Sunday, October 07, 2007


FIVE articles below today:

Useless Queensland health complaints body

Probably better known as the hospital whitewash commission

VALERIE Prowd was admitted to Nambour hospital in January 2005 with a broken leg. Sixteen days later she was dead. The tragedy rocked her loving husband Ray, who is relentlessly seeking answers. He has waged a paper war on health bureaucrats and has even attacked the Queensland Health Quality and Complaints Commission, which he said was too slow to investigate his wife's death. Mr Prowd believes his wife suffered a severe reaction to a narcotic painkiller which should not have been prescribed. He says he had five different death certificates - all "useless bits of paper".

At a Maryborough sitting of the Queensland parliamentary select committee on health, Mr Prowd had his day. "The Health Quality and Complaints Commission is about as useless as they come," he said. When told the commission said it needed six more weeks to complete a report, he told the hearing: "I could write a novel in that time." Mr Prowd complained also to the Crime and Misconduct Commission and was astounded when it referred his complaint against the commission to the commission.

Also critical of investigators was Leesa MacLeod, whose 57-year old mother, Ursula, died on the Gold Coast after obesity surgery known as biliary pancreatic diversion or BPD. Mrs MacLeod was 136kg when the operation was carried out at Allamanda Private Hospital. The hospital ceased BPD when it was revealed others also had died from the procedure. In a poignant submission to the select committee, Ms MacLeod said she was kept in the dark about the probe. "The investigation has taken so long it has greatly added to my grief and suffering," she wrote, claiming the commission was a grossly under-resourced toothless tiger.

Then she made what must be seen as a startling observation - the Health Quality and Complaints Commission and the Medical Board did not co-operate with each other. If correct, it is an astounding claim. "Information is not freely passed between the two entities," she said. She also said they changed courses of action when it suited them.


38 more patient deaths probed in Queensland

QUEENSLAND'S new health watchdog is investigating the deaths of 38 patients believed to have died from negligence or catastrophic failures in the medical system. Medical staff are facing criminal prosecutions over two of the deaths. With only seven of the 38 investigations finalised, more prosecutions are likely.

Informed sources said the remaining 31 cases could take a year to complete while investigators quiz scores of doctors, nurses, ambulance officers, wardsmen and grieving family members. The deaths were among 5067 complaints fielded by the independent Health Quality and Complaints Commission in its first year. More than 4400 complaints were "resolved", some over the phone.

The Courier-Mail learned the watchdog body received disturbing claims of gross negligence, system error and communications breakdowns resulting in deaths in Brisbane, the Gold Coast, Logan, Townsville, Cairns, Redcliffe, Normanton, Cherbourg and other Aboriginal communities.

Some of the details filtered out last week during Queensland parliamentary select committee hearings into the commission's first year. One serious case involved a 43-year-old Woodridge woman - previously reported in The Courier-Mail - who died on a stretcher at Logan Hospital because no beds were available. Other deaths were blamed on drugs mix-ups. The parents of a psychiatric patient who committed suicide complained their daughter was sent home without adequate treatment.

Nine complaints were referred to the State Coroner and two to the Child Guardian. Not all complaints were about failures in hospitals, with 1600 mostly minor grievances with private medical practitioners and dentists. The Health Quality and Complaints Commission was set up in 2006 after a health systems review by private consultant Peter Forster. It followed health inquiries by Anthony Morris, QC, and Geoff Davies, QC, who revealed major flaws in the system highlighted by the Bundaberg Hospital tragedy.

The new watchdog's CEO, Cheryl Herbert, said the commission had made a significant impact in its first year. "We are immensely proud of our achievements," she said. Mrs Herbert said complaints could be broadly placed in two categories: service and quality. She said the commission had 77 staff, of which 58 were permanent. Mrs Herbert called for better co-operation between the Coroner, the Crime and Misconduct Commission and police in investigating complaints. She said a computer systems upgrade in November would lead to better management of complaints.


NSW Surgeons told to accept cuts -- as saving lives 'too expensive'

A CASH-strapped Sydney hospital has ordered orthopaedic surgeons to cut back on operations and not book "emergency" cases outside business hours because it costs too much money. In another indication the NSW health system is at breaking point, The Daily Telegraph can reveal Sutherland Hospital this week told surgeons to scale back orthopaedic surgery as it was having a "detrimental effect" on the budget. The internal memo by the hospital's clinical group manager Aileen Lawther, sent on Tuesday, also complained of increased costs caused by "emergency" operations conducted after 5pm.

The letter has outraged surgeons who are concerned management is putting lives at risk. "Overall, the elective cases are being managed well ahead of the allocated clinical timeframes," the letter said. "While that is an indicator of the improved efficiencies within the service and beneficial to patients, it is having a detrimental effect on the budget for the procurement of goods to support the work."

At the same time, the hospital has also made an embarrassing plea for donations from the public to fit out its operating theatres. In a pamphlet distributed to families in southern Sydney, the hospital urges people to donate $100 to help buy six anaesthetic machines at $80,000 each. "We need your assistance to purchase these machines and ensure the best possible treatment is available to all residents of the Sutherland Shire," the letter said. The Daily Telegraph revealed last month that the State Government was capping the amount of donations hospitals could receive from charities to buy equipment.

