Labor MLA for Lismore: Rural Health Inquiry’s Lismore hearing to be live webcast on Thursday 17 June 2021

 

Office of NSW Labor MLA for Lismore, Janelle Saffin, media release, 17 May 2021:

Rural Health Inquiry’s Lismore hearing to be webcast

NSW Labor has ensured that the NSW Parliamentary Inquiry into health and hospital services in rural, regional and remote NSW’s Lismore hearing on Thursday June 17 will be webcast, according to State Member for Lismore Janelle Saffin.

“This is a good win because all locals, together with all residents of rural and regional NSW need to have access to their Parliament and its processes,” Ms Saffin said yesterday.

“I lobbied for this Inquiry to sit in our Electorate of Lismore and it is important that as many people as possible get to hear testimony from individuals and organisations who made submissions about their experience of the health system.

“The Inquiry has already held hearings in Deniliquin and Cobar, both of which were not webcast. I understand that the transcripts then took over a week to be released publicly.

“This was unacceptable to many country people and media outlets, so my colleague, NSW Shadow Minister for Health Ryan Park raised these concerns directly with the Chief Executive of the Department of Parliamentary Services.

“In light of the high level of public interest in the Inquiry’s work, the Committee, chaired by Labor MLC Greg Donnelly, now will be trialling the live webcasting of its hearings in Wellington tomorrow (Tuesday, 18 May) and in Dubbo on Wednesday (19 May).”

The Inquiry was established on 16 September 2020 to inquire into and report on health outcomes and access to health and hospital services in rural, regional and remote New South Wales. It has received more than 700 submissions from people across NSW.

Live stream details:

https://www.parliament.nsw.gov.au/Pages/webcasts.aspx

How NSW Northern Rivers hospitals are coping with COVID-19 restrictions backlog of elective surgeries

The COVID-19 pandemic impacted on Australian public hospitals with regard to elective surgery and the impact played out thus......

Australian Government, Australian Institute of Health & Welfare:

In terms of elective surgery, following a decision by National Cabinet, restrictions applied to selected elective surgeries from 26 March 2020 including:

• Temporary suspensions of all urgency Category 3 procedures and selected urgency Category 2 procedures.

• No restrictions applied to Category 1 procedures and exceptional Category 2 procedures.

• Similar restrictions on elective surgery were in place through the private sector.

On 16 September 2020 The Sydney Morning Herald reported that:

NSW's elective surgery waiting list has blown out to more than 100,000 patients that will take at least six months to clear after national cabinet's moratorium on non-urgent operations triggered an unprecedented backlog.

A staggering 10,563 patients were overdue for their elective surgeries on June 30, nearly 20-times the number of overdue patients on the same day in 2019, the latest Bureau of Health Information report shows.

Operating theatres are running at up to 115 per cent their pre-COVID activity levels to get through the state's waiting list that hit 101,026 patients on June 30 – a 20 per cent jump (an additional 16,896 patients) compared to June 30 last year.

Patients needing cataract surgeries, total hip replacements, and ear, nose and throat surgeries were waiting up to 55 days beyond the clinically recommended timeframe, the report released on Wednesday showed…..

More than 10,500 people were waiting for knee or hip replacements at the end of September, according to the quarterly Bureau of Health Information report, up more than 22 per cent from the same time in 2019.

According to NSW Health Care Quarterly, Trend Report of September 2020:

July to September 2020 had the largest number of patients on the waiting list for urgent and semi-urgent procedures of any quarter over five years.

The number of patients on the waiting list for nonurgent procedures was up 30.0% (17,803) over five years, from 59,319 in July to September 2015, to 77,122 in July to September 2020. However, it decreased from its highest level in April to June 2020.

By 9 December 2020 The Sydney Morning Herald was reporting that:

Orthopaedic surgeries were not only running behind, with 27 per cent occurring later than clinically recommended, but also had larger than usual wait lists at the end of September, up 21.3 per cent for knee replacements and 25.6 per cent for hip replacements compared to 2019. Usually on-schedule eye surgeries were also hit hard.

