11

JULY, 2018

Secret hospital errors
Bureaucratic cover ups
Political lobbyists burying reports

Are you afraid of offending others?

Even worst, are you scared of being sued?

Welcome to the biggest threat to Australians economic and education future. Secrets.

And whether the excuse is political correctness, hurting someone’s feelings or threatening a business profits, the result is decreased honesty. And as a result of less honest debate, costs are skyrocketing and standards are slipping.

Honesty keeps people, well, honest. People, health professionals and hospitals.

When ‘Irma’ put her husband into a nursing home, she couldn’t find out information about past complaints or health department of health investigations.

A month later his regular insulin medication had been changed without consultation with his regular Doctor. After several episodes of unstable blood sugar his foot ulcer had dramatically deteriorated.

She was in the process of filling a complaint against the nurses. She was rung one morning to hear that her husband was dead from a ‘hypoglycaemia’ episode.

After five years of fighting a range of government departments ‘Eirma’ received no explanation for her husband’s sudden demise, no apology for the missmanagement of his diabetes and no investigation into the nurses, who oversaw his stable condition that deteriorated into a gaping leg ulcer, then sudden death.

Had she been able to access information about the nursing home’s history she would have seen numerous complaints about poor nursing care and other residents who had died suddenly from diabetic complications.

The issue is not medication errors, or ignorant, uncaring staff.

It’s secrets.

A growing Australian problem.

‘To patients, the healthcare system is a black box. Doctors and hospitals are unaccountable, and the lack of transparency leaves both bad doctors and systemic flaws unchecked.’
Marty Makary

When ‘Julie’ and her husband wanted to start a family, she asked her rheumatologist if it was OK to continue taking Methotrexate while pregnant. ‘Julie’  was assured that there was no problem taking the drug through her pregnancy. There was no information about common medication errors for people with rheumatoid arthritis, or drug company warnings about the drug.

“But come and see me after the first trimester” was her Doctors advice. “Just to see how your going”.

Julie’s child was subsequently born with developmental difficulties. After several years of paediatric assessments, a diagnosis was made of a permanent and devastating disability.

A member of her family who worked in a health department overseas, was aghast that ‘Julie’ had been given this drug while pregnant.

“This drug is banned for pregnant women in my country” said ‘Julie’s sister in law.

‘Julie’ was told she faced a lifetime of caring for a very sick child. On the advice of a friend she approached a law firm and sued for damages. Her final payout was $100,000, just enough to pay off the morgage.

Sixteen years later ‘Julie’ is her son’s full time carer. She doesn’t work and has no other children. Her husband left, several years after the law suit was settled. He now has children with his second wife.

The issue was not just that one private specialist gave incorrect information about well know side effects of a dangerous drug.

It was the secretive environment that he prescribed drugs in. Until the arrival of the internet, people simply had no access to information about the side effects of drugs and other medical treatments.

“The real gain for the health system is in fixing rats**t outcomes. But governments of all persuasions won’t let us off the leash.”
Dr Armitage, previous CEO of Private Healthcare Australia and previous health minister of South Australia.

Secrecy kills and maims. Ask the victims of the bank scams from the Royal Commission. And with this most recent and all other Royal Commissions, it turns out that everyone knew about problems for years, but just covered things up.

Numerous reports have been compiled about which hospitals are sub standard and which are safe and effective. But non of them are available for the public to see.

Private healthcare Australia commissioned a report into the error rates of 600 private  hospitals across the nation. The report took four years to compile and rated the hospitals from A+++ to C— based on infection rates. The health insurance body was clearly frustrated by some of the results.

“There are a whole lot [of hospitals] that are C-triple-minus,” Dr Armitage said. “And we just keep backing up the truck full of gold bars” to pay them.

He wanted to make the results of the report public. Private hospitals lobbied against this. Major political parties refused to support the release of the report. To this day it remains hidden from patients, who’s lives depend on the quality of the medical treatment they are paying to receive.

‘At present, a veil of secrecy hangs over which hospitals and clinicians have higher rates of patient complications, and which are safety leaders.’
All complications should count: Using our data to make hospitals safer.

 

Public health bureaucrats are also withholding data on hospital errors from the public.

According to a report from the Gratten Institute written byStephen Duckett and Christine Jorm,

‘one in every nine patients who go into hospital in Australia suffers a complication, and if they stay overnight the figure increases to one in four.’

The report said that everyone should have information about avoidable error rates in Australian hospitals.

At present, statistics on hospital errors are collected, but they are kept secret, not just from patients but also from doctors and all hospitals.

Australian patients are surrounded by a ring of secrecy.

If this data was made public, it would highlight the areas where there is a big gap between the best and the worst-performing hospitals, and enable patients, Doctors and taxpayers – to identify which hospitals are performing well and which are not.

