Kiwi Polemicist

August 21, 2008

Waikato Hospital puts a band-aid on their inefficiencies

In this article the NZ Herald describes in glowing terms the transit lounge (more on that below) at Waikato Hospital. The Herald presents this lounge as a solution to a problem and, as usual, misses the real story. The real story is that this lounge is in fact indicative of the inefficiencies of the public health sector and an ambulance at the bottom of the cliff. Allow me to explain.

In case you haven’t had the pleasure of staying in a public hospital I will set the scene for you. You’ve been in hospital for a while and you’re hoping that today is the day they set you free. The usual posse of three doctors turns up at about 8:30am and you are delighted to hear that you can go home and actually get some sleep. The doctor says that you can go as soon as you have your discharge papers, so you quickly pack your bag and lie down to wait. And wait, and wait, and wait. An inspiring hospital lunch turns up, followed by more waiting (this is why they call you a “patient”). Eventually the house surgeon turns up at 4:00pm with your paperwork , and you escape from the hospital as quickly as your infirmities will allow. The first breath of fresh air is quite a shock to your system, almost enough to put you back into hospital.

That’s a good scenario, because you’ve had a bed to lie on whilst waiting for your paperwork. If they’re really short of beds they might kick you out and get you to sit in the day room.

The delay is because that, after the doctors have seen you, they have to finish their rounds before they do all the paper work. They might also get called to see inpatients who need urgent attention or to people in the emergency department. Our public hospitals are mainly old and badly designed, which means that doctors spend hours of each day just walking between patients. Meanwhile, you’re taking up a bed and the emergency department is crying out for beds so they can get people out of their department. It’s called bed block and the hospitals employ staff to do nothing but try and keep it under control.

That’s where the Waikato Hospital transit lounge comes in. Instead of you taking up a bed while you’re waiting for your paper work, you take up space in a transit lounge, which is a lot more comfortable than the day room of a ward. I’m not saying that it’s a bad idea, but all it does is shift the problem so that it’s not so noticeable. It’s like having a dead cat in the lounge and moving it into the laundry when you’ve got visitors coming: you’ve still got a dead cat in the house, but it isn’t so noticeable.

So what is the problem that Waikato Hospital is trying to disguise? The problem is that public hospitals are hugely inefficient, like all government businesses. A private hospital can do a procedure for about half the cost of a public hospital, therefore if the government didn’t run hospitals everyone would have more money in their pockets. If you’ve got a dead cat in your house don’t just move it about, take it outside and bury it.

Click here to read a post about Auckland Hospital’s emergency department.

Have you experienced the inefficiency of public hospitals? Post a comment and share your story.



  1. […] ♦ bed block, which I covered in this post. […]

    Pingback by Slices of life from Auckland Hospital « Kiwi Polemicist — August 25, 2008 @ 12:26 pm

  2. […] use of time, money, energy and other resources. Socialism takes away the profit motive and inefficiency becomes rampant, as anyone who has spent time in a public hospital will tell […]

    Pingback by Go to the ant, O classical liberalist « CCL: Christian Classical Liberalist — October 27, 2008 @ 11:28 am

  3. If the junior doctor had pre-prepared the discharge summary and had access to a laptop or tablet computer during the ward round, s/he could issue you with a discharge summary within a couple of minutes of you being discharged. I have done precisely this at Hawera hospital, which has this system.

    All it needs is for junior doctors to start preparing the summary during the admission and for ward round to be conducted in the 21st century.

    Comment by macdoctor01 — May 30, 2009 @ 9:28 pm

    • MacDoctor: you’ll never have a career as a bureaucrat with logical and practical thinking like that. Time and again front line hospital staff have told me that they’re never asked for their opinion regarding systems, ward design, etc..

      My limited experience of smaller hospitals – like Hawera – is that they do better than larger ones, and it’s interesting that Prebble says that 400 beds is as high as you can go without the hospital “collapsing under its own complexity”. Hastings isn’t small but the CCU nurses have silent pagers connected to the patients’ call buttons, which saves disturbing the patients with infernal bells. I don’t know if the general wards had these. Meanwhile, the cattle yard called Middlemore builds new wards with audible bells; it’s no wonder that the patients are sleep deprived.

      Comment by Kiwi Polemicist — May 30, 2009 @ 9:53 pm

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