Page 3592 - Week 08 - Wednesday, 18 August 2010
Next page . . . . Previous page . . . . Speeches . . . . Contents . . . . Debates(HTML) . . . . PDF . . . . Video
benchmarked hospitals. Staff at the Canberra Hospital think that they do a lot better than being consistently comparable with other benchmarked hospitals.
When you look at the sections of the review which deal with the benchmark data and you go through all of those, you can see that, on the ACHS—the Australian Council on Healthcare Standards—clinical indicators, of the 18 indicators used, for 10 there was no significant variance. Against seven of those indicators, Canberra Hospital performed better than the benchmark performance. And on one of them it was unspecified or the opinion varied about that indicator. So on 17 of the 18 indicators used to assess the clinical standards, and therefore the patient safety, at the Canberra Hospital—on 17 of 18 measures, independently verified—the Canberra Hospital came out at or better than the benchmark.
When you look at Women’s Hospitals Australasia, and 38 of their indicators, you will see that in 23 of them there was no statistical variance or no significant variance. On 10 of those indicators, they were better than benchmark performance. On four of them, they were worse than benchmark performance. And on one it was unspecified or opinion varied about the outcome. Again, when you add those up, on 33 of 38 indicators, the Canberra Hospital’s maternity service performs at or above the level of its peer hospitals.
If you look at the ones that are worse than benchmark performance—I have gone to all of those as well—and the reasons for that, you will see that there are slightly higher rates of use of general aesthetic for caesarean sections. I am advised by the doctors that this is largely to do with the fact that women with high BMIs are often referred to the Canberra Hospital if they are unable to birth in their own area. For example, in rural areas women with high BMIs traditionally have a higher rate of failed attempts at epidural, and therefore a caesarean is the option after the epidural fails.
In relation to forceps-assisted deliveries, where there is a slightly higher use of forceps in deliveries at TCH, this has to be read in conjunction with the extremely low caesarean rate. The TCH caesarean rate is 14 per cent of deliveries assisted by caesarean section compared to the peer benchmark of 22 per cent of births in first-time mothers. So part of the reason is that you are trying to avoid major abdominal surgery and there is a natural link between a very low caesarean rate and a higher use of forceps to deliver babies in those situations.
Turning to the neonatal death rate within seven and 28 days, and the indicator in this area, the Canberra Hospital is the major neonatal intensive care referral centre for many of the surrounding regions. There are very small numbers of neonatal deaths, which means that small changes to those numbers will increase the percentage, particularly when you are gathering six-monthly data. And this is data that is collected every six months.
So when Mr Hanson stands up and tries to again raise and put forward the view that this has been all about patient safety, I reject that view. I think that is the vehicle that commenced some of the public discussion around the maternity service and women who were unsatisfied with the level of care they received at Canberra Hospital. But on
Next page . . . . Previous page . . . . Speeches . . . . Contents . . . . Debates(HTML) . . . . PDF . . . . Video