Volume 194 - Issue 6
Dissecting the health system
Author: Allan D Spigelman
Med J Aust 2011; 194 (6): 322. || doi: 10.5694/j.1326-5377.2011.tb02986.x
Published online: 21 March 2011
Published online: 21 March 2011
Terminal decline. A surgeon’s diagnosis of the Australian health-care system.
Dr Mohamed Khadra. Sydney: Random House, 2010 (xiii + 263 pp, $34.95). ISBN 9781864711370.
THE AUTHOR of this work is a respected surgeon, educator and author, who has done more than most in giving back to the community in which he now lives, as well as to other, more distant, communities. It is therefore disappointing that his latest book is a passionate but superficial tour through the recent history of the Australian health care system.
It lacks the rigour required for such analysis. Many of the key political and medical figures involved in the introduction of universal health insurance were interviewed. Not surprisingly, they provide a retrospective justification for their stance of some decades ago.
The method of diagnosis is lacking, in that there was no attempt to revisit contemporary texts and media of the time under evaluation. There is much extrapolation from powerful anecdote, leading to gross generalisations and oversimplification of the issues under discussion.
There is an almost paranoid obsession with the meddling bureaucracy who obeyed the command to go forth and multiply. The obsession is justified to some extent but does not provide the entire explanation for the system’s woes. Reference to “an anti-doctor nurse turned journalist” bobs up out of nowhere.
A glass half empty approach is adopted, from the title through to the denouement. There is repetitive pining for the days, viewed through rose-tinted spectacles, when the medical profession ruled the system and uninsured patients allegedly received wonderful care from charitable consultants.
However, once the negativism has passed, which, unfortunately, is not until near the end of the book, the author makes some reasonable recommendations for cure.
The publication is more suited to a series of media articles. If one is looking for serious investigative journalism, then the book does not, at least in the opinion of this reviewer, represent value for money.