In parliament yesterday morning, Attorney-General Vickie Chapman tabled Independent Commissioner Against Corruption Bruce Lander’s 66-page report, Troubling ambiguity: Governance in SA Health, in which he described the state’s biggest department as having a culture and practices that enable corruption.
Health Minister Stephen Wade admitted yesterday he had not read the report in full before announcing the Government’s response.
Today, he revealed that Cabinet had signed off on the Government’s response despite him – the responsible minister – not having read the report.
Wade also said that there was “nothing new” in it, but later said there was “lots of new information” from Lander’s “six years of insight”.
Lander’s report said misconduct was “common and accepted” within the department, conflicts of interest were often left undeclared and unmitigated, and poor record keeping had undermined his own investigations into alleged cases of corruption, which had to be abandoned as there was little chance of successful prosecution.
“I am concerned that the governance and administrative arrangements in SA Health are ripe for exploitation by corrupt employees,” the report said.
Less than an hour after it was tabled, Wade addressed a press conference – flanked by the CEOs of SA Health’s local health networks, but not the department’s chief executive – to announce that the Government was setting up a cross-agency taskforce in response to the ICAC’s concerns.
He said the Government’s response “will be driven fundamentally by clinicians, not by lawyers”, despite ICAC singling out clinicians as a major cause for concern in the report.
In parliament later, the Health Minister said he had only “started” reading the report “and I’ll continue to read it”
In an interview with FIVEAA radio this morning, Wade conceded he had not read the report before he discussed the Government’s response to it at a Cabinet meeting.
Wade told the program the Government had received Lander’s report on Friday last week and that he received a copy, and started reading it.
But then he stopped because he was told it was inappropriate for him to have a copy.
“I wasn’t entitled to read the report,” he said.
“My understanding is that the report was given to the Attorney-General – there was a misunderstanding.
“I did get a copy of the report. I started to read it. When I became aware that I wasn’t entitled to have it, I put it aside.”
He said he shouldn’t have been given the report for legal reasons.
Asked whether he had discussed the matter in Cabinet before he was able to read the report, he said: “Yeah that’s right.”
Asked whether he had devised a response to the report without reading the report, Wade said: “No, well, let’s be clear – there was nothing new in this report,” he said, adding that the ICAC had raised issues that eventually appeared in the report with Wade on his first day as Minister.
He said those issues were raised again with him in meetings with Lander following the Commissioner’s public statement in October that SA Health was “riddled with maladministration” and “very likely” harboured corruption.
“On the very first day that I was minister he raised these issues with me (and) he raised these issues again in two separate (October) meetings,” said Wade.
“He wrote a letter to the Health department in October with a synopsis of what’s in this report – so there’s nothing new.”
But later in the interview, Wade said: “It’s a detailed report – it gave us a lot more information.”
“It gave us six years of insight in terms of what he’s seen and what he believes needs to be done.”
You can listen to the full interview by clicking here.
Opposition Leader Peter Malinauskas told reporters today: “It seems completely extraordinary, and nothing short of unacceptable, that we’ve got a Premier and a Minister who are signing off on a public policy response to an ICAC report without even reading it first.”
Lander cited numerous examples of concern in his report, including that public funds which should have been held in SA Health controlled accounts were being held in separate bank accounts, including those of independent and unrelated entities, “to prevent SA Health knowing of those funds”.
“In some cases management in the LHN appeared to have consented to the conduct because they also subscribed to the view that the arrangement was needed to protect the interests of the LHN or at least those who worked within it.”
Lander said some specialists had approved their own timesheets, and detailed one instance in which a timesheet had been approved for one to be working and paid at a particular public health site, but there was evidence “the particular specialist was in fact working at another location and being separately remunerated”.
In another incident, a clinician claimed to be working full time when in fact they were regularly not attending work two days in every week.
“There was no system in place by which assertions on timesheets could be verified, and the salaried specialist’s claims were assumed to be correct,” Lander writes.
“No audits on timesheet data were conducted.
“My investigations into these matters raise the question of whether the South Australian public is receiving the full value of taxpayer funds directed to salaried specialists and how SA Health is able to effectively monitor employees to ensure this occurs.”
Lander also cited a case in which a manager controlled rosters for part of both a public and private hospital where SA Health staff worked at both locations.
“That manager had an interest in the private hospital but there did not appear to be sufficient processes in place to manage the manager’s conflicting private interest,” the report said.
In another example, a manager was “engaged to provide advice on the delivery of certain services at a public hospital which were delivered by a scheme in which the manager derived a benefit”.
“This conflict did not appear to be identified or declared.”
Lander also questioned the cost of doctors’ rights of private practice within SA Health, arguing that they had “a financial incentive” to treat private patients “differently and more favourably than public patients, for example, by being placed on surgical lists ahead of public patients”.
He outlined poor procurement practices leading to potential wastage of taxpayer funds and the lack of a consistent conflict of interest policy across SA Health.
And he warned that parts of clinical trials were not conducted by SA Health employees, but rather by staff engaged by third party institutions.
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