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Parable of the inhospitable hospital


No Advantage white text against blue background image of boatsOnce upon a time in Erehwon, a prosperous but isolated town, there was a small hospital. The town council, which was responsible for the funding and management of the hospital, refused to fund its expansion. Two factions vied with one another to control the Council, with an election due the following year.

The roads surrounding Erehwon, which was visited by many tourists, were narrow and dangerous. There were many accidents, and ambulances constantly came to the hospital bringing the injured. People from outlying settlements without their own hospital also came there. As a result local patients who had booked appointments at the hospital were often obliged to wait to see the doctor because he was attending more urgent cases.

Among the townspeople there was considerable irritation at this inconvenience. This was noted by focus groups conducted by both factions seeking to control the Council. They put the blame on those who had come without appointments, and flayed one another for pandering to them.

The ruling faction cast around for a solution that would solve the problem without damaging Erhewhon's chances of winning the coveted Ethically Tidy Town Award. They came up with the idea of a No Advantage policy. All around the town they placed posters emblazoned with the No Advantage logo and headed: A Fair Go for All.

Under this policy, no one who arrived at the hospital without an appointment would receive any advantage from having come unannounced. Emergency patients would henceforth be called Intruders or Malingerers.

To ensure that no advantage flowed to them, they would be escorted from the hospital premises and ranged along the footpath under the open sky. The elderly, babies and those suffering from unusually serious accident would be permitted to sit on the nature strip.

After the hospital medical staff had seen all those with appointments, they would tend to as many of the Malingerers as could be seen in office hours. This would ensure the latter enjoyed no advantage.

To the ruling faction the policy promised to be fair and effective, though their opponents criticised it as too mild. So it was implemented. The whole town was satisfied that the queue along the footpath and the pathetic scenes on the nature strip would be a firm signal to potential Malingerers that they would have no advantage.

But, alas, cars crashed, families came down with botulism, children broke legs playing, visiting bikies were glassed by locals, grey nomads were bitten by spiders, and the number of people brought without appointment to the hospital increased. They overwhelmed security, and soon the queues stretched down to the main street. The cries of children and the stench of open wounds wafted even to the Town Hall windows.

Clearly the No Advantage Policy needed to be strengthened. The council took counsel and refined it. The hospital was declared a war zone, and martial law imposed within its grounds. The queues were routed out of town.

In order to reduce the queue and discourage further arrivals, a junior nurse was sent each morning to walk briskly along the queue and to call out those who did not look very, very sick. After this triage, those selected were driven some kilometers out of town and left on the other side of the shire boundary.

But still the Intruders continued to arrive: on crutches and stretchers, with drips, catheters and prostheses, escorted and alone. The council saw with alarm, and their opponents with grim satisfaction, that the policy was not working. It had again to be strengthened.

Intruders waiting in the queue henceforth received no food. And, because some regular patients missed appointments and had to be seen the next day, the Malingerers could only be seen several days after they came to the hospital. This ensured they would receive no advantage over any patient who had made an appointment.

Sadly even the best of healthcare policies could not control the breaking of bones, the crushing of spleens, the poisonings, blockings, complications in pregnancy, aneurisms and other events that are part of the human lot. People kept coming without appointment and the queue kept growing.

In desperation the majority faction invited their opponents to a joint meeting in order to discuss how the policy could be made more effective.

The faction members had come to the view that the policy did not define advantage broadly enough. Many of the Malingerers had a considerable advantage over some patients with appointments in that their general health was not as impaired. This advantage needed to be removed. So they argued that the policy should be extended to mandate slicing the flesh, breaking the bones, infecting the blood and weakening the heart of Malingerers.

Their opponents, however, believed that this did not go far enough. It was unconscionable that these people should enjoy the advantage of being parasites on the body politic of Erewhon. In order to pay for the space they were occupying, they should be set to work on the railway spur being laid to the local quarry.

One councillor, a local painter, proposed a more radical solution. The core advantage conferred on the Malingerers was the gift of being alive. If this advantage were removed from them, discreetly and humanely, there would be no queues, and soon no problem.

Most councillors dismissed this proposal as Unerewhonian. But some looked thoughtful.

In the following months before the council election, burned babies and victims of accidents, strokes, appendicitis, domestic violence and heart attacks continued to arrive at the hospital without appointment.

And more councillors began to look thoughtful. 

Andrew Hamilton headshotAndrew Hamilton is consulting editor of Eureka Street

Topic tags: Andrew Hamilton, Nauru, asylum seekers, no advantage



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Existing comments

We have crossed over into madness. If Tony Abbott promises to cut refugees' toes off, Julia Gillard will have to cut their fingers off.