On 19 February 2021 elective surgery wait times were again in the news:

Waiting for elective surgery can be a postcode lottery in NSW, with waits as long as 375 days at some country hospitals but just days in the city.

So how are public hospitals in the Northern NSW Local Health District faring?

Given that this health district has a significant retiree population, by way of example I looked at three elective surgeries which appear to occur with relative frequency in older people.

PUBLIC HOSPITAL ELECTIVE SURGERY MEDIAN WAITING TIMES IN NORTH-EAST NSW

Lismore Base Hospital:

Hip Replacement - the median wait was 83 days in 2011-12 and blew out to 127 days by 2017-18 and latest figures for 2019-20 stand at 102 days.

Total knee replacement - the median wait was 150 days in 2011-12 and blew out to 229 days by 2016-17 and latest figures for 2019-20 stand at 142 days.

Currently Lismore Base Hospital patients tops the state for the longest wait for knee replacement - a median 375 days - with 63 per cent of patients waiting more than a year. 

Shoulder joint replacement - the median wait was 14 days in 2016-17 and blew out to 16 days by 2018-19 and latest figures for 2019-20 stand at 14 days.

Ophthalmology - the median wait was 323 days in 2011-12 and latest figures for 2019-20 stand at 341 days, the highest median waiting time in the last nine financial years.

Between July and September 2020 a total of 1,360 unspecified elective surgery procedures were performed.

Grafton Base Hospital:

Hip replacement - the median wait was 6 days in 2011-12 and blew out to 77 days by 2017-18 and latest figures for 2019-20 stand at 67 days.

Total knee replacement - the median wait was 10 days in 2011-12 and blew out to 145 days by 2017-18 and latest figures for 2019-20 stand at 135 days.

Shoulder joint replacement - the wait was 8 days in 2016-17 and blew out to 11 days by 2017-18 and latest figures for 2019-20 stand at less than 5 days.

Ophthalmology - the median wait was 285 days in 2011-12 and latest figures for 2019-20 stand at 326 days, the highest median waiting time in the last nine financial years.

Between July and September 2020 a total of 652 unspecified elective surgery procedures were performed.

The Tweed Hospital:

Hip Replacement - the median wait was 65 days in 2011-12 and blew out to 130 days by 2017-18 and latest figures for 2019-20 stand at 119 days.

Total knee replacement - the median wait was 114 days in 2011-12 and blew out to 201 days by 2017-18 and latest figures for 2019-20 stand at 197 days.

Shoulder joint replacement - the median wait was 24 days in 2016-17 and blew out to 28 days by 2017-18 and latest figures for 2019-20 stand at 22 days.

Ophthalmology - no patients listed between 2011-12 and 2019-20.

Between July and September 2020 a total of 1,084 unspecified elective surgery procedures were performed.

Murwillumbah District Hospital:

Hip Replacement - the median wait was 39 days in 2011-12 and blew out to 48 days by 2017-18 and latest figures for 2019-20 stand at 30 days.

Total knee replacement - the wait was 53 days in 2011-12 and blew out to 59 days by 2017-18 and latest figures for 2019-20 stand at 30 days.

Shoulder joint replacement - the median wait was less than 5 days in 2019-20.

Ophthalmology - the median wait was 323 days in 2011-12 and blew out to 336 days by 2014-15 and latest figures for 2019-20 stand at 128 days.

Between July and September 2020 a total of 438 unspecified elective surgery procedures were performed.

Casino & District Memorial Hospital:

Performs limited orthopaedic procedures predominately as day surgery.

Does not currently perform ophthalmology surgery.

Between July and September 2020 a total of 252 unspecified elective surgery procedures were performed.

Maclean District Hospital:

Provides a small number of elective orthopaedic list procedures once a month.

Does not currently perform ophthalmology surgery.

Between July and September 2020 no elective surgery of any type occurred.

Ballina District Hospital:

Does not currently perform orthopaedic or ophthalmology surgery.

Between July and September 2020 a total of 307 unspecified elective surgery procedures were performed.

Byron Central Hospital:

Does not currently perform orthopaedic or ophthalmology surgery.

