IN QUEENSLAND WE ARE FINDING OUT WHAT HAPPENS WITH A WELL-ENTRENCHED PUBLIC HEALTH BUREAUCRACY

Hospitals' hidden harm:

One in 10 people who enter a public hospital suffer some sort of harm, a confidential review tabled at the health inquiry has shown. Queensland Health bureaucrat John Wakefield yesterday told the inquiry that while this was an unacceptably high rate of harm, it was not harm caused by the Dr Patels of the world but by well-intentioned staff making mistakes.

Dr Jayant Patel, who worked as director of surgery at Bundaberg hospital for two years, has been linked to the deaths of 80 patients. Dr Patel fled in April and police yesterday confirmed accused pedophile and fake psychiatrist Vincent Berg has also left the country. Mr Berg, under investigation for allegedly molesting a Townsville boy, left on Wednesday last week. A savage backlash over the health crisis is expected against the State Government at today's by-elections for the southeast seats of Chatsworth and Redcliffe.

Dr Wakefield is Queensland Health's Patient Safety Centre executive director. The centre compiles information to help standardise state hospital systems. His comments on patient harm were made as the inquiry also received the confidential Queensland Sentinel Event Review. The review disclosed that 84 very serious incidents warranting in-depth investigation occurred in the previous 10 months. Two related to surgery on the wrong patient or the wrong body part but it did not say in which hospital. Four related to a surgical instrument or material being left in a body cavity or in a wound. Two deaths occurred during inter-hospital transfers while nine were categorised as "sudden and unexpected death of an infant associated with labour or delivery". There were 21 unexpected patient deaths two of which occurred during surgery, while another two patients died due to an adverse reaction from an incompatible blood transfusion. Another two were described as "direct maternal death". Forty-two deaths were related to the suicide or unexpected deaths of mental health patients.

Dr Wakefield told inquiry commissioner Tony Morris that a previous national study into harm in hospitals found that one in six patients who had been admitted suffered as a result of the health care they received and that half of these were preventable. He said that most adverse events were due to human error and the cost to the nation was about $4 billion a year. "It is estimated that 50,000 patients suffer a permanent disability and 18,000 preventable deaths occur per annum in Australia as a result of adverse events," he said. "There is no evidence to suggest that the Queensland public health system is any better or worse than any other health care system in the first world in relation to preventable patient harm."

Dr Wakefield said there had been an "absolute focus on productivity at all costs" and the elective surgery program had been part of that in the past few years. "Let's be open and honest about the fact that we actually do harm patients as a result of hospital care, we don't mean to but we do." He conceded that there was no system in place to assess clinicians' performance when concerns were raised. The inquiry indicated yesterday that it may not meet its September 30 deadline.

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Bureaucracy still rules, OK

I got quite a shock this week reading the positions vacant columns in recent Queensland Health Service Bulletins. There is page after page of jobs for managers, administration officers, public affairs officers, project officers, information technology workers, social workers and nurses - but few for doctors. There is a sick joke going around that Queensland employs more spin doctors than real doctors.

Despite the Morris inquiry into health, which has damned the bureaucracy, Queensland Health remains bloated with non-medical staff. The bureaucracy still rules. Emergency surgery by new Health Minister Stephen Robertson is needed.

But what has Premier Peter Beattie learnt from the inquiry? Not much, apparently. It is almost as if he is in denial. He was very cute this week dragging his wife, Heather, along to his press conferences. Against all the evidence of grotesque medical blunders and a bullying and secretive bureaucracy moulded by his Government, Beattie and his missus emerged to tell us we were all really to blame for the hospital crisis for growing old and needing medical treatment.

It was bizarre, yet reporters seemed too polite to challenge the Premier. After all, nobody wanted to appear to be insulting his wife, a nursing educator. I wonder how the 108,571 people on medical waiting lists felt when they heard suggestions it was their own fault for getting sick?

Also this week the Premier attempted to shift the blame for his Government's failings in health by blaming the Feds. This was an old Joh trick. What makes the waiting lists look even more pathetic is the Labor boast that it carries a Budget surplus. The money was there, but not spent.

Now Newspoll confirms that Beattie's store of goodwill has begun to drain away. The Labor Government and the Opposition parties are neck and neck. Beattie has squandered an awesome lead. (He enjoys 63 seats in a House of 89.) The hospitals crisis obviously has dealt the Labor Government a savage blow.

So have the Liddy Clark affair and the the dirty water surrounding Energex and the unseemly exit of former speaker Ray Hollis. Accountability starts at the top. Taxpayers money is still going on secret bonuses for government executives and cronyism is rife. As Beattie dashes from one photo opportunity to the next, I have a horrible feeling the unelected bureaucrats are running the show.

The above column by Des Houghton appeared in the Brisbane "Courier Mail" on August 20, 2005 but does not appear to be online anywhere except here

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.

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