Mon | Oct 22, 2018

Garth Rattray | 'Mek mi go home go dead'

Published:Monday | October 2, 2017 | 12:00 AM

A very ill 77-year-old man was taken to one of our no-user-fee hospitals in a collapsed state. He ended up sitting in a chair for more than 36 hours with an IV stuck in his arm.

When it became too much for him to bear, he approached a doctor and announced, “Mek mi go home go dead!” The old man took his own discharge and went home to a veritable shack, where he lived alone with no one to care for him.

A 68-year-old master carpenter came to my office with severe shortness of breath. He was a very fit man until he suddenly developed shortness of breath with very mild exertion. He was also unable to lie flat in bed without extreme difficulty breathing. Examination revealed loud heart murmurs and crackly noises in the bases of both lungs. The veins on his neck were engorged and his legs were swollen. He was in severe heart failure from heart valve disease.

He could not afford to pay for his investigation and treatment, so he was referred to one of our major no-user-fee hospitals. However, there was no dedicated cardiologist and he was treated with medications designed only for temporary relief. He lived through several repeated clinic appointments before his heart became weaker, his lungs flooded, and he died gasping for air on a bed.

When a 70-year-old farmer came to me complaining of blood and mucus in his stool, his family scraped together enough money for a colonoscopy. It revealed colon cancer. He could not afford any more private care, so he was referred to one of our major no-user-fee hospitals. He entered the clinic system and, because essential scanning machinery was malfunctioning because of lack of funds to repair it, he was put through a series of clinic appointments that lasted well over one year.

By the time that he had all the necessary investigations to assess the progress of the cancer, it had spread to his liver. He was scheduled for chemotherapy and succumbed within weeks of treatment.




A 45-year-old single mother of two young boys turned up at the office with sudden and severe headache. She was writhing in pain and her neck was stiff. She was sent off to one of our no-user-fee hospitals with a diagnosis of ruptured aneurysm. There, she was admitted and stabilised. However, after more than a week of waiting on available ICU staff for her post-op care, she rebled and died.

A 68-year-old patient turned up with a chest infection and out-of-control diabetes. Because of his financial status, he, too, was sent to one of our major no-user-fee hospitals. Overcrowding led to inadequate care and he lay in bed on his back for so long that he developed a skin ulcer. It became infected and he became septic. This led to cardiovascular collapse and renal failure, which led to his demise.

Those were only a few patients who suffered needlessly, simply because they are poor. Statistically, they would be alive and well today if they had the finances to adequately take care of their health needs. In this modern and ethical day and age of ours, no one should die simply because they are poor.

In a country where many citizens can afford fully loaded, top-end luxury vehicles, something is terribly wrong when others are dying just because of poverty. In a country where there is so much government wastage, where a minister of finance can spend $8.3m on phone bills and no one at any level is held to account, no one should die in our no-user-fee hospitals.

The principle of available no-user-fee health care is a sound one. However, the premise on which ours was instituted is not; it was started because it was seen as politically expedient - a vote-getter. It was erroneously thought that the 10 per cent of patients that paid their public clinic and hospital bills contributed little, but their contributions amounted to about $2b annually. All that was lost and now people are suffering and dying because we just can't afford no-user-fee health care at this time.

The Government should reduce the suffering and save lives by billing everyone and asking those who can pay something to do so.

- Garth A. Rattray is a medical doctor with a family practice. Email feedback to and