Page 166 - Week 01 - Wednesday, 16 February 2011
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been managed at the hospital. The custom and practice was a phone call, or doctors dropping in and signing the form but not necessarily giving the reasons.
There are some hierarchical issues that staff have spoken to me about—not feeling empowered to ask the doctor to note a clinical reason if the doctor has signed the form. They do not feel that they are empowered to say, “Doctor, you have to actually give me a clinical reason for that.” Doctors are generally being rushed.
So I do not think there is a simple reason as to why the policy was not being followed in its entirety. I think there was a lack of understanding by some staff around the fact that all three requirements of the policy had to be met—that is, it required the signature, the clinical reason and it needed to be put on the electronic patient system. I think there was a belief by some staff that, if you met one of those, that was adequate. There is not a simple answer as to why it occurred.
What I can tell you now is that it is very clear. Staff are being trained; forms are in place. Those forms have been changed to give doctors options of clinical reason instead of just a blank, which it was before. Doctors have been informed that there will be no re-categorisation without the complete form being filled in by themselves, if their patient is to be moved.
The Auditor-General acknowledges that it is a good policy. She acknowledges that the right framework was put in place, but there has not been strict adherence to all elements of the policy. It is one part of the elective surgery management policy. So for that part of the elective surgery management policy, that element had not been adhered to in a satisfactory way. That has been changed.
MR SPEAKER: A supplementary, Mr Hanson?
MR HANSON: Minister, do you therefore accept that the Auditor-General’s review and the other investigations that have been conducted have actually had a positive effect on the implementation of ACT Health policy regarding elective surgery?
MS GALLAGHER: Yes, I do. I think the Auditor-General’s review has; so has the Katherine McGrath report and the other consultancy that we issued into examining elective surgery waiting list management. My view on any review that is done is that something positive should come out of it. I think the Auditor-General’s report goes some way to explaining the complexities of the parties that we are dealing with regarding elective surgery management. It also gives us a forum to tell all of those parties that things have to change, that the current practice is not adequate and that the government expects better. I expect that we will see a lot better in this area.
MS BRESNAN: A supplementary, Mr Speaker.
MR SPEAKER: Yes, Ms Bresnan.
MS BRESNAN: Minister, will there be any process put in place to record reasons which might fall outside clinical reasons or will now only a clinical reason be allowed for any downgrading to occur?
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