Local patients are subsidized. The more locals go into our
public hospitals, the more the government has to subsidize. A
recent change in funding policy has seen the budget given to public
hospitals fixed at a certain amount each year. That means the best
way to earn money in a public hospital is not to have any patients
at all and not to do any operations. As KBW said, if our public
hospitals have no patients, he will jump up and clap hands.
Administrators run the hospitals now, not doctors who are just
employees. The CEOs of hospitals are MBAs and the few who are
doctors haven't practised medicine for years. Consultants do not
'blindly follow' the administrators, they are required to do
so....
Hospital administrators have to bring in private patients to
balance the hospital's finances. What choice do administrators
have? The subsidy from the givernment is fixed. If more subsidized
patients come to you (and you cannot refuse them), when patients
demand to have more attentive service (in comparison you can easily
wait up to 12 hours in a British NHS hospital on weekends...I have
seen it), how are you going to balance the books and meet patient
demands? Staff are overworked...do you increase staff? Where's the
money coming from? You cannot increase charges or patients will
kpkb. You cannot employ more staff because the government won't
give you more money and anyway, there is a directive to cut
manpower by 2% each year. So staff becomes disillusioned, unhappy
and leave, which exacerbates the problem for remaining staff.
Hospitals like TTSH with a vast majority of local subsidized
patients have a big challenge to remain in the black. Remember that
if your hospital loses money, doctors will not have salary
increase. Keep doctors' salaries low, they will leave for the
private sector or overseas hospitals. Talk is cheap, what would you
do differently in their shoes?
Everyone is looking for a better life, a higher salary. Doctors are
the same...If you can earn more in the private sector with less
work and more autonomy, being your own boss...why not move
out?
If local patients who can afford it go to private hospitals instead
of public hospitals, that would be very welcomed
by hospital administrators, the Minister and staff of public
hospitals. With fewer patients, they can finally offer the better
care that they want to provide but are unable to due to lack of
resources.
If you can afford to go private, perhaps it is more ethical for you
to go, so that poor patients can get better care in public
hospitals.