Kyogle, Bonalbo, Nimbin and Urbenville Multi-Purpose Services:

Do not currently perform surgery.

NOTE:

All statistics were found at the Australian Institute of Health & Welfare.

Shortage of doctors at Lismore Base Hospital due to Queensland-NSW border closure

Life during the COVID-19 pandemic has become a little harder across the NSW Northern River region......

ABC News, 12 August 2020:

A senior doctor at a major hospital on the New South Wales north coast says the closure of the Queensland border is a "political stunt".

Chris Ingall, an executive on the Medical Staff Council at the Lismore Base Hospital, said the health service was "scrambling" to cope with the effects on patients & staff, who must quarantine for 14 days if they enter Queensland from outside the so-called border bubble in the Tweed Shire.

"You've got over 100 doctors that work at Lismore Base Hospital that live in Queensland; they are no longer available to us because they don't want to leave their families & not get back," he said.

"So we are scrambling for doctors, anaesthetists, emergency doctors, a lot of the frontline doctors who are no longer going to be able to support Lismore Base Hospital."

Dr Ingall said it was having a significant impact on the risk posed to residents in the Northern Rivers.

"This doesn't need to happen at all from a medical perspective because there is no community transmission in the Northern Rivers," he said.....

Queensland has relaxed its border restrictions for people "entering to obtain specialist health care, or as a support person to a person obtaining specialist health care, that cannot be obtained at their place of residence".

But those entering from beyond the border bubble will have to go into government-provided quarantine for 14 days.

The cost for an adult is $2,800; one adult and one child is $3,255.

People classified as vulnerable or who can prove financial hardship can apply to have the fees waived.....

A word from the NSW Northern Local Health District.......

TheDaily Examiner, 18 March 2020:

THE Northern NSW Local Health District boss says the group is working with North Coast Primary Health Network to ensure the region has an appropriate and effective response to Covid-19 (coronavirus).

Chief executive Wayne Jones said this included regular daily briefings at a state and local level, sharing information with primary health providers, providing advice on testing and monitoring, and working with Queensland Health.

Covid-19/flu clinics are established at Lismore Base Hospital and The Tweed Hospital, for those with respiratory symptoms or fever and who were at risk of Covid-19, such as those in contact with a Covid-19 case, or those who had returned from overseas in the 14 days before the onset of symptoms.

The clinics are open from 10am to 6pm seven days a week.

People do not need to call ahead to attend these clinics, but if attending an Emergency Department outside these hours, or attending a GP, are asked to phone ahead, or discuss symptoms with healthdirect on 1800 022 222.

A spokeswoman said anyone with acute symptoms could present to an ED and alert staff on arrival.

“As with other public hospitals in NSW, we are arranging to double the ICU capacity in hospitals in Northern NSW and to prepare for a significant increase in respiratory presentations to Emergency Departments,” Mr Jones said.

“All our facilities are planning for a potential increase in presentations of people with respiratory illness over the coming weeks and months, and we’re working with NSW Health to maximise available critical care resources.

“We have not cancelled elective surgery, but are reviewing the need to bring some cases forward, particularly those which may require Intensive Care support, in light of the expected increase in demand for ICU services in the coming weeks…...

Will the Clarence Valley see an upgrade of Grafton Base Hospital within the next three years or will it take a decade to commence?

Grafton Base Hospital is a 50-99 bed public health facility which offers health services to an est. 51,647 resident population in the Clarence Valley on the NSW North Coast and an additional annual tourist population which can reach or exceed 1 million visitors.

In the first quarter of 2019 ambulance arrivals at Grafton Hospital were up 11.5 per cent, emergency department presentations rose by 3 per cent, emergency presentations climbed by 4.2 per cent, hospital admissions increased by 14.9 per cent with acute admissions totalling 3,127 patients and the elective surgery waiting times continued to grow.

In that same quarter during the NSW state election campaign the Nationals MP for Clarence on behalf of the Berejiklian Coalition Government promised voters in the Clarence Electorate a much needed $263.8-million overhaul of Grafton Hospital.

At the time doubts were raised about the genuineness of this promise as it contained little detail.

