Page 116 - Week 01 - Wednesday, 16 February 2011
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When allegations were made last year by doctors and patients that lists were being managed inappropriately so that urgent category 1 patients were being downgraded without clinical reason, the minister was in denial. She accused me, in her words, of besmirching the surgical booking areas and surgeons.
Let me turn now to what the Auditor-General found. I will quote from the report:
… classification of clinical urgency categories did not always reflect ACT Health’s policy and procedures, and therefore raised doubts on the reliability and appropriateness of the clinical classifications for patients within the waiting list … in 2009-10, 250 patients in Category 1 were reclassified and a significant number of these reclassifications (97 percent) occurred without documented clinical reasons … Audit examined 259 records of all Category 1 patients whose clinical urgency category had been reclassified from Category 1 to Category 2. Audit identified 55 reclassifications (or 32 percent) that had no evidence of having been approved by a doctor …
The report goes on to state that there was a:
… consistent practice by some doctors to ‘stage’ (downgrade) patients’ clinical urgency category close to the clinical recommended timeframes for these patients.
And more damning, Mr Speaker:
This often followed a request for review by the hospitals … In particular, downgrades of patients’ urgency category, often without documented clinical reasons, raised considerable doubts about the reliability and appropriateness of the clinical classifications for patients on the waiting lists.
When I raised the concerns of the doctors and patients, the minister’s response was to say that I was I besmirching people. Does the minister stand by that insult or will she apologise now that the Auditor-General has found that there were indeed problems with how urgent patients were being downgraded?
This is, however, the minister’s pattern of behaviour: first to deny, then to attack the messenger, then to try and cover up, and when the truth is exposed, to blame the department. This is exactly what she did in this case and it is exactly what she did in the obstetrics bullying case.
The problem is that the Auditor-General did not just find fault with the bureaucrats who the minister was so quick to blame, but she found systemic problems. I quote again from the report:
ACT Health conducted an internal review of the outpatient services at TCH and a draft report in October 2010 found deficiencies in strategic planning, inconsistent application of policies and procedures across the OPDs, ad hoc processes for managing the waiting lists, and poor and inefficient communications with clinicians, consumers and staff.
Further, the report goes on to state:
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