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SA Health's "spectacular" delay in revealing what's wrong at the RAH

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SA Health is “refusing” to release documents that would reveal what’s gone wrong at the new Royal Adelaide Hospital and why.

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More than eight months ago, InDaily made a Freedom of Information application for access to reports about adverse incidents during the first year of the new Royal Adelaide Hospital’s operations.

The FOI Act says these applications must be dealt within 30 days – although it also allows time extensions.

We applied to see Safety Learning System reports, de-identified to protect patients’ privacy, on the basis that there is a clear public interest in the problems that occur in taxpayer-funded hospitals.

SA Health staff routinely record all sorts of adverse incidents and events – from medical malpractice causing a patient’s death to potential slipping hazards – in Safety Learning System reports.

Last year, Safety Learning System reports from the Lyell McEwin Hospital obtained under the FOI Act by Greens MLC Tammy Franks showed that the hospital’s short stay unit had facilitated suicide attempts, and that patients had killed themselves after receiving treatment there.

The SLS reports were among the repeated warnings the department had received about the facility’s “appalling” conditions, over several years, before it was finally closed in December 2017.

The Freedom of Information officer who initially dealt with InDaily’s Royal Adelaide Hospital FOI application told us in January this year that she was “80 per cent through processing it”.

In late February, a second FOI officer said she was “hoping to be able to release the information in the next few weeks”.

In March, she apologised for the delay but explained that the reports were taking longer to de-identify than expected.

“I am hoping to have the determination ready within the next few weeks,” she wrote at the time.

Under the FOI Act, a department can be taken to have “refused” an application if the 30-day period has expired.

We have yet to hear back from the officer since receiving an email from her in June, in which she wrote that our application was being reviewed “by the CEO” – presumably the CEO of the Central Adelaide Local Health Network, which administers the Royal Adelaide Hospital.

A spokesperson for SA Health told InDaily the FOI determination is still being finalised.

“In accordance with section 14A of the Freedom of Information Act 1991, a formal extension of time may be granted by the principal officer of an agency if they are satisfied, that the application is for access to a large number of documents or necessitates a search through a large quantity of information,” the spokesperson said. 

“As CEO of the Central Adelaide Local Health Network, Lesley Dwyer is also principal officer and is involved in the determination processes of FOI.”

Dwyer is ultimately responsible for the operational management of the Royal Adelaide Hospital.

Whoever occupies that role is also a “principal officer” under the Act, responsible for determining the fate of many Freedom of Information requests.

“System-design-wise that isn’t really ideal,” said Adelaide commercial lawyer Paul Gordon, who specialises in privacy and technology, and is experienced in FOI law.

“It probably would be more transparent and a more robust system were FOI requests dealt with by an independent agency.

“What the system’s trying to do is to balance state interests against transparency.”

But beyond potential conflicts of interest in the operations of the FOI Act, he said, accredited FOI offices within government departments need to be better resourced to ensure a reasonable workload.

“Probably the reasons why these things take time is they have a workload issue,” he said.

“What’s needed is … more resources into FOI processing.

“The system isn’t working.”

Certainly, the number of SLS reports completed by Royal Adelaide Hospital during its first year would be large – in the hundreds of pages.

However, “nine months is pretty impressive from a delay perspective,” said Gordon.

“I’ve had to wait three months … nine months is pretty spectacular.”

Bernadette Mulholland, senior industrial officer with SASMOA, told InDaily SA Health simply does not respond to the doctors union’s FOI requests.

Rather, she said, the union is forced to apply for an internal review of the FOI application, again receives no response, and finally escalates the matter to the South Australian Ombudsman – in every instance.

“One of the commitments that the Liberal (Party) made when coming into power was that there was going to be greater transparency,” she said.

“I’ve seen none of that.

“They’re (SA Health are) becoming a very secretive organisation.”

She said she would raise the problem with Health Minister Stephen Wade next time they meet.

In a statement, Wade said the department had received and responded to more FOI requests “than ever before” in the last financial year.

“In 2018/19 the Department received 165 FOI requests and responded to 119 of those,” he said.

“That is more than double the 70 requests and 61 responses in the previous financial year.”

InDaily will apply for an internal review of our application and, failing that, an Ombudsman’s review.

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If this article has raised issues for you, you can call LifeLine on 13 11 14 – or you can call the Mental Health Triage Service / Assessment and Crisis Intervention Service on 13 14 65.

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