ABSURD PUBLIC HOSPITAL PRACTICES KILL LITTLE GIRL

Queensland Health has been accused of ignoring a top-level report that might have saved the life of a 10-year-old girl. Elise Neville died two days after being seen and sent home by a junior doctor in charge of Caloundra Hospital's emergency ward in January 2002. The State Liberals said this was contrary to a special report delivered to Queensland Health in 2001 which said that senior doctors – not junior doctors on their own – should work in emergency wards. The Liberals said yesterday that the report was not only ignored by the department, but had been kept secret. Details were obtained this week by Liberals deputy leader Bruce Flegg through Freedom of Information.

The Review of Emergency Services, Sunshine Coast Health Service District, was written by Dr Bill Rodgers, former medical superintendent at Nambour Hospital. Its recommendations were not implemented and when Elise Neville went to Caloundra Hospital after a fall from a bunk, inexperienced junior doctor Dr Andrew Doneman was in charge and 20 hours into a 24-hour shift. Dr Doneman did not admit the young girl to hospital or perform tests that would have shown she had a serious head injury. She was sent home after some minor treatment, and died two days later from internal bleeding and swelling of the brain.

Dr Doneman pleaded guilty in the Health Practitioners Tribunal in November 2004 to unsatisfactory professional conduct. He was sacked by the Government, though he was later allowed to practise after an appeal to the Medical Board. The Australian Medical Association and College of Emergency Medicine said at the time Dr Doneman had been made a scapegoat for Queensland Health's "unsafe practices" of making staff work dangerously long hours.

Dr Flegg, the Liberals' health spokesman, yesterday accused the State Government of a blatant cover-up of information in the Rodgers report which was relevant to Elise Neville's death. He said that if the report, which examined emergency medicine arrangements at Caloundra and other Sunshine Coast hospitals, had been acted on instead of covered up "the result would have most probably been quite different". The report said: "The population of Caloundra mandates an emergency department capable of dealing with emergencies and principal house officer (senior) level staffing is considered appropriate." Dr Rodgers recommended that until Queensland Health could recruit principal house officers, senior medical officers should maintain 24-hour duty cover for the department. His main recommendation was: "Caloundra Hospital appoint five principal house officers to staff the emergency department at all times."

However, Dr Flegg said that one year after the report was written a junior doctor with less than two years' experience was on duty in the emergency ward when Elise Neville was taken in. "Not only were these recommendations hidden from the public, they were ignored," he said. Dr Flegg said the Queensland Health report was never made available to the Medical Board tribunal, the Coroner, the Neville family, their lawyers, or Dr Doneman. "It seems that the Government would have left this report under wraps, as they failed to produce it," he said.

Queensland Health said a decision was made in October 2001 to recruit five senior doctors for the emergency ward, but the first did not come on board until early 2002. Five principal house officers, plus two emergency specialists, were working there now. Health Minister Stephen Robertson said he was unaware of the document but would investigate.

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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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