Australian Society of Orthopaedic Surgeons co-ordinator Stephen Milgate said the hospital's actions would impact on already long waiting lists. "We are concerned that elective surgery is coming under pressure again and waiting lists will grow because operations have to be scaled back," he said. Opposition health spokesman Jillian Skinner said Sutherland Hospital was indicative of the health system. "It is very revealing of what middle management is dictating to doctors how they are to treat their patients and it's all driven by cutting costs," she said.

Health insiders yesterday said they hadn't seen so many senior doctors going on the record slamming the health system since the Camden/Campbelltown crisis. In the last week two senior doctors, Dr Tony Joseph from Royal North Shore and Dr Valerie Malka from Westmead, have condemned the system - calling it a shambles and demanding the Government take immediate action.

Yesterday Dr Kate Porgeos, a member of the Australasian College for Emergency Medicine and acting director of Gosford and Wyong hospitals, added her name to the list. "Everywhere across Sydney we are seeing severe access block, you can't see patients in appropriate places, we are very dependent on junior medicos and often overseas trained doctors or locums - we feel like we are losing registrars because they say it is a sweat shop and go elsewhere," she said. "It is a very stressful workload and you constantly feel like you are cutting corners and it is unsafe."


Radiology logjam in NSW

I have been in hospitals (e.g my local Brisbane Catholic hospital) where a typed radiological report was made available to me within an hour or two of the scan. That's what's possible. That's not remotely what many Sydney people are getting, however

THOUSANDS of X-rays and other medical scans are not being interpreted by radiologists in Sydney hospitals because of outdated technology and a national shortage of radiologists. In some cases films and scans have been lost. Liverpool Hospital has confirmed it has a backlog of 4500 images that have not been reported on by a radiologist. But a radiologist from the hospital, who did not want to be named, said the number of X-rays, CAT scans and MRI scans not being diagnosed by a radiologist was twice that.

At Westmead Hospital, staff say the backlog of scans not accompanied by a radiologist report is even greater, running into tens of thousands. The Opposition health spokeswoman, Jillian Skinner, said the backlog at some hospitals was putting patients in danger by delaying the diagnosis of potential conditions, including cancer. "A backlog of X-rays means patients aren't getting treated and therefore their lives are potentially at risk," she said. "The Commonwealth provides the training places at the university but without the resources and support from the State Government at the hospital level, they can't work."

Hospitals including Royal Prince Alfred and Westmead Children's have a computerised digital imaging system and are not reporting the same level of backlogs of unread scans. Some hospitals are paying private radiologists twice the rate they pay salaried radiologists to report on scans. Westmead, Liverpool, Royal North Shore, Nepean and Coffs Harbour hospitals are among those believed to be experiencing delays in reporting on images and are waiting for digital systems to be introduced.

A spokeswoman for Sydney South West Area Health Service said Liverpool Hospital would move to electronic reporting of all radiology examinations within 12 months. The health service and the Government denied that patients' safety was compromised and said that even if a radiologist had not viewed the images, a doctor or other professional would have in most cases.

Michael Fulham, head of medical imaging for the area health service, said the digital imaging system installed at Royal Prince Alfred Hospital in 2000 ensured that films were always available to medical teams managing patients. The digital system itself was not the solution, but "where you have a shortage of radiologists, I think the next best thing is ensuring the films are available where they are needed", Professor Fulham said.

The president of the Royal Australian College of Radiologists, Liz Kenny, blamed a national shortage of radiologists and radiographers for the problem. But Dr Kenny, who also represents the interests of private radiologists, was reluctant to plumb the depth of the problem. "It is hard for radiologists to read all the scans that are taken," she said. "The number not being reported is likely to be many thousands." She called for more radiology training positions.

The Health Minister, Reba Meagher, said NSW had increased the number of trainee positions for radiologists from 56 to 93 in the past six years. "The Royal Australian and New Zealand College of Radiologists has not approached the Health Department to suggest this number of trainees is insufficient," a spokeswoman for Ms Meagher said.


Bully culture rife in NSW hospital

NSW Premier Morris Iemma says he is disturbed by a report alleging bullying of staff at Sydney's Royal North Shore Hospital. Mr Iemma said today Health Minister Reba Meagher had briefed him on the September 18 report into the RNSH, which was leaked to News Ltd newspapers yesterday. Written by public servant Vern Dalton and nursing professor Judith Meppen, it found evidence of endemic misconduct by nurses, doctors and other medical staff at the hospital.

It said there were strong concerns about bullying and harassment and staff have been too terrified to speak out. The report was written shortly before a pregnant woman miscarried in the hospital's emergency department toilets after waiting two hours for attention.

Mr Iemma said he was "disturbed to see these reports" and pledged to weed out any bullying. "It has no part in our health system," he told reporters. "It is a disciplinary matter that does go to misconduct. "Anyone found to have acted in this way will be dealt with." He said new northern Sydney area health chief executive Matthew Dally had already made a good start in tackling the bullying problem at RNSH.


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