A BUREAUCRACY FINALLY IN THE GUN

Queensland's health system has been exposed as Australia's worst because of a long-running culture of government secrecy and an obsession with saving money. In a sweeping final report, Health Commission head Geoffrey Davies has recommended criminal charges against Dr Jayant Patel, the rogue surgeon whose botched operations at Bundaberg Hospital sparked the inquiry.

The Beattie Government's cover-up culture came in for extended criticism. Former health minister Wendy Edmond was blasted for being instrumental in the cover-up of information and her successor Gordon Nuttall's conduct in the job was described as "misleading, unreasonable and careless". Mr Davies, a retired Court of Appeal justice, also said two Bundaberg Hospital administrators who failed to take action, Darren Keating and Peter Leck, should be prosecuted. He found that Dr Keating's failure to adequately respond to complaints about Dr Patel had shown a gross dereliction of duty. Dr Keating had "persistently ignored or downplayed the seriousness of these complaints" and had been keen to describe them only as personality conflicts.

Mr Davies recommended the Crime and Misconduct Commission prosecute Mr Leck for official misconduct. He said Mr Leck had performed his duties carelessly or incompetently and his conduct should be referred to Queensland Health chiefs for discipline under the Public Service Act.

But the central criticism in yesterday's 538-page report was levelled at politicians and the health bureaucracy. Mr Davies said Queensland's whistleblower protections were inadequate and called for a central body to oversee public interest disclosures. He also recommended the Queensland Ombudsman's powers be widened to further protect whistleblowers. And he called for the establishment of a "one-stop shop" with investigative powers to handle complaints and weed out incompetent doctors.

On the political front, Mr Davies found that successive state governments followed a practice of concealment and suppression of elective surgery waiting lists and measured quality reports. "This in turn, encouraged a similar practice by Queensland Health staff," he said. "In my view it is an irresistible conclusion that there is a history of a culture of concealment within and pertaining to Queensland Health."

Mr Davies found that the Beattie Cabinet had led this concealment culture to protect its political fortunes. The former Coalition government had been guilty of similar offences. Mr Davies found that the suppression of material and the use of Cabinet to hide it -- by shielding it from Freedom of Information requests -- had been contrary to the public interest. He stopped short of recommending legislative change to halt the practice, but said it was clear that successive governments had abused the Freedom of Information Act.

Premier Peter Beattie's correspondence to the commission was also criticised as being untrue. Mr Beattie had written in part: "I am prepared to act to continue my government's record of openness and accountability." Mr Davies concluded that this had been "inconsistent with the facts".

Mr Beattie yesterday refused to change his Government's culture, saying after the release of the report that Queensland's freedom of information laws and whistleblower protections would not be overhauled. He also firmly backed his Cabinet colleague Mr Nuttall, who is now the Primary Industries Minister. Mr Nuttall said the attack on him was unwarranted and he would not be pressured into resigning from Cabinet. Ms Edmond declined to comment when approached at her Brisbane home, and later faxed a brief statement via her solicitor saying she was disappointed at Mr Davies's criticisms of her.

The Health Commission report said Queensland had Australia's lowest level of funding per head of population for its public hospital system. That underfunding had been exacerbated by several factors. These included the fact that Queensland was Australia's most decentralised state, that Queensland had the highest population growth, and that it had a lower than average number of medical practitioners.

Mr Davies labelled Dr Patel, the surgeon whose actions sparked the inquiry, as a medically incompetent liar whose clinical bungling and lack of judgment killed at least 13 people and injured many others. He recommended that Dr Patel, who had been Bundaberg Hospital's director of surgery, be investigated for manslaughter. Police plan to charge Dr Patel, believed to be living in the US, in about eight months.

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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