Page 31 - Week 01 - Tuesday, 15 February 2011
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MS GALLAGHER: This is an issue that the Auditor-General identified in her report. It is also an issue that ACT Health has been working on with surgeons to rectify it. It is not always the surgeons themselves, and these are processes that have already changed within ACT Health, but during the time of the audit it is not always the doctor’s inclination to give a reason why. The doctor may sign the form but not indicate a clinical reason. Whilst it fitted in with the policy that a clinical reason was required, that policy was not always being followed.
There were also other arrangements for dealing with re-categorisation; for example, the doctors’ rooms making contact with surgical bookings area and asking that patients be reclassified, and those processes are going to be stopped.
In terms of what the audit found, the audit did not find a patient where they had been re-categorised without doctor authority. The problem is that all—
Mr Hanson: That’s not true.
MS GALLAGHER: It is not not true, Mr Hanson. They did not find a patient where there had not been some contact with the doctor. As to whether the forms had not been signed by the doctor or a clinical reason given by the doctor, that is a different matter. But, in my discussions with the surgical bookings area when we have been talking about improvements to these areas, in some instances those decisions can be made over the phone and not documented and that is not appropriate. It is not in line with ACT Health policy and the forms and the systems have been changed already to make sure that those instances do not happen again.
I should also say that during the time of the audit about 250 upgrades were made—people’s categories were upgraded—and we found the same issues there in terms of clinical reasons and not in all cases where doctors’ signatures had signed off the reclassification.
So, yes, this refers to about two per cent of the elective surgery work in relation to downgrades, but the same problems were identified in the same amount of upgrades where people were upgraded from category 3 to category 2 and from category 2 to category 1.
MR SPEAKER: A supplementary, Mr Seselja?
MR SESELJA: Thank you, Mr Speaker. Minister, why were there instances of several patients being reclassified on the same day without documented clinical reasons?
MS GALLAGHER: Again, only a clinician can answer why that decision was taken. It may have been taken because that doctor was going on leave and was not able to deal with those patients within the 30-day time frame and was not happy to reallocate those patients to another doctor. The system that was in place was that if a doctor had so many category 1s that it was impossible for those category 1 patients to be dealt with within the 30-day time period, the doctors and the surgical bookings unit would speak to each other. They were offered extra operating times if extra operating times
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