GOOD OLD BUREAUCRATIC BUCK-PASSING

Even when people are dying, nobody's to blame in a bureaucracy

BUNDABERG Hospital's top bureaucrat Peter Leck has used his return to the stand at the health inquiry to deflect some of the blame for the Jayant Patel scandal, criticising his offsider Darren Keating, Queensland Health and even hospital medical staff.

Mr Leck, who initially asked to be exempt from giving evidence on the grounds of mental illness, testified from a closed court with only audio of his testimony beamed into an adjacent room at the Brisbane Magistrate's Court.

He gave evidence to the first inquiry in May. He told commissioner Geoff Davies that because he had no medical training, he relied on his director of medical services, Dr Keating, to bring any clinical issues to his attention. He said Dr Keating had repeatedly reassured him that concerns being raised about chief surgeon Dr Patel were nothing to worry about.

Mr Leck -- suspended from his general manager's position pending the inquiry's outcome – said he was under constant pressure from Queensland Health to bring the hospital in under budget and to avoid bad publicity.

But Mr Leck, who was warned last week by Mr Davies, QC, to expect rigorous cross-examination, had his own conduct spotlighted by senior counsel assisting David Andrews, SC – particularly the failure to subject Dr Patel to credentialling and privileging checks during his two-year tenure. It is a district manager's sole responsibility to ensure such checks take place.

Mr Leck said he had delegated the credentialling process to Dr Keating and had pressed him several times about the need to get it up and running. "I kept on pressing and he became a little short with me and basically said that he had a lot on his plate and that he couldn't work the hours that I worked because he had family," Mr Leck said.

Mr Leck was also questioned about why he failed to report to his superiors the death of Gerry Kemps - one of Dr Patel's patients who died after surgery in late 2004 - which was required in the event of an unexpected death.

Late yesterday senior counsel assisting, David Andrews, SC, showed the inquiry an e-mail from Mr Leck to his director of nursing, Linda Mulligan, on January 13 this year in which he said they needed to "quieten down" any potential rumours circulating about Dr Patel. Mr Leck said he wrote the e-mail in response to a group e-mail from a staffer. Mr Leck said he assumed the first e-mail referred to Dr Patel because he had told other staff about the allegations that had been made about him.

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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