Wednesday, June 30, 2010

Doctors query local control of medical services

The Australian, June 30, 2010

SENIOR doctors have raised the alarm over another element of the federal government's health reform program.

They warn that the original promise that the system would be "run locally" is under threat as states move to set up hospital networks.

Local control was central to Kevin Rudd's original pitch for his health reform plans in March, and at the time was seen as a partial riposte to Tony Abbott's plan to restore local hospital boards.

But doctors from NSW, Victoria and rural Australia say local clinical control faces being severely curtailed by a requirement that doctors and nurses given seats on the networks' governing councils are drawn from neighbouring networks. Senior doctors say the condition -- ostensibly to reduce conflicts of interest -- will ensure clinicians on the councils will be unfamiliar with the issues and have limited ability to influence what goes on.

Sydney emergency specialist Sally McCarthy, president of the Australasian College of Emergency Medicine, said the issue was "of great concern" and allowing only external clinicians would "completely undermine" the government's pledge for local control.

"I don't think you can read it in any other way . . . than a deliberate move to continue to shut clinicians out of meaningful involvement and decision-making," Dr McCarthy said.

Friday, June 25, 2010

Saturday, June 19, 2010

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Tuesday, June 8, 2010

SMH: Cancer patients denied surgery

Cancer patients denied surgery

KATE BENSON
June 8, 2010

HUNDREDS of patients in Sydney, many needing spine and cancer surgery, have been left off hospital waiting lists for up to a year because overworked staff did not file the paperwork.

The mistake, which doctors say has affected more than 800 people, some in acute pain, has forced the health department to order a blitz on the centralised surgery bookings system in western Sydney. But angry surgeons claim some patients have already deteriorated as a result of the fiasco.

The error has also made politically sensitive hospital performance figures - much vaunted by the health department - look better than they are.

A spokeswoman for the Sydney West Area Health Service said about 200 forms were still waiting to be processed but denied 800 people had been affected.

She said 93 per cent of patients needing urgent elective surgery had been treated within the required 30-day time frame.

While most urgent cases were being seen, surgeons said at least 300 patients at Westmead and another 300 at Mt Druitt and Blacktown - some needing surgery for bladder or skin cancer - were never allocated to the list so the performance figures were false. The remaining 200 forms belonged to patients from other hospitals in western Sydney.

The number of cases missing from the lists was the tip of an iceberg, said the chairman of Westmead's medical staff council, Peter Klineberg.

''Most surgeons stopped even trying to put patients forward because they refused to tolerate them getting lost in the system.

''There is a lot of frustration over this, a lot of ill will. This might have seemed like a good idea at the time but it discounted the human factors,'' he said.

Donald MacLellan, the health department's program director of surgery, has been called in to audit the bookings and close the centralised office. But it could take at least six months to resolve the crisis. Hospitals will be ordered to revert to booking their own patients.

''It's a crazy situation but we're just grateful at long last something is being done,'' the chairman of the division of surgery at Westmead Hospital, John Fletcher, said yesterday.

Since March last year, surgeons in western Sydney were told to submit booking forms to a central office in Blacktown, regardless of which hospital would perform the surgery.

The system was put in place by the former chief executive of Sydney West Area Health Service, Steven Boyages.

But a statewide freeze on employing non-clinical staff meant bookings, which should have been entered into the computer system within three days, mounted and were ignored.

Professor Fletcher said surgeons had pleaded with the department to acknowledge the system's failure, but their calls had fallen on deaf ears.

''In some cases, we even had patients allocated to lists but they were not notified, so we had theatre staff standing around expecting them,'' he said.

The introduction on March 1 of the state trauma plan, whereby Westmead received a greater proportion of severely injured patients, would also make it difficult for surgeons to clear the backlog, but staff had been given a guarantee the new bookings office would be adequately staffed and resourced.

Do you know more? kbenson@smh.com.au

http://www.smh.com.au/nsw/cancer-patients-denied-surgery-20100607-xqu1.html