Report delivers cure for sick system

A report into the conduct of Queensland Health doctors detailing serious issues relating to workplace attendance, treatment and billing practices has been referred to the Crime and Misconduct Commission.

Health Minister Lawrence Springborg said the Queensland Audit Office’s report Right of Private Practice –Senior Medical Officer Conduct outlined how soft accountability standards had resulted in some doctors exploiting the system which was introduced by the Labor Government in 2006.

Mr Springborg said the report, commissioned at his request, had also found prima facie evidence that Labor's model had resulted in private patients at public hospitals being seen on time more consistently than public patients.

"I'll let the Labor Party and the Union bosses that bankrolled their re-election explain to their members and supporters how they introduced and let flourish such a perverse outcome in our public hospitals,” Mr Springborg said.

Mr Springborg strongly reiterated that the report should not reflect on the overwhelming majority of senior doctors in the public health system whose services to the sick were appreciated and valued by all.

"But it is evidence of a failed unaccountable system that is open to abuse by a minority,” he said.

“Some doctors treated private patients in public hospitals despite not having a right to private practice and in some cases, doctors were ‘double-dipping’ by performing private work while they were being paid to work in the public system.

“The report also highlighted issues where doctors claimed for work during rostered hours, but were not actually there.

“The report also recommends that new processes be put in place to ensure patients have fair and equitable access to services, regardless of their ability to pay.

“Let me assure Queenslanders that this CanDo LNP Government will ensure new contracts for Senior Medical Officers will put an end to Labor's model where some doctors have repeatedly claimed overtime -despite having turned up late for work.”

Mr Springborg said work on the six recommendations outlined in the report to fix these issues was already underway.

“Our government promised at the election to revitalise frontline services and deliver a better health care system for Queensland,” he said.

“The lack of transparency and accountability identified in this report makes a solid case for placing senior doctors on contracts and will allow Hospital and Health Services to address current shortcomings.

“Asking doctors to sign the new contracts which reward performance and deliver improved patient outcomes will help us end duplication, reduce waste and restore accountability.

“Hospital and Health Service Boards will have oversight of local contract processes and it will be their responsibility to take corrective action if this type of contrary conduct resurfaces.

“It will also ensure every dollar possible is directed into the health services Queenslanders need most.”

The report recommends that the performance of senior doctors should be assessed based on agreed levels of clinical and non-clinical activity.

“Key performance indicators are the cornerstone of Queensland Health’s contracts for senior doctors with realistic performance measures to be decided between clinicians and their employer,” he said.

“These measures will be outcome based and will be a massive step forward from a system that primarily rewarded hours worked.”

Hospital and Health Services have already begun implementing the recommendation to improve rostering practices to reduce unnecessary overtime and fatigue.

These improved practices will also ensure that rosters properly manage the delivery of clinical services for all wards, theatres, clinics and hospitals.

Hospital and Health Services have also begun improving their activity data collection at a local level to ensure future funding is directed to where it is needed most.

[ENDS] 11 February 2014

Media Contact: Alexandra Foley 0419 794 294

Fast Facts:

Recommendations:

1. Strengthen the management of conflicts of interest for senior medical officers by: 

• Introducing written mandatory declaration of outside employment for SMOs
• Requiring SMOs to provide updated information when situations change
• Better defining conflicts of interest in the context of public service SMOs undertaking secondary employment
• Strengthening the process for assessment of conflicts of interest
• Undertaking education and awareness training for SMOs in conflict of interest obligations

2. Investigate the extent of unrecorded leave and undertake appropriate remedial action

3. Develop rosters for the efficient delivery of health services including:

• Aligning SMOs’ work patterns with rostered hours for payroll purposes
• Managing fatigue in accordance with Queensland Health guidelines

4. Assessing an SMOs performance based on an agreed level of clinical and non-clinical activity

5. Monitoring patient access to ensure that patients have fair and equitable access to services, regardless of their ability to pay

6. Establishing controls to maintain a consistent standard to collect and report activity data for funding and statistical purposes