Those doubts are now resurfacing……

The Daily Examiner, 21 June 2019, p.3:

A major hospital upgrade looks to be a while off as the Clarence Valley joins the long queue of regions promised big projects at the New South Wales election.

The $263million commitment to the Grafton Base Hospital redevelopment was made in the final weeks of the campaign in March and is just one of many major infrastructure promises outlined in the 2019-20 Budget Papers.

However, there there was no specific line item in the 2019-20 Budget and Nationals MP Chris Gulaptis was quick to point out it would take time.

“It’s not a line item as such as we are still in the very early planning stages but there is a commitment for works to commence during this term of government,” he said.

“In the meantime, consultation needs to occur between the LHD, clinicians and the community to ensure the redeveloped hospital is able to provide for the community into the future.”

Mr Gulaptis said he had received assurances from Premier Gladys Berejiklian, Treasurer Dominic Perrotet and Deputy Premier John Barilaro that all election commitments would be honoured and provided a letter from Health Minister Brad Hazzard responding to representations he made after winning the election.

In the letter, Mr Hazzard said the project was one of many promised but work would still start before the end of the current term of parliament.

“In the period prior to the March election, the NSW Government announced a significant number of upgrades to hospital and health facilities across the state,” he said.

“This requires a prioritisation of when projects will commence over the next four years and will occur in alignment with the annual budget process.

“Once funding is made available through the budget process, Health Infrastructure will work with the local health district and clinical staff to progress the project through the planning stages.”......

If you're not feeling well but think things can't get any worse - you forgot to factor in the Australian Minister for Health's cost cutting ways

The Age, 4 August 2017:

State and territory health ministers say hospital treatments and services will suffer under a Commonwealth proposal to withhold budgeted funds and reduce spending.

Federal Health Minister Greg Hunt has drafted a directive to the Independent Hospital Pricing Authority to review its public hospital funding method.

It would result in retrospective funds not being paid and reduced services in future, Queensland Health Minister Cameron Dick said in a joint statement issued after the COAG Health Council meeting in Brisbane on Friday.

Mr Hunt drew condemnation from Queensland, Victoria, Western Australia, South Australia, the Northern Territory and the ACT when he confirmed he would uphold the direction.

"States and Territories have already funded services and boosted frontline staffing taking into consideration Commonwealth funding," the statement said.

Independent Hospital Pricing Authority (IHPA), media release, 17 July 2017:

IHPA releases Consultation Paper on Pricing Framework for Australian Public Hospital Services 2018-19

The Independent Hospital Pricing Authority (IHPA) today released its Consultation Paper on the Pricing Framework for Australian Public Hospital Services 2018-19. The consultation is open to the public until Thursday 17 August 2017.

The Pricing Framework for Australian Public Hospital Services 2018-19 outlines the major policy decisions which will underpin the National Efficient Price and National Efficient Cost Determinations for 2018-19.

This year IHPA will seek feedback regarding work that has been progressed on pricing and funding for safety and quality as well as canvassing options to enable new and innovative approaches to value based or preventative health care models.

The Chair of the Pricing Authority, Shane Solomon said, “IHPA has continued to work closely with the jurisdictions, clinicians and other stakeholders to make significant progress on the implementation of national reforms to incorporate safety and quality into the pricing and funding of public hospitals in Australia.

“A range of factors must now be considered including risk adjustment and how the approach can be embedded as part of broader system change.

“The success of a safety and quality pricing and funding mechanism is dependent on national, state, and local health systems working together to support the implementation of a model and ensure that it is working to improve safety and quality across all services,” he said.

“The Consultation Paper is an important opportunity for stakeholders to engage with IHPA on the approach to pricing and funding for safety and quality as well as the emergence of new innovative pricing models to help improve public hospital services across Australia. We strongly encourage all interested parties to provide feedback as part of this process,” concluded Mr Solomon.

The Consultation Paper on the Pricing Framework for Australian Public Hospital Services 2018-19 is available on the IHPA website.

Submissions should be emailed as an accessible Word document to submissions.ihpa@ihpa.gov.au or mailed to PO Box 483, Darlinghurst NSW 1300 by 5pm on Thursday 17 August 2017.

