[comment caption=Is the public health system failing us?]Many people are spending thousands of dollars on private surgery in Otago because the public system is failing them, Dunedin ear, nose and throat surgeon Martyn Fields says.
Mr Fields, who works in both the private and public sectors, says the Government funding system based on population, rather than the incidence of disease, is unfair and is hammering lower middle-class working people in the South who do not have health insurance.
These people were struggling to borrow money to have operations privately because they knew they would never get seen in the public system.
About 60% of his private patients did not have insurance and had used the private sector because funding for their care in the public system was inadequate, he said. While such operations might not be for life-threatening conditions, they were for conditions which affected people's ability to participate in education or work.
In his specialty, among the conditions people were seeking treatment for were tonsilitis, sleep apnoea and nasal obstruction.
Not being able to breathe or hear properly had a large impact on people's ability to take part in everyday life.
In some cases it could be dangerous - patients were at risk of crashing their cars by falling asleep at the wheel.
Those patients with urgent conditions, such as cancer, did get seen publicly and treated, but "everyone else is at risk of falling through the cracks".
This did not apply only to his specialty.
Mr Fields was critical of the Ministry of Health edict that patients had to be given certainty they would get an operatio1n in six months if they were placed on a hospital waiting list. There was no scientific basis to justify a six-month cut-off date.
"Saying it offers certainty is a political claptrap when the choice is no surgery at all, or paying the full cost in the private sector."
It also allowed the government of the day to hide the true level of need in the population.
Patients who did not make the six-month waiting list could be put on "active review" for another six months and at the end of it be told their condition did not qualify for surgery.
Mr Fields said a funding system based on population was clearly not equitable.
He was aware some North Island patients were getting elective surgery within six months for conditions which patients in Otago were being told there was no funding. If a condition such as tonsilitis, for instance, was more common in the South then more funding should be given to treat that disease, he said.
Mr Fields was also critical of the plan to remove public funding for laboratory tests from private specialists.
It had wrongly been assumed that this would mainly affect those who had medical insurance, he said, but it would just add to the bills for the low income earner who had decided to seek private treatment because it was unavailable in the public system.
Those with significant incomes would already have insurance or could cover the cost easily.