‘A Fairfax Media analysis of the 47,900 “positive” patient reviews of 1840 medical practices on HealthEngine found 53 per cent had been changed in some way. ‘
Esther Han, Sydney Morning Herald 

Even patient feedback on rating sites is being kept secret from the Australia public, without the knowledge of the reviewers.

The medical search site Health Engine was originally set up to help both Doctors and patients find the right health service, quickly and easily.

But a recent expose revealed that 53% of their patient reviews have been changed, often sanitising the comments by removing any negative feedback. No indication was given to the reader that this had occurred.

Australians have no equivalent to the guarantee of Freedom of Speech in the First Amendment. We have as a consequence, less transparency than our American cousins.

Instead, investigative journalists are frequently subject to litigation. Suing for defamation is relatively easy in Australia, with the laws favouring the plaintiffs. Legal costs can be prohibitive, some stories are never able to be told.

“The vast majority of cases are settled,” wrote Peter Bartlett and Sam White, two well-known media lawyers, “not on the merits of the claim, but on a purely commercial basis. The cost of going to judgments is just too great.”

The 2018 Brisbane writers’ festival recently ‘disinvited’ international writer Germaine Greer and the ex premier of NSW Bob Carr, on the grounds that they were too controversial.

Bob Carr told the Guardian Newspaper that he …”thought writers’ festivals embraced controversy”

Even the liberal espousing Australian Broadcasting Commission has fought tooth and nail to keep the salaries of it’s staff hidden from the tax payers who foot their bill. The organisation unsuccessfully spent three years fighting to block a Freedom of Information request. It revealed left wing media presenter Jon Fain collects $285,249 a year, while COO Marc Scott receives $773,787.

Australia’s courts are routinely prohibiting reporting on some aspects of criminal cases. Jason Bosland, a law professor at the University of Melbourne believes that many of these orders go beyond what is legally necessary or in the public interest. In some cases Australian courts have ordered that information in the public domain be removed from Australian news sites, even though the information in them could be found outside the country.

Jeff Richardson, Professor of Health Economics at Monash University has stated that thousands of people are likely to be dying every year as a result of preventable hospital errors.

He said that if the last major Australian studyThe Quality in Australian Health Care Study in 1995 was correct, 350 patients were dying every two weeks because of the problem.

Professor Richardson has called for compulsory reporting and that Doctors who did report adverse events, should be immune from prosecution.

‘”The issue of adverse events in the Australian health system should dominate all others. However, it would be closer to the truth to describe it as Australia’s best kept secret,” he said.
Julia Medew Sydney Morning Herald.

Other countries are far ahead of Australia, in terms of transparency and public accountability.

In Britain, two journalists started a website called Dr Foster. It allows patients to compare hospitals and assess their safety standards.

The site collects up-to-date information on issues such as patient safety, clinical effectiveness and patient experience. Hospitals are ranked for their safety, one is the worst and five is the best.

The CEO Tim Bake says the site is successful because of it’s independence from bureaucratic and commercial interference.

In the US the media company US News puts together a yearly report called Best Hospitals in the US, that rates hospitals on Doctors feedback, public reports and patient feedback.

All Australians have is a government run, directory style website called My Hospitals. It lists addresses, specialties available and gives extremely limited data covering blood born infection rates and Emergency Department waiting times.

Information about private hospitals is absolutely minimal and no prices are listed. This is despite the fact that the majority of oncology and orthopaedic procedures in Australian are now carried out in the private sector. Among wealthy countries, Australia now has the third-highest out-of-pocket medical costs. Almost a fifth of health spending in Australia comes from out of pocket costs.

Lack of transparency simply means higher errors and higher costs. Markets that don’t have to be accountable, have no incentive to improve.

Australia is bad at providing transparency and suffers high costs as a result.

Increasing numbers of Australians are being forced into bankruptcy due to health costs and lack of health insurance coverage. Federal government data shows that “ill health or the lack of insurance” was the primary cause of non-business-related personal insolvency for 1830 people in 2016-17.

Propping up private health insurance is like putting lipstick on a pig – John Menadue.

There are 34 insurers with 40,000 variations of policies available. Due to complexities and deliberate obfuscation, the public is confused about exclusions, inclusions and gap cover. It is subsidised by Australian taxpayers at a cost of $11bn a year. The motor industry never got a subsidy like this.

So what’s the answer?

Step outside the system and look at

  • Medical tourism
  • Health startups
  • Pay as you go

When a system is broken, step outside it and find another solutions.

“They access public hospital outpatients departments for the coordinated specialist care they require from specialist teams, such as physiotherapy, rehab and social work: it provides them with a ‘one-stop’ shop and they learn fairly quickly that declaring their private health insurance status might create more expense.”
Dr Christine Walker