Page 1747 - Week 06 - Tuesday, 6 June 2006
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bill or take advantage of the briefing that was offered—and I am sorry about this—because it means that it really has only been in the last couple of days that we have become aware, in the context of the bill, of some continuing concerns amongst doctors and consumers regarding the way quality assurance committees work and will continue to work when this bill is passed.
The concerns are not new and clearly have been considered in the development and drafting of this legislation. I concur with Mr Smyth about the aspects of the quality assurance committees that he has discussed today. But the history of acknowledging adverse events in hospitals is of relevance here. While adverse events have long been a feature of healthcare and their incidence has long been a concern in our hospitals, it was only in the mid-nineties that a substantial project was carried out to look at the incidence of adverse events in Australian hospitals and procedures were put in place to look at them and learn from them.
When the results came out, people were shocked and concerned but not a lot happened. Slowly, however, in looking at how to deal constructively with the problem of undisclosed and unacknowledged adverse events, two closely connected concepts have gained prevalence as ideas or intentions, if not always as the reality. They are the need to make hospital care accountable and responsive to consumers and the establishment of a culture designed to acknowledge and learn from adverse events.
This bill is mostly concerned with the quality assurance committees, which are the confidential, self-governing committees of medical peers that oversee the quality of clinical practice. This bill is quite a substantial rewrite of the legislation. It ends the unhelpful division between the private and the public hospital systems and makes many considered changes to governance, reporting and privilege issues. It is, in fact, the outcome of quite a substantial body of work and it is disappointing that it has been in front of the Assembly for such a short time before having to be debated.
My position then is that I would like to flag that there are still some aspects of the model that need closer attention. I advise the Assembly, particularly the minister, that we should look more carefully at these outstanding concerns when the next health legislation amendment bill comes up in a few months time.
The key concern is that quality assessment committees will remain too closed and so are in danger of being self-serving. For example, I have been contacted by a doctor from the medical board with concerns regarding lack of transparency. As it currently operates, the committee may make decisions to curtail a doctor’s or another health professional’s rights to take on particular work, but those constraints might not be passed on to other jurisdictions.
There was a recent health complaints commission inquiry where 30 medical practitioners refused to provide statements to the commissioner. There were undoubtedly complex reasons why this was the case, but it reflects an unhealthy culture which we need to move beyond. While these quality assurance committees have the powers to conduct their own inquiries, they do not appear to be required to cooperate with health boards or the minister. I have been given the example of specific concerns about a doctor that were raised two years ago with such a committee yet there has still been no response. It seems that quality assurance committees can be too much a law unto themselves.
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