Jim Jones | 28 November 2012  

good story

Michael Sullivan OAM | 28 November 2012  

The bishops are meeting, to paper over their shame over the sex abuse scandals, but how about they consider doing something useful? Surely, with those sanctimonious politicians we all suffer from, with rather too many of them Roman Catholics, now is the opportunity for the bishops to stand with one voice and point out to Abbott and Pyne, and all the RCs on the equally revolting ALP side, that they are wrong, they are sinners, they need to drop their destructive slander of 'illegals' and come up with something called 'a policy' on refugees. On top of that, since our politicians react to the huddled masses of voters, in the pulpit should be a priest demanding intelligent thinking from the 6% of the population that attend church.

janice wallace | 28 November 2012  

A potent tale for those who have 'ears to hear'.Jesus' parables aimed to stop us in our tracks. They aimed to take us out of our cosy certainties into the gory reality that oppression serves the interests of the ruling class. They invite us to explore how we can respond to shatter a spiral of violence and injustice. W.H. Auden said: 'You cannot tell people what to do, you can only tell them parables.' Andrew's parable needs to be read out in parliament and forwarded to all our politicians by email.It needs to be sung from the rooftops and dramatised in the city square.

Fiona Dodds | 28 November 2012  

It always seemed ridiculous to me and shifty somehow that we were suddenly so concerned with the saving of boat peoples lives that it was up to us to stop them coming by making their lives more difficult if they managed to survive the journey - as a lesson for others.If I was a refugee and my children's lives were in danger or my own life wasn't worth much where I was existing, I'd jump on a boat and take my chances too even if I ended up on a crowded and hopeless place...at least I'd be safe and perhaps my children would eventually have a better life. Life is full of wars and irrational ethnic hatreds. People are always going to find their lives endangered. They are always going to try for a safer life. If we want to stop the refugees, we'd have to stop the wars. In the meantime, let's take them in. We can find out if they're suspect in 3 months like other countries in the world do. Then let's welcome them, but not their hatreds. Any refugee continuing to harm ancient enemies goes back to the beloved fight at home.

Bernadette | 28 November 2012  

Yet another wonderful, mythical land that does not have to deal with the reality of limited resources. Also the councils of the surrounding towns are not held to account that they have not provided their citizens with proper health care. No, its only the denizens of Erehwon who are callous and cold-hearted. For the record, I am favour of helping asylum-seekers. Just because we cannot help everybody does not mean that we help no one. However, too many of the contributors to this e-journal simply ignore the facts of the real world. It seems to be more important to accuse those who disagree with you of being impervious to the suffering of others. This world is full of those who are genuinely in need of asylum. The sad reality is that demand far exceeds supply. Let's start talking about limits, and yes, that means some people will miss out. Anyone who fails to address this issue in a meaningful way leads me to suspect that I am looking at a moral poseur.

MJ | 28 November 2012  

In real life in Ailartsua, unlike in fairy tales, emergency departments in hospitals are crowded by people who shouldn't be there because they do have a medical emergency. Their presence seriously delays treatment for those who are genuinely sick.

john frawley | 28 November 2012  

Thanks for trying, Andrew. You missed out the bit where the hospital put up the sign that said: "This hospital does not exist (unles you're a local ratepayer)". Also, you might give us a ray of hope - maybe a few kind souls who came to the queue to offer help, and a few councillors who argued for a more Christian response.

Russell | 28 November 2012  

If the asylum issue was easy, it would have been solved long ago. It seems to me that a story such as this tends to present it as simple.

Frank | 28 November 2012  

We don't have an 'asylum-seeker' problem. We have a 'lack of leadership' problem. And that leadership problem is not just with our politicians. Janice is right, an authoritarian organisation like the Catholic Church could wield considerable clout if it mobilised to bring both sides of politics to task. Imagine the Cardinal announcing that the rights of asylum-seekers are inviolable, and then sticking to his guns interview after interview. Imagine the Bishops conference speaking out as one against the 'policies' of both major parties and advising their flocks not to vote for either major party. Imagine all priests identifying with asylum-seekers by, say, wearing large stones around their necks when celebrating the mass. Imagine Catholic lay organisations fielding independent candidates, sworn to bring decency to the way we treat asylum-seekers, in every seat in the next federal election. Imagine. But I won't hold my breath...

Ginger Meggs | 28 November 2012  

And where are the bean counters? Julian Burnside has done the numbers. (LNL with P Adams Tues) I think it was $20.000 per year for each asylum seeker - not 'illegal' on the dole against $350,000 per year for each asylum seeker in detention.

Mary | 29 November 2012  

So following John Frawley's point - isn't the Emergency Department problem caused by an inadequate triage system? If the government can be seen as a triage team for political "patients" - so much for the "do no harm even if you can't do any good" guideline.

AURELIUS | 29 November 2012  

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