– ENDS –

Independent Hospital Pricing Authority (IHPA), Ministerial Direction, 16 February 2017:

Ministerial Direction

On 16 February 2017 IHPA received a Ministerial Direction from the Hon. Greg Hunt under section 226(1) of the National Health Reform Act 2011.

The Direction requires that IHPA undertake implementation of agreed recommendations of the COAG Health Council on pricing for safety and quality to give effect to:

1. nil funding for a public hospital episode including a sentinel event which occurs on or after 1 July 2017, applying to all relevant episodes of care (being admitted and other episodes) in hospitals where the services are funded on an activity basis and hospitals where services are block funded; and
2. an appropriate reduced funding level for all hospital acquired complications, in accordance with Option 3 of the draft Pricing Framework for Australian Public Hospital Services 2017-18, as existing on 30 November 2016, to reflect the additional cost of a hospital admission with a hospital acquired complication, to be applied across all public hospitals; and
3. undertake further public consultation to inform a future pricing and funding approach in relation to avoidable hospital readmissions, based on a set of definitions to be developed by the Australian Commission on Safety and Quality in Health Care.

IHPA will incorporate the requirements under this Direction into the final Pricing Framework for Australian Public Hospitals 2017-18 due to be published on the IHPA website in early March 2017.

IHPA will undertake further consultation as part of its annual consultation process on the draft Pricing Framework for Australian Public Hospitals 2018-19 due for publication in June 2017 and provide a report back to the COAG Health Council by 30 November 2017.

Note: This follows on from a Direction received on 29 August 2016 which required IHPA to provide advice to the COAG Health Council on options for pricing for safety and quality.

More information

For any questions, please contact enquiries.ihpa@ihpa.gov.au

Links

• View the full Ministerial Direction online
• View previous Direction from 29 August 2016

Would believing Australian Health Minister Greg Hunt's denials be the height of foolishness?

Along with making home-owning aged pensioners pay for their Centrelink/Vet Affairs pensions by way of a debt against the value of their houses, it appears as though funding private hospitals at the expense of public hospitals may be on the Liberal-Nationals-Murdoch-IPA Coalition wish list.

A list voters never actually get to see unless the Liberal and National parties are re-elected to government - at which time its contents are usually presented to the electorate as fixed policy.

Here it is. Minister claims to 'rule out' hospital funding overhaul but taskforce continued to meet. You can't trust Turnbull with Medicare. pic.twitter.com/3THdSs3kkx

— Senator Murray Watt (@MurrayWatt) May 29, 2017

Basic outline of unsubmitted recommendations of the
Global Access Partners (GAP) Taskforce on Hospital Funding

Via Twitter

The Sydney Morning Herald, 29 May 2017:

Health department bosses have described their radical proposal to remake hospital funding as "future gazing" after the Turnbull government declared it would never adopt the controversial policy.

The private health insurance rebate would be abolished, consumers would be charged more for extras cover and the states would be forced to find more money for public hospitals under the plan.

As revealed by Fairfax Media on Monday, the nation's most senior health bureaucrats – Department of Health Secretary Martin Bowles and his deputy Mark Cormack – are members of a secretive taskforce formed to develop the policy around a "Commonwealth Hospital Benefit" (CHB).

Health Minister Greg Hunt immediately ruled out adopting the policy.

"Not government policy. Won't be government policy. Will never be government policy," Mr Hunt said.

Mr Hunt said the taskforce – funded by the department but run by a private think tank called Global Access Partners – pre-dated his time in the portfolio and he had already told bureaucrats he was not interested: "I've rejected it once. If it ever comes forward, I'll reject it again."

Officials attended a GAP meeting that explored the proposal just four days after Mr Hunt apparently told them not to pursue the idea in March.

And Mr Cormack met with members of GAP as recently as May, two months after they say Mr Hunt ruled out the proposal…..

They insisted there was nothing secret about the taskforce even though it was never announced, never released anything publicly and branded its material – leaked to Fairfax Media – as "confidential".

Mr Bowles insisted the taskforce was fully independent – even though the government paid for it with a $55,000 contract…….

