Camden District Hospital Maternity Ward and Liverpool Hospital Euthanasia Allegations
The Hon. PATRICIA FORSYTHE [3.41 p.m.]: I move:
That, under Standing Order 52, there be laid upon the table of the House within seven days of the date of passing of this resolution all documents in the possession, custody or control of the Minister for Health, Minister for Infrastructure and Planning, and NSW Health, relating to the re-opening of the maternity ward at Camden Hospital between 2002 and 24 February 2004, and the media announcement by Liverpool Hospital concerning the alleged euthanasia of Audrey Hamilton in 1999, including any document which records or refers to the production of documents as a result of this order of this House.
The New South Wales health system is experiencing a crisis of this Government's making. It is vital that this House be provided with all the documents relating to the safety of Camden District Hospital maternity ward. As it stands, the reputation of good people—doctors, nurses and dedicated public servants—is being put at risk by a Government that is focused on spin and cover-up. This Government is not prepared to be open and honest with the Parliament and the community of New South Wales. It has certainly put the lives of patients at risk. In doing so it has not been prepared to be open and honest with the families of people who sadly have died in hospital.
Honourable members may well recall answers to questions in another place during the first week of parliamentary sittings about the ongoing safety of the Camden District Hospital maternity ward, the opening of the ward and, indeed, whether it was opened to meet a political need rather than when it was ready and appropriately staffed. The Premier and the Minister for Health effectively misled the other place on crucial points of fact pertaining to this case. They moved quickly to shut down the matter and in doing so misled the Parliament. Most importantly, they misled the people of New South Wales about the safety and security of patients who attended the Camden District Hospital maternity ward. Sadly, the most glaring case is that of the Lalic family. I am sure honourable members are familiar with this case, because it has been the subject of not only questions in another place but also wide media coverage. Baby Natalia died just five days after she was born at Camden District Hospital. We still do not have clear answers about that case and neither the Premier nor the Minister for Health has been able to provide a complete explanation. If there was a lack of adequate specialist staff at the hospital as a result of a political decision, it is imperative that the community of New South Wales understands that.
I said at the beginning of my contribution that the health system is in crisis. That crisis is the result of this Government's actions and the tragic case of Natalia Lalic demonstrates that point. This Parliament must get to the bottom of the issues that have been the subject of so much speculation and media stories in recent times. My motion is an attempt to establish the facts surrounding the safety of the Camden District Hospital maternity ward. Last year the Opposition, with the support of the crossbenchers—and I thank those honourable members, as I did then—successfully moved a motion to provide access to documents relating to the maternity ward's closure and the death of Sarita Yakub. Those crucial documents demonstrated that the Government and the Minister for Health at that time, the Hon. Craig Knowles, were involved in a cover-up. Honourable members need only look at the answers provided by Ministers about some of these issues to understand that this Government's usual response is to shoot the messenger rather than to address the message.
The Opposition wants not only information about Camden District Hospital maternity ward but also a better explanation about allegations of euthanasia at Liverpool Hospital. We are particularly interested to know whether Liverpool Hospital's media officer misled the family concerned, the media and the people of New South Wales. Of course, I am not targeting an individual departmental officer but, rather, the directions that that officer may have been following. Once again, I am sure the evidence will show this is a case of spin on the Government's part to cover the tracks of its Ministers, in this case the Premier and the former Minister for Health. They are prepared to paper over the real crisis that is now gripping our health service.
The Premier and the present Minister for Health have recently made misleading claims in the Legislative Assembly. It is vital that this House have an opportunity to review all the documents relating to these cases. I remind honourable members that when questions were asked about the death of Natalia Lalic the Premier clearly stated that a number of medical specialists were present at the birth, including a paediatrician. In fact, the paediatrician had to come forward to say that he was not present at the time.
We need to understand how the Premier and the Minister for Health were able to make those sorts of statements. The people of New South Wales expect this House to review all the facts surrounding the safety and security of patients in our hospital system. Confidence in the Government's handling of this crisis and the ongoing management of the New South Wales system has hit an all-time low. That is why we must review the Government's decision-making processes and examine all the facts contained in the ministerial and departmental documents.
I do not wish to take up too much of the House's time; there are many other issues of importance to the House and the good governance of New South Wales to be debated. However, establishing a health system that the community can have confidence in must be one of our highest priorities. I urge all members of the House to support this motion so that the people of New South Wales can have access to all the facts surrounding the Government's cover-up of the health crisis.
The Hon. Dr ARTHUR CHESTERFIELD-EVANS [3.51 p.m.]: This motion is another example of an attempt to open up the facts about the health system. It would seem that Camden hospital was forced to take maternity and emergency cases in order to make the Government look good for the last election. However, the hospital was not adequately resourced. It is not clear whether that related to the fact that doctors simply did not want to work at the hospital or there was insufficient funding to get salaried staff to go there.
I believe that the hospital management was aware that it could not adequately resource Camden hospital, and it probably told the health department and the Minister that, but it had