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  1. 1

    Doctor Whom

    Blanket statements about all screening for cancers are unhelpful.

    Part of the problem is that the great unwashed, and many, if not most, health professionals don’t understand the economic and epidemiological basis and clinical for deciding to screen or not to screen on a population basis.

    The current hold up in the National Bowel Cancer screening project is a disgrace. Combined with the lack of any innovative community based initiatives for bowel cancer screening makes one despair for any future commonwealth takeover of other programs. The bowel cancer program was launched without any real consultation with GPs who the commonwealth pays anyway and without any consultation with state services that have to do the follow up colonoscopies.

    So that without even a full rollout of the program there are unacceptable queues for ‘scopes and only limited funding for the extra ‘scopes required.(in the public sector – not a great problem in the private sector)

    The Feds have absolutely no idea how clinical services work (or how they are funded) on the ground.

    The BCSP had names, postcodes, numbers who sent in a FOBT, numbers of positive tests etc – yet at no stage has that info been readily available – de-identified- to enable clinical serv ices or Div of Gps to do some community based work on getting more in. Not to mention that most GPs (and proceduralists) will not claim the rebates for the scheme because the paper work costs more to complete than the rebate is worth. – Sadly perhaps a sign of things to come when Canberra takes over.

    We could free up colonoscopy availability by simply restricting ‘scopes to those with clear symptoms, a family history or positive FOBT. UK doesn’t fund colonoscopies unless FOBT, symptoms or history and they have a rate of ‘scopes per 1000 running at 25% of what we do here – we could have scope availability increased by 4!

    Bowel cancer screening and follow up saves lives – no ifs or butts – and it pretty bloody cheap for lives saved.

    Everyone is getting all excited about obesity. Its sexy, groovey and open to all kind of paternalism (or nannyism) and moralising (or finger pointing as Bobby Zimmerman would say) -great fun for all. We know bugger all about how induce behavioural change to reduce obesity in individuals and SFA about how to do it on a population basis. But it doesn’t stop us throwing $quillions at it.

    Bowel cancer, unlike anti-obesity, isn’t groovey, doesn’t lend itself to blaming and faddish diets, or superior feelings if you miss out on it . Its a messy business that can save lives cheaply.

    Reply
  2. 2

    Doctor Whom

    I did talk about public/private b ut as we all know that is just a form of words.

    Public means a state run service partly funded by state partly by commonwealth – all paid for by taxpayers- and capped.

    Private means colonoscopies done outside state services but largely funded by the commonwealth -paid for by taxpayers – with a small contribution by either patients or private (subsidised) health insurance – and uncapped.

    Madness

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