Under the plan, the Commonwealth would "pool" the approximately $20 billion it currently gives to public hospitals each year with the $3 billion it pays to private sector doctors and the $6 billion it spends on the rebate to help people pay their private health insurance premiums. 

It would use the money to pay a standard benefit for services regardless of whether they are performed in a public or private hospital, or whether people choose to be treated as public or private patients.

While the Turnbull government struck a three-year hospital funding deal with the states last year, it has flagged it wants a more long-term, less ad-hoc agreement – and a CHB proposal could fit the bill. COAG is set to revisit the issue of hospital funding next year to set the course for a post-2020 agreement.

News.com.au, 29 May 2017:

He told Senate Estimates yesterday it was his job as head of the department to look at the future of health funding.

He confirmed the department had entered into broad policy work on the proposal.

However, it emerged he did not put the $55,000 contract for the consultancy work to tender.

Mr Bowles said he gave the work to Mr Peter Fritz, the head of GAP, after they met in 2016 and told the Senate it was possible for him to award contracts for work costing less than $80,000 without a tender process.

Senator Watts probed Mr Bowles about connections between GAP and the Australian Health Research Centre which is funded by a number of large health insurers.

Members of the AHRC attended taskforce meetings, he revealed.

However, Private Healthcare Australia which represents insurers has raised major concerns about the plan.

“I’m genuinely stunned,’ Private Healthcare Australia chief Rachel David said when she was told the work had been paid for by taxpayers.

“It was a dramatic overhaul of the health system that totally changed the role of private health insurance, eliminated the difference between public and private hospitals and wold have put doctors on salaries,” she said.

“It would have been inflationary, there was no demand management,” she said.

This is what Global Access Partners Pty Ltd (formerly CSD Pty Ltd estab.1969) says of itself:

Global Access Partners (GAP) is an influential network that initiates high-level discussion on global issues, encouraging the sharing of knowledge, progress and policy change. Through its events, GAP promotes Australia’s capacity to find solutions to the challenges facing the worldwide community, and translates these solutions into business opportunities.

It appears to have been founded by:

Peter Fritz - who besides being GAP Chair & Group Managing Director of TCG Pty Ltd also chairs a number of influential government and private enterprise boards - and Catherine Fritz-Kalish currently GAP’s Managing Director.

Its offices are at 71 Balfour St, Chippendale NSW 2008 Australia.

GAP sees its participation in health public policy to date thus:

* The Australian National Consultative Committee on Health (formerly known as the Australian National Consultative Committee on e-Health) was established as a result of Global Access Partners’ 2004 Forum on ‘Better Health Care through Electronic Information’.

The ANCCH represents the major ICT industry players and other stakeholder groups. The Committee contributes to the debate around the public and private health agenda in Australia with a view to promote and realise better patient health outcomes through the application of changes to process, and the interaction of technology to improve efficiency, safety and productivity.

The group also provides a forum for public-private partnerships in order to promote improved execution and industry development.

The Committee  raises issues of national importance, influences government policy and supports the interests of its members. Its four broad areas of interest are agency coordination, chronic disease management, connectivity and infrastructure, and change management.

The ANCCH initiatives in the area of health and wellbeing over the last seven years have ranged from discussions of national health policy to the problems of implementing an Australia-wide e-health infrastructure and the potential applications of genetic testing in drug therapy to the management and long term funding of chronic "lifestyle" diseases in an ageing Australian population.

* GAP Taskforce on Government Health Procurement (2015-2016) is a cross-sectoral multidisciplinary group established by Global Access Partners to analyse Australia’s public health procurement and offer practical proposals for reform (see final report). The Taskforce considered the impact of procurement processes on the age and reliability of medical equipment, service levels, innovation and competition. Its final report highlights some of the inefficiencies of current health government purchasing  and calls for a more rational tendering process to reduce costs and waste in the system, while improving the quality and safety of care.

