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SA Health to answer to ICAC on culture concerns

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The state’s anti-corruption watchdog this week met with senior SA Health bureaucrats, including CEO Chris McGowan, as the troubled agency attempts to overturn a culture found to be “riddled with maladministration”.

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Independent Commissioner Against Corruption Ann Vanstone is expecting a detailed written response from SA Health about efforts to address a bombshell report tabled 18 months ago by her predecessor Bruce Lander, which revealed a professional culture that facilitates corruption, and in which misconduct and unmitigated conflicts of interest are “common and accepted”.

In response to questions from InDaily about whether she shared her predecessor’s concerns about SA Health’s professional culture and whether she had seen anything to suggest the issues Lander raised were being addressed, Vanstone revealed she had this week met with SA Health officials on the matter.

“Earlier this week I met with senior members of SA Health and was provided a verbal update on efforts to address some issues identified by Mr Lander,” Vanstone said in a statement.

“A more comprehensive written response has been promised to me soon.”

Her office has confirmed that McGowan was one of the senior figures present at the meeting.

Vanstone said that “although I do not have the same breadth of experience of investigating SA Health matters as my predecessor, the Hon. Bruce Lander QC, I have no reason to doubt the circumstances he described in Troubling Ambiguity: Governance in SA Health”.

In August last year, Lander told parliament he had various ongoing “live investigations” into potential criminal misconduct within SA Health, including cases “at the more serious end of the spectrum”.

He had also revealed that he had sought funding for a formal audit of the agency, but that this was denied by Treasurer Rob Lucas.

“I think the Government was wrong not to provide me with the funds necessary to go out and undertake an evaluation – I think Health would have been a better agency now had that evaluation been carried out,” Lander said last year.

“I think there was a good opportunity… to do an evaluation [given] the problems that have been within Health for a number of years. They’ve not been addressed… they were allowed to fester [and] they’re getting worse.”

Asked whether she had approached the Marshall Government with a similar request, Vanstone said: “I have not at this point requested additional funding to myself undertake an examination of SA Health.”

It comes after revelations this week that a surgeon at an Adelaide public hospital has been charged with 25 counts of deception following an ICAC investigation into allegedly inaccurate timesheets.

In a public statement on Tuesday, Vanstone said that a 56-year-old Kingswood man had allegedly deceived SA Health by submitting timesheets between June 2017 and April 2018 falsely claiming he had been recalled to a metropolitan hospital to perform surgery.

She said in some instances claims were allegedly made for procedures with which the surgeon had no involvement, while in others he “merely offered advice to a more junior doctor but did not perform the relevant procedure himself”.

Other claims involved procedures that the surgeon allegedly did perform, but in ordinary working hours for which he was already being paid, or which were undertaken in the surgeon’s private capacity.

“It is alleged that in all but one instance the timesheets were certified and authorised by the surgeon himself,” Vanstone said.

Lander’s Troubling Ambiguity report detailed his concerns about the use of timesheets, arguing at the time that “persons who approve salaried specialists’ timesheets have little or in some cases no ability to determine whether or not they are accurate”.

“Some salaried specialists have approved their own timesheets,” the report said.

“The Auditor-General has expressed concerns about timesheet practices in SA Health and has noted the absence of processes to ensure all medical officers’ timesheets are submitted and approved.

“He has said that there are no policies and procedures existing to check medical officers’ attendance records.

“In 2016 in response to the concerns that the Auditor-General previously raised, [the department] advised him that it would develop a formal policy and procedure for time recording processes.

“I understand that a policy of this kind was created and applied to salaried specialists but that it has since been withdrawn.

“The consequence is a troubling ambiguity about the manner in which SA Health is managing its employment relationship with salaried specialists because it does not appear that SA Health has in place an effective system by which it clearly communicates to its salaried specialists the expected level of service; and can be satisfied that the level of service it is purchasing is in fact being delivered.

“The ill-defined employment obligations and insufficient means of validating the performance of contractual duties gives rise to an increased risk of corruption and maladministration in public administration.”

In a statement to InDaily today, SA Health said it had made “significant progress” in tackling the issues raised by ICAC.

“SA Health has made significant progress against the agreed program of work and is expected to close out the formal program in the near future,” the statement said.

“While the official program will conclude, the issues that are being addressed will receive ongoing focus and attention.

“Program deliverables such as the Cultural Evolution Pathway, released last September, will continue to guide improvements to SA Health’s governance and culture.

“In addition, the newly-developed Policy and Integrated Compliance frameworks will continue to support a focus on integrity across the health system.”

The Cultural Evolution Pathway, whose development has been led by deputy chief public health officer Dr Mike Cusack, is a program to develop an “integrity culture at scale” across the health network.

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