, hours or even be sent home and referred to your local doctor.
If you’ve had the experience of staying overnight in the hospital you know that you don’t exactly get to choose your room mates, your curtains, your bed, your lighting or your meals.
But if you could?
Would we collectively pay for that?
Wold it be used?
Would it be abused?
What if sleeping in your own room with some of the comforts of home meant that you healed faster and your chance of a revisit was lower?
When you leave the hospital what can you expect in terms of after-care, guidance and education around how to manage what is just happened to you?
For a broken arm would you expect someone to sit down with you for half an hour and explain the type of break, the length of healing time, how to manage the injury, discuss potential mental health implications and check in weekly via a home visit?
What if it was 90 minutes? What if you were assigned a specific person to follow up with you every second day, over lunch, of your choosing? There may be a bit to much encouragement to break another bone if this is the case.
Back to the ambulance example, what if the ambulance turned up, stabilised you and then left? And it was your job to get yourself to the hospital if you weren’t critically ill but needed medical attention.
What if no one turned up?
What if a helicopter turned up and took you to hospital they gave you your own room, Assigned you a doctor for your entire stay, gave you a food menu, ensured that you had the best night sleep, and that every step of the way you were communicated to with what was happening.
On top of that you were given all the necessary information required to heal.
What do we want this for everyone, or are we happy to pay per visit?
When we experience ourselves or someone we know in hospital care, there is an innate feeling that it should be better. The question is how much better and how much are we willing to pay.
Perhaps an ideal health care system is one that is similar to the fire service; well resourced, highly trained (as are many of our health care providers) and supported employees, seemingly balanced work load, hardly ever puts out fires but is fully prepared to do so and if office building is evacuated, every fire engine in the city turns up!