How the NSW public hospital system still fails those with mental health issues

“To see a mentally ill person in 2014 at a public hospital in NSW treated in such an appalling manner is really beyond comprehension. The sight of the deceased wandering the corridor naked and covered in excrement while the senior nurse is seen to mop the floor apparently oblivious to her is horrific. While this appears not to be a system failure it is clearly a serious human failure. It is for another place to take such disciplinary proceedings as appear necessary.” [Excerpt from a NSW coronial inquest judgment delivered on 7 September 2016]

ABC News, 12  May 2017:

The daughter of a woman who died after she was left to wander the halls of a New South Wales hospital while naked and covered in faeces says nurses there lied to her about what happened.

Miriam Merten died in 2014 from a brain injury after she fell over more than 20 times at the Mental Health Unit of Lismore Base Hospital, on the state's north coast.

A coronial inquest heard she was locked in a seclusion room for hours, and when the two nurses supervising her unlocked the door they allowed her to wander around naked, covered in faeces.

She continued to fall over outside the seclusion room.

Coroner Jeff Linden found she died from "traumatic brain injury caused by numerous falls and the self-beating of her head on various surfaces, the latter not done with the intention of taking her life".

"The sight of the deceased wandering the corridor naked and covered in excrement while the senior nurse is seen to mop the floor, apparently oblivious to her is horrific," he said.

The state's chief psychiatrist Murray Wright said he was equally shocked.

"I can't speak for what was happening in the minds of those nurses but I think it's an absolutely appalling incident," he said.

Ms Merten's daughter, Corina Leigh Merten, said she only found out exactly how her mother died when a journalist contacted her recently.

She said that at the time of her mother's death, nurses gave her a different version of how her mother died.

"I was in school, in Year 12, my dad came and picked me up and we went straight to the hospital," she said.

"At the time they told me she slipped and fell in the shower."

Now 20, Corina Merten said she did not know the coronial inquest was on.

"I'm so disappointed that it took a reporter for me to know what actually happened to my mum," she said.

ABC News, 13 April 2017:

The New South Wales Health Care Complaints Commission said it had found that two nurses caring for a patient who later died from a brain injury kept no record of about 20 falls captured on CCTV.

The woman, known as Patient A, was filmed wandering naked and covered in faeces in Lismore's Adult Mental Health Unit in mid-2014.

CCTV footage showed that in the seven hours before she was transferred to intensive care she fell 24 times.

For most of that time she was alone in a locked room, but nursing records of her confinement made no mention of any falls.

During a five-hour period in the seclusion room, no-one entered to check the patient's temperature, pulse, respiration or blood pressure.

Patient A was not offered any food or water and had no access to a toilet.

The woman died from a brain injury the following day.

The HCCC found the two nurses charged with her care guilty of professional misconduct.

Far too late to benefit Miriam Merten, Health Minister Brad Hazzard said the State's Chief Psychiatrist and a parliamentary committee would review whether failures in mental health care persist.

See: Civil and Administrative Tribunal New South Wales, Health Care Complaints Commission v Borthistle [2017] NSWCATOD 56 decision concerning “Patient A” and Health Care Complaints Commission v Burton [2017] NSWCATOD 57 decision concerning “Patient A” .

NSW Health Care Complaints Commission (HCCC), Annual Report 2015-16:

Each year complaints relating to mental health make up around 12% of all complaints received by the Commission.

In 2015-16, there were 759 complaints in this category.

This means that over the five years from 2011 to 2015-16 the Commission has received 3,051 complaints concerning mental health….

Over the last five years the Commission received:

807 complaints about medical practitioners;

647 complaints about psychologists;

438 about mental health services in a public hospital and 299 about psychiatric hospitals;

302 about nurses; and,

220 about community health services.

In addition to the 12% of all health complaints being listed as complaints concerning mental health providers, another 5.4% of all health complaints are complaints concerning psychiatry providers.

This annual report also stated that 21% of all mental health complaints between 2011-12 to 2015-16 related to professional conduct and 31.9% related to treatment.

Of the mental health complaints received in 2015-16 there were:

46 referred to professional council;

40 resolved during assessment;

55 referred for local resolution;

23 investigation conducted by the HCCC;

46 referred to the HCCC's Resolution Service;

12 discontinued with comments;

7 referred to another body/person; and

226 discontinued with no reasons stated.

