Page 4333 - Week 14 - Wednesday, 27 November 2013
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She said:
… I do know the policy that is in place is that ultimately it is the clinician that is the decision maker. The clinician is the only person that is able to downgrade if a downgrade is to be made of the clinical category of their patients on the elective surgery waiting list.
“It is only done by their treating doctor. That is it.” She said:
… can I stand here and say that that is simply untrue and there is no evidence to say that that is a practice that is employed by ACT Health … I was asked a number of times whether or not I think admin staff approach doctors and ask that their patients be downgraded, or that pressure was put on doctors, I think, to downgrade their clients; and I can absolutely say that that is not the case.
These are quotes from the minister. And on and on, the quotes contain categorical denials. But when the Auditor-General provided her report, the story was very different. The story was:
… the 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 …
The report said:
… in 2009-10, 250 patients—250 patients in Category 1 were reclassified and a significant number of these reclassifications (97 percent) occurred without documented clinical reasons;
The report continued:
Audit identified 55 reclassifications (or 32 percent) that had no evidence of having been approved by a doctor.
It also stated that it was:
… consistent practice by some doctors to ‘stage’ (downgrade) patients’ clinical urgency category close to the clinical recommended timeframes for these patients. This often followed a request for review by the hospitals.
So with respect to what the doctors and the patients alleged, and what Katy Gallagher in this place categorically denied, the Auditor-General found to be true. It is all in black and white. It is all in the Hansard or in the Auditor-General’s report of 2011:
… 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.
We also know that there was a problem in the emergency department where data was fabricated. The Auditor-General found:
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