Friday, September 09, 2005

A COVERUP UNCOVERED

The "Dr. Death" inquiry in Queensland ended because the inquiry chief was seen as too hostile to the bureaucrats who were ultimately responsible for the deaths of many unfortunate people in a Queensland public hospital. Like the USA, however, Australia has a Federal system so the inquiry chief presented the report of his findings to a Federal agency rather than to the State government which appointed him. So it has now become public knowledge. It confirms the worst suspicions you could have about a health system run by secretive bureaucrats:

Sacked health inquiry chief Tony Morris, QC, has used Federal Parliament to launch a scathing attack on the Queensland health system and call for sweeping reform. Mr Morris delivered the 33-page submission to the Standing Committee on Health and Ageing last night.

The submission, also sent to Mr Beattie and Queensland Health director-general Uschi Schreiber, catalogued a "plethora of systemic problems", serious dysfunction at Bundaberg hospital and a shocking culture of concealment in the bureaucracy. He urged a rapid response team investigate serious clinical problems anywhere in Queensland, a review of pay scales for doctors and nurses, and the re-education of bureaucrats to ensure they were effective "rather than remote and aloof". He called for Queensland Health's regulatory functions to be handed to a separate commission or organisation which would deal with complaints and standards.

Mr Morris's submission was made to the federal body after Mr Beattie installed new inquiry head Geoffrey Davies, QC, who starts his own proceedings today. A Health Report published in The Courier-Mail today reviews the issues raised in the 50 days of the health inquiry sittings and highlights the issues dealt with by Mr Morris in his federal submission.

Mr Morris was most scathing in his submission about the culture of concealment in the health system. "The institutional reaction to adverse events and crises is consistently the same; first you deny the facts, secondly you bury the evidence, and thirdly you shoot the messenger," he said. "People who are trouble-makers . . . are subjected to trumped-up disciplinary complaints and threats of civil and criminal action; have their honesty, their motives and their clinical competence challenged; are victimised with inconvenient rosters and other workplace impediments and are otherwise bullied until they are eventually eased or squeezed out of the system."

Mr Morris said one of the most urgent needs was honesty about the limitations of the public health sector. "Queensland Health as presently constituted simply cannot be trusted to tell the truth about itself," he said. "In considering events at (Bundaberg), especially in relation to (surgeon Jayant) Patel, one inexorably comes to the irresistible conclusion that structural and systemic factors are at the heart of the problems facing the public health sector. "What occurred at Bundaberg is not itself the disease – it is merely an acute symptom of a condition which is chronic, widespread and potentially terminal."

Mr Morris said good luck rather than good management was the reason other Patel-like disasters had not occurred more often. "Most of the factors have been present for several years, perhaps much longer, at most, if not all, hospitals throughout Queensland," he said. "Patel himself was like a bacillus which, introduced into an unhealthy body, found the body in such a weakened condition – its defensive systems so atrophied – that it could wreak havoc without detection or resistance for two years."

Dr Patel, the former Bundaberg Hospital chief surgeon, remains in the US while Queensland homicide detectives prepare a case against him. Dr Patel had lied to the medical board and Queensland Health about the action he had faced for gross negligence in the US.

Mr Morris said Dr Patel's deceit had succeeded because "the system at every stage was capable of being duped". He also condemned Queensland Health's concealment of the case of bogus psychiatrist Vincent Berg, who used "crude forgeries" to be registered by the medical board and get a job at Townsville Hospital.

In a rebuke of former health minister Wendy Edmond and sacked director-general Steve Buckland, Mr Morris said: "It cannot be accepted that in the Berg case, the decision to conceal the facts was the correct one. The only way that Queensland Health could have helped (Berg's psychiatric patients) was by prompt, full and frank disclosure. "The Berg case is illustrative of a tendency on the part of Queensland Health to cover up any embarrassing information."

Mr Morris highlighted the reputation of Queensland Health for bullying staff and for adopting a shoot-the-messenger attitude. There was a need for clinical problems to be addressed in an open, frank and honest way. Mr Morris listed 23 recommendations, including:

* Urgent reforms to the collection of waiting list data for elective surgery.
* Supervision and improved training for overseas doctors.
* Added protection for whistleblowers who disclose confidential information to journalists, unions, MPs or professional associations.
* A health sector ombudsman to act as a gatekeeper for complaints.
* A need for every hospital to have a clinical chief-of-staff, a practising clinician rather than a bureaucrat.
* An overhaul of the funding model for hospitals to ensure that the health needs of patients were prioritised.
* Ensure doctors and nurses have genuine representation in hospital management.

Source

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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?

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