Establishing a no-fault insurance scheme in WA has been a crusade for Perth's leading trauma surgeon
DR Sudhakar Rao has literally held in his hands the lives of thousands of patients with life-threatening injuries.
As Royal Perth Hospital's Director of Trauma Service he has made the decision to amputate limbs. He's seen legs torn off, flesh ripped from the fingers.
The trauma service at RPH has more than 5000 admissions a year, nearly 100 a week, almost half of which are there as a result of some form of road crash.
Deaths are hard to deal with, especially those of young people. But it's the stories of the patients who don't die that stay with him.
"There was a really lovely family," he said. "The whole family were in the car. Dad asked his son to get something from behind and he got out of his seatbelt to get it and was handing it to his Dad and his Dad lost control of the car. That happened 10 years ago and the boy is a quadriplegic." Each year in WA there are around 92 similar cases which fall into the catastrophically injured category of car crash victims - those who don't die but are left with spinal cord injuries, traumatic brain injuries, multiple amputations, severe burns or permanent blindness.
For each of those patients dealt with by Dr Rao's team there is a family whose lives have been changed for ever in a split second. They deal with huge financial costs as well as the emotional ones as they struggle to pay for medical bills, equipment, and therapy.
Up until now only those victims with someone to blame were covered by Compulsory Third Party insurance to help cover the cost of rehabilitation, estimated to be around $4"million a patient.
The others - about 44 each year - unable to find another driver at fault have been at the mercy of the public health and disability sector, personal insurance and family.
Such inequality has plagued Dr Rao throughout his career and he was among a vocal group which campaigned for years for the change in legislation passed by State Parliament last month.
For Dr Rao, who spent 10 years trying to get things changed in his capacity as State Director of Trauma and the Chair of the Royal Australasian College of Surgeons, lobbying the Insurance Commission of WA, the change is overdue.
"What we lacked for so long was a no-fault basis for care in long-term rehabilitation," he said. "In the trauma area we never differentiate with care, we treat everyone the same. If someone comes from a road crash we get the history, whether they were wearing a seat belt, or not. That makes absolutely no difference in acute care.
"But when patients left our service and went to rehab those who didn't have compensation often missed out.
"Non-compensable patients would miss out on wheelchairs and would have to wait longer for aids such as special communication systems and special nursing care as they relied purely on the public system. They would see the different treatment and say 'how come I am not getting this?'"" ICWA commission secretary Kane Blackman said Dr Rao has been a great advocate for no-fault insurance, and the expanded cover would ensure that from   July 1, anyone who is catastrophically injured receives the care they need.
"We are working collaboratively with Dr Rao and the health and disability sector to ensure this is done effectively and efficiently," Mr Blackman said." Read Dr Rao's full story at perthnow.com.au
THE FAMILY COST Simon Witham's family farm was sold after his sister Roslind suffered catastrophic injuries in a car crash.
"I didn't speak to my Dad for a while. I probably went off the rails to a certain degree, was probably a bit selfish and self-centred. I'm sure it changed my behaviour. For the first 21 years of my life that farm was home."Read his full story at perthnow.com.au