Page 2339 - Week 06 - Wednesday, 23 June 2010
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Canberra and Calvary hospitals, anaesthetists from both hospitals, senior executives at both hospitals and representatives of New South Wales Health. They form the Surgical Services Task Force. This was negotiated and put together by that group, with their endorsement that this is the best way to manage this. And you do have to manage this. You have to make sure that your throughput is going through in the most organised way, that the doctors are getting the sessions they want, that the times available for patients broken up into category 1, category 2 and category 3 are being done.
Now, for example, there is a letter which says—
Mr Hanson: Is that for clinical reasons?
MS GALLAGHER: There is a letter sent to doctors. Requests for admission forms come to the surgical booking area and, for example, a VMO may do a session of one morning every three weeks. If the VMO has requested admission for 10 patients for category 1, there is a very high chance that those cannot be fitted into their list, and if they cannot be done on the available time for that doctor they will fall outside the 30-day period, in which case those doctors are given alternatives, outlined in the letter: “Is your patient categorised in the right category? Is it clinically appropriate that they fall outside category 1? Should they see another surgeon? Do you want more session time in the operating theatres in which to perform this surgery so your patient gets it on time?” They are the options that are being put forward and then the surgeons fill out the form and fax it back to the surgical booking area.
Only a surgeon can make a change to a patient’s clinical condition, the category they are put in on the elective surgery list. So, yes, there are letters that ask them to audit their patient load. Yes, there are letters that say: “You cannot physically operate on all these category 1s in the time allotted to you at the hospital. What are we going to do about that?”
Mr Hanson: Downgrade them.
MS GALLAGHER: No. “Will you refer to another surgeon?
Mr Hanson: What other surgeon? There is a staff shortage.
MS GALLAGHER: “Do you want more operating time? Is your patient in the correct category?” There are a number of questions asked—
Mr Smyth: So will you downgrade them?
Mr Hanson: Will you downgrade them?
MS GALLAGHER: and the doctor is the only one that—
Mr Smyth: So you misled?
MS GALLAGHER: No, I did not, Mr Smyth. I did not mislead—
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