I live Melbourne in the state of Victoria, in Australia.  It is a great place to live.  It's relatively clean, relatively safe, trees everywhere, national parks that I can go mountain biking in within the city limits, and pretty good beaches within an hours drive of the city.  Every time I go overseas and am flying back into Melbourne I think "gee it's good to live here".  But recently this opinion has changed. Why? Because I'm a doctor working in public hospital Emergency Departments.  The Victorian health system is in a mess.  Despite demand going up 6-8% per annum every year for the last 10 years, there have been minimal increases in staffing and resources.  In fact the number of hospital beds for us to admit patients into has been cut!

Anyway the list of problems and implications facing Victorians is long, and I can't write them all in one go, but recently the Australian Medical Association started a blog site for doctors in Victorian hospitals to have a little rant on, and nicely made it so you can do it anonymously, it's called doctors4hospitals.  Have a look, it's a sad read really.  Doctors are committing suicide, driving home from work in tears every day, being physically and verbally abused by nursing staff, patients and families, working hours and hours of unpaid overtime and being paid a pittance for the privilege. As nice as it is for the AMA to start this up, they already know everything on this page, and it can have no real political sway.  Why? Because we have nothing to bargain with.  We can't strike.  Recently in Adelaide every Emergency Physician in town resigned as they were getting nowhere in their negotiations with the AMA and the government.  The state government even tried to take them to court to make them go back to work and were told, "um, they quit, they're not on strike, they don't work for us anymore and you can't force people to work against their will, that's called slavery". And what happened? Their demands were instantly met.  Unfortunately in Victoria, there are too many doctors to achieve a critical mass of people willing to resign, and meanwhile the AMA dawdles along having conditions dictated to it by the government.  What an appalling state of affairs when we have a federal government (who refuse to intervene in the public hospital crisis as they're run by state governments) who are willing to spend BILLIONS of dollars on failed military hardware purchases, fighting wars that we have NO business being part of in Iraq and Afghanistan, and other defense "initiatives" while slashing budgets and services in the health sector despite record demand, the most obese population on earth, and an aging population. What a disgrace.

Recently the Victorian health minister Daniel Andrews had an official survey from the Australasian College of Emergency Medicine handed to him from ED directors across Victoria, most of whom admitted to fiddling their admission statistics so they wouldn't be hit with funding penalties (as under our great system if your hospital is drowning under record numbers of patients and you can't get them out of your ED quick enough you have your funding CUT!).  So what do you think the man in charge if thie system had say about it?  "I don't believe you". He then issued an official statement through DHS that basically said "I know no-one's doing it, but in case you are, stop it".  This is what we're dealing with.  A bunch of finger pointing, committee dawdling, heads-up-our-arses politicians, bureaucrats, and middle-management who have the gall to say, openly and publicly, when presented with hard data, "I don't believe it".  It's like the mayor of Chernobyl saying "the nuclear plant is running perfectly, we have no problem and I won't be investigating claims of a meltdown".  Well that's nice Mr Andrews but there's one thing you can't ignore.  The fact that doctors are leaving the public system in droves, and like the inevitable cloud of nuclear dust that eventually enveloped Chernobyl and killed it's residents, your health system is going to start killing patients (it is already), and you can pretend for as long as you like that it's OK, and not listen to the doctors who are keeping the system afloat, but when there are none of us left, and all you can get are less well trained overseas doctors to staff your Emergency Departments, and we have all moved to Western Australia or Queensland who have doctor-friendly systems in place, we'll all look back and say "we told you so".  Asshole.  Did you know they already realise this and instead of creating incentives to keep us here, they are already advertising to overseas doctors, (scroll down to "Incentive packages for international medical graduates") with pissweak incentive packages that are no-doubt going to cost them less than it would to keep locally trained doctors here. And why is it that I can't get paid ONE CENT of overtime, yet they are offering free health insurance to new overseas doctors, so they can go to the PRIVATE hospital and not have to get treated in the crap public system??!!

Personally when I get my final specialist qualification next year I'm going to walk out on the public system for good,  I can't in good conscience continue to support a system that intentionally and systematically abuses its most valuable employees.