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    T Hannan

    All the previous replies are important and valuable contributions to this debate. There is political bantering and talk of remedies to correct the system. Despite these perspectives there has been and will remain for the foreseeable future a continued failure to improve health care delivery. This is because the current model of care in this country and for many OECD nations (apart from the USA) is inappropriate. There is very little accurate nor realistic insight into the core drivers of our costly and at times poor quality of care delivery. Apart from a dominant focus on hospital-based care there-more beds, more doctors, more nurses-there is no clear cut direction to reform prevention which has since the 1980s been seen as the best way to enhance the health of the nation. In addition there is a constant failure to openly address the roles clinicians have in the overuse, underuse and inappropriate use of health care resources. The changes in doctors incomes pales into insignificant when these factors are measured in their contribution to health costs and quality as well as the variations in health care.

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