Australia: Public medicine demands coverups

There is so much failure to conceal

Specialist doctors say governments are gagging them from speaking out about serious flaws in the public hospital system that are costing lives and harming their patients. Members of the Royal Australasian College of Physicians (RACP) have complained they are being forced to sign public hospital contracts preventing them from telling the public about major problems affecting health care Australia-wide.

They said a 30 per cent drop in the number of hospital paediatric wards since 1992 had resulted in children being placed alongside adults who were sometimes psychiatrically disturbed or dying. "I know of children having adult emergency patients in the adjacent bed," Melbourne-based physician Peter Lazzari said in Cairns, where he was attending the RACP's annual scientific conference. "That adult emergency may be a death or a cardiac arrest or a massive haemorrhage, and you can imagine the trauma to the child as a result of that deliberate exposure by the government of children to adult illness," Dr Lazzari said.

Rural Victoria-based paediatrician Peter Goss said he risked the sack for speaking out, but could no longer continue to remain silent when children's welfare was at stake. "It's the first time in a year that I've said anything because speaking out in public prior to that caused me such significant emotional stress from the harassment," Dr Goss said. "These sorts of scandals would not be propagated if the medical staff were allowed to openly ... tell the general population what's going on. "Children will get better more quickly in an environment which is child-friendly and will be cared for more safely if we retain nurses with paediatric experience. "Over the last three years across Victoria, there are multiple examples of hospitals who have downsized children's wards and co-located adults in those wards. "An entire children's ward in Ballarat was closed last year."

Dr Lazzari said governments, both state and federal, had forced medical practitioners to become unwilling jailers and executioners, having to tell patients they might have to wait years in pain for necessary surgery and might even die waiting. "Instead of a diagnosis and an operation, we're actually ... giving those patients who can't get through the waiting list system a sentence," he said. "We say 'yes, you need that hip operated on otherwise your health is going to continue to deteriorate. "'You're going to have continuing pain, continuing suffering, your weight's going to become more of a problem, your exercise program is going to become more of a problem, and you may well die because it's going to be five or six years before you get your operation. "'We're giving you a term of imprisonment with your illness and ultimately you may well die'. "It's a disgrace," he said.

Dr Lazzari said he had decided to speak out because he believed doctors had a major democratic responsibility to raise issues of concern with public health. "We need to be able to speak up freely, but accurately and fairly," he said.

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One Australian coverup comes unglued

Queensland Health has been forced into another embarrassing backdown after admitting it wrongly disciplined a whistleblower doctor. The doctor had exposed serious concerns about a senior manager at the Prince Charles Hospital. The man was disciplined last year after checking into the background of a woman appointed to a senior nursing position at the hospital when he had concerns about her ability and referees.

However, the department has now been forced into an about-face, admitting it was wrong, and the matter has been referred to the Crime and Misconduct Commission for investigation. Health Minister Stephen Robertson yesterday told State Parliament that at a May 5 meeting, he personally apologised to the doctor and offered to pay his legal fees and strike the disciplinary action from his record. "We also accorded the doctor with whistleblower status, and the director-general of Queensland Health has taken steps to ensure that he will not be disadvantaged because of the disclosures he has made," Mr Robertson told Parliament.

The doctor first raised concerns about the woman's ability to manage her position and the process of her appointment with hospital management in April last year. He asked for a review of the appointment process, saying her former supervisor had not been contacted as a referee by the hospital before the woman was hired in 2003. Despite the doctor seeking whistleblower protection in May last year, Queensland Health took disciplinary action against the doctor in September for breaching the woman's privacy. He appealed against the action.

Mr Robertson said the incident demonstrated the importance of the soon-to-be-established independent Health Quality and Complaints Commission, which would ensure the concerns of staff and the public were properly managed. The issue was first raised in State Parliament last November by Liberal Party health spokesman Bruce Flegg, who accused the department of ignoring complaints from 18 staff about the woman's appointment and shredding documents relating to the issue.

At the time, the hospital said the appointment had been endorsed by two external reviews. Yesterday, Dr Flegg said the incident had all the hallmarks of poor Queensland Health management including staff bullying and decisions by bureaucrats not clinicians. "This was an appalling episode in the management of a critically important clinical unit," he said.

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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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