Case study included in HCCC Annual Report 2015-16 at page 58:

The Commission investigated a complaint against a mental health inpatient unit in a regional public hospital. The key facts were that:

* Patient A was scheduled under the Mental Health Act 2007 (NSW) with a dual diagnosis of schizophrenia and alcohol abuse

* The patient was difficult to manage due to lack of insight, non-compliance with medication and high level aggression.

* The decision to co-locate the patient in a double room with Patient B – both unpredictable and potentially violent patients – without any a risk assessment.

* On a night shift, required observations either not carried out at all or were not carried out in the manner required, but staff signed off that all care level checks were completed

* Overnight Patient B was killed by Patient A.

The investigation found that care and treatment of Patient A was inadequate. His care plan was ineffective, rigid and failed to improve his condition. There were lost opportunities in terms of appropriate, alternative ways to manage and treat him. Furthermore, his safety and that of others was put at risk through the decision to co-locate him with patient B and because staff failed to carry out the required observations.

SANE Australia 2013 report:

A Mental Health Council of Australia study (2011) found that people with mental illness reported similar levels of stigma from health professionals as from the general community.

Some of the study’s key findings are that:

* Almost 29% reported that a health professional had ‘shunned’ them. These figures rose to over 50% for people with post-traumatic stress disorder and borderline personality disorder.

* Over 34% had been advised by a health professional to lower their expectations for accomplishment in life.

* Over 44% agreed that health professionals treating them for a physical disorder behaved differently when they discovered their history of a mental illness.

NSW Health Care Complaints Commission decisions recorded in 2016 & 2017 re other nursing staff complaints relating to treatment of patients with a psychiatric illness:

RNs Haridavan Pandya and Sumintra Prasad – Unsatisfactory professional conduct, 2 February 2017, concerning their care of a mental health patient at Bungarribee House mental health unit in Blacktown hospital on 28 February 2014.

RNs Abraham Thomas and Donna Hayden, and Ms Julie Rumble – Unsatisfactory professional conduct, 11 May 2017,concerning the death of a mental health inpatient at Dubbo Mental Health Inpatient Unit on 28 February 2014.

Mr Stephen Woods – disqualified from being registered as an enrolled nurse for a period of 12 months, 16 May 2016, concerning a physical and verbal attack of a patient in the Mental Health Intensive Care Unit at Hornsby Hospital on 9 April 2014.

Mr Neil Mullen (RN) – Unsatisfactory professional conduct – Reprimand and conditions imposed, 18 July 2016, concerning care of care of nine patients in the Shellharbour Hospital mental health unit on 30 and 31 July 2014. 

Mr Mike Siebe Greive - Registered Nurse - Disqualified for 18 months, 30 March 2016, concerning a female mental health patient at the Hornsby Hospital Adult Mental Health Unit between October and December 2013. 

Registered Nurses Wendy Kennedy, Christopher Parker and Jisnu Dowsett cautioned and Stewart Thompson reprimanded by a Nursing and Midwifery Professional Standards Committee, 1 June 2015, concerning care of a patient at Lismore Adult Mental Health Unit’s eight bed High Dependency Unit on 19 and 20 February 2013.  The patient was found deceased in his room on the morning of 20 February 2013.

Mr Ronnie Obusan - finding of unsatisfactory professional conduct – reprimand and conditions, 19 January 2016, concerning the nurse’s interactions with a patient in the mental health unit at Nepean Hospital in 2012. 

I'm sure NSW residents would all like to believe that each and every time they present at a public hospital they will be treated with professional care and respect.

Unfortunately that is not always the case as prejudice, discrimination and racism are rarely acknowleged by government as existing within the state health care system and are therefore tolerated by default.

“Stigma against people who have experienced a mental illness is deeply entrenched in our culture. It finds expression everywhere from the Parliament to the front bar. From courtrooms and pulpits to playgrounds it is possible to hear people who experience mental illness cast in an unfair light.”  [National Survey of Mental Health and Wellbeing Bulletin 6, Carr & Halpirin 2002, Stigma and discrimination]