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Legislative Assembly for the ACT: 2000 Week 7 Hansard (28 June) . . Page.. 2146 ..
MR MOORE
: I am just a little wary about what I say about this report because I have already been forced by the Assembly to withdraw a word which I thought was a perfectly reasonable word to use in a description of something. You are asking me to put an interpretation on the report, which I am happy to do and I will tell you what it is, but I want you to keep it in that perspective.My understanding of the communication problem was that the communication was done by phone rather than, as is the recommendation of the committee, by having a doctor who needs to do an urgent operation going to the theatres and speaking to the duty anaesthetist. That is my interpretation of the report, from the brief discussions I have had with Dr Delaney on the communication problem. That is probably what they are referring to.
I want to remind members that a death review committee is an educational rather than a disciplinary committee and its aim, of course, is to improve practice. When the senior surgeons and senior doctors involved in a death review committee like this one make a recommendation to their colleagues, it is about that style of recommendation to improve how you do things. "Colleagues, if you need to do an operation urgently, do not just rely on a phone call saying, 'Have you got a theatre available?' because communication can break down in those terms. Go down to the duty anaesthetist and say, 'I do need a theatre right now, this very minute'."
Of course, when we read the rest of the report we realise that, in fact, Dr Jeans would not have been able to do that because, first of all, the patient that we are talking about had to go through a resuscitation process to be sure that he was ready to have the operation that we are talking about.
Mr Wood, I have to say that I presume that this will come out further in the coronial inquest that is to follow this matter. I presume that we will get a much clearer idea from the coroner and I presume, considering the amount of public interest in this situation, the coroner will use the opportunity-I hope the coroner will use the opportunity-to clarify the sorts of issues that you have raised.
MR WOOD
: Thank you for that, Mr Moore. It raises more questions than it answers. Are we to assume, then, that doctors will be instructed not to use the telephone, even an internal telephone in the hospital? It strikes me as absolutely remarkable that there is a suggestion here that the interface has to be personal. Goodness me, are we all going to go off the phone? Is it the inference, Mr Moore, that these contacts have to be made personally? Indeed, was the doctor in the hospital and was it possible to do that?MR MOORE
: In fact, my understanding is that the allegations raised originally by Dr Jeans created the picture of a doctor stomping up and down the corridor of the hospital saying, "I can't get a theatre, I can't get a theatre," but what happened, as we can pick up from the death review committee, was that he was not there for quite some time and, in fact, telephoned. He did have a registrar there and the registrar had drawn his attention to the fact that the particular patient was rapidly going downhill and the processes were put in place. But I would say, Mr Wood, that if somebody was so seriously ill, as we know from the information in the report, as to have a mortality rating before they started the process of 100 per cent-
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