Once 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 is consulting editor of Eureka Street.