Kostelka: „Two Class-Medicine“ or just a Lack of Transparency and Communication in Our Healthcare System?

„Two Class-Medicine“ or just a Lack of Transparency and Communication in Our Healthcare System?

ORF-Series "Bürgeranwalt" (“Advocate for People”) – Broadcast of March 29th, 2008

In many Austrian hospitals it is not transparent to patients for how long they have to wait for a surgery-appointment which is medically indicated. If fixed surgery appointments are suddenly postponed due to a lack of transparancy and the necessary communication between the doctors and the patients, patients without an additional health care insurance are often forced to take their seat on the „substitute´s-bench“. In 2008 Transparency Austria wrote a report on „Deficits in the Health Care System“ and triggered a political discussion in the media about the question whether the „Two Class Medicine“ has already become reality in Austria.

Ombudsman Dr. Kostelka took the case of Ms. M.S. as an occasion to demonstrate that persons only insured as provided by law and therefore without private insurance can not expect the same quality of medical treatment like persons with private insurance.

Ms. M. S. suffers from a very painful and burdensome skin disease which adversely affects her private life and impedes progress of her professional life. Additional problems have been caused by pain in her hips making necessary a detailled coordination of the necessary therapy steps. Ms. M.S. was glad to meet the right doctors for her problem. She was told that her main problem could be solved after the removal of the skin parts concerned and their substitution by a skin transplantation. After that the hip surgery was supposed to take place.

On February 19th 2008 the complainant showed up at 8.15 a.m. at the competent department in the Vienna General Hospital. There the necessary preperations (blood test etc.) for the skinsurgery planned for the next day were carried out. Unfortunately nothing came of it. The responsible surgeon personally told Ms. M.S. that her surgery had to be postponed due to an emergency patient having to be operated urgently. She was asked to go home and to phone the surgeant the next day.

Despite consulting the hospital staff the complainant could not reach the necessary information concerning her delay. Nobody wanted to explain to her what influence the mixture of planned and emergency surgeries had on the allocation of surgery appointments. The office for complaints installed at the Vienna General Hospital which the patient tried to reach was already closed at 3 p.m on that day. Feeling completely desperate she more and more got the impression that she was left alone with her pain and felt treated like a second class person. For that reason she decided not to call upon the surgeon personally but to address to the Ombudsman the next day.

Ombudsman Mr. Kostelka first referred to § 17a Abs. 3 of the Vienna Hospital Law according to which "the process of organization and treatment in the hospital has to correspond to the needs of the patients“. Even though preferential treatment for emergency surgeries might be justified patients who could not be treated and had to be sent off could expect a proactive approach by the Hospital´s staff. Ms.M.S. had felt a lot better treated, if she had been taken seriously with her concerns and had been offered a new appointment for the surgery.

Prof. Dr. R. pointed out that Ms. M.S had been treated in a correct manner. When talking to Ms. M.S. he just was on his way without his timer and therefore could not arrange an appointment for the surgery, but he could have told her a new date for the surgery, if she only had called him- like he already offered to Ms. M.S. on the day of the planned surgery. Due to a shortage of time resulting from the high number of treatments and surgeries he or his staff were not able to phone Ms. M.S. For that reason they were waiting until the patient from her side called. According to Prof. Dr. R. there is no „Two Class Medicine“ in the General Vienna Hospital and Ms. M.S. will be ofered a new appointment for her surgery soon.

The question why the communication between the medical staff of the General Vienna Hospital and the patient could not have been more transparent remained unanswered. Nonthetheless Ms. M.S. is optimistic that she will be operated soon. The dis-cussion, however, whether the allocation system of surgeries should be more transparent has not yet come to an end.