In an interview with InDaily in October, Independent Commissioner Against Corruption Bruce Lander identified clinicians as the main focus of his corruption investigations concerning SA Health over the past several years, and warned that the prosecution of doctors over suspected corrupt practices had been frustrated by poor record-keeping within the department.
In a report to parliament released last week, Lander described misconduct within SA Health as “common and accepted” and identified rostering, doctors’ right of private practice and use of “special purpose funds” among key areas of concern.
The report said that the department has been unable to properly monitor its specialist doctors for time spent at work and duties actually discharged during work hours, and that some clinicians “with considerable private interests and secondary employments are not being properly managed against the risks that those interests and employments pose to the provision of public health services”.
In a letter to the state’s doctors late last week, South Australian Salaried Medical Officers’ Association senior industrial officer Bernadette Mulholland said that the reputation of doctors had been sullied by the ICAC report, and that clinicians should lead the process of change in response to it.
“The good standing of specialists working in our public hospitals has recently been called into question by the Independent Commissioner Against Corruption report,” Mulholland wrote.
“SASMOA intends to work in a deliberate, measured and methodical way, together with members, to ensure proper governance and administration in SA Health.
“SASMOA supports the strong position of the Minister for Health and Wellbeing when he stated clearly and unambiguously that this ‘is a change that will be fundamentally led by clinicians and not lawyers.’”
Wade made the comment early last week as he announced the government would launch a cross-agency taskforce, to be led by the chief executive of the Department of Premier and Cabinet, to fix problems within SA Health.
The Government has so-far dismissed calls for an independent inquiry – such as a Royal Commission – into SA Health and refused to give the ICAC $2 million to fund an evaluation of the department.
Mulholland stressed in her letter that the vast majority of clinicians worked extremely hard and blamed the department for failing to engage with them effectively.
“Many of you will have read and heard the commentary, some of which has been ill-informed, and whilst the reports may seem alarming, the overwhelming majority of specialists are highly-skilled and dedicated professionals who work incredibly hard to deliver high quality health services to the community in an environment where battling SA Health for resources for patient care is now the norm,” she wrote.
“In the past SASMOA members have been frustrated by the failure of SA Health to provide guidance and leadership.
“SASMOA has for many years encouraged SA Health to genuinely engage with clinicians to improve its culture and practices.”
She wrote that at culture of bullying and harassment had become accepted within SA Health and blamed the department for enabling it.
“It is time to end the bullying and harassment of medical officers – it is time to stamp out a negative culture presided over by SA Health,” the letter said.
“There is no place for inappropriate behaviour in the workplace and any individual who has engaged in criminal activity should be prosecuted and dealt with in accordance with the law.
“Such conduct cannot and will not be tolerated.”
In an interview with InDaily this morning, Mulholland said if clinicians had acted inappropriately then the ICAC should “cut out the rot”, but that the reputation of the profession of the whole should not be tarnished by the actions of a small number.
“We don’t want the reputation of a large group of clinicians (to be damaged by the actions) of the few,” she said.
“If ICAC has the ability to cut out the rot, we absolutely support (that).”
“We’ve not seen accountability and responsibility of the department and that needs to be looked at – they abdicate their responsibility for things that go wrong.”
She said it was important that clinicians lead the process of change in the department because they were best placed to understand the day-to-day working of SA Health policies such as doctors’ rights of private practice.
She said she had yet to see evidence of doctors exercising those rights during the hours they are meant to be seeing public patients, and said the union had been frustrated in its attempts to meet with department officials to discuss rights of private practice arrangements.
The State Government announced a review of doctors’ rights of practice in Treasurer Rob Lucas’s state budget last year.
“The Government identified these issues 18 months ago and, in our first State Budget, announced our policy to review Rights of Private Practice – that policy has not changed,” Lucas said in a statement.
“We said at the time that while South Australia currently charges a nine per cent fee to clinicians for the right to use public hospitals to treat private patients, compared to 68 per cent in Queensland and Western Australia and up to 90 per cent in New South Wales.
“The current Enterprise Agreement under the former Labor government covering clinicians doesn’t expire until December next year, and negotiations cannot begin until six months prior.”
Lucas told reporters this morning that the Government had legal advice saying they could not review the rights of private practice arrangements until the next round of enterprise agreement negotiations next year.
In a statement to InDaily this afternoon, an SA Health spokesperson said: “The issues raised have emerged over a number of years, as acknowledged by the ICAC Commissioner.”
“Work to address the issues has been underway for a period of time however the cross-agency taskforce will work with all stakeholders and unions to develop a full response to the ICAC Commissioner’s report.”
Mulholland added that SASMOA was in favour of the ICAC being appropriately funded to evaluate SA Health, but argued that the past decade of heated political dispute about the department was having an impact on doctors’ ability to do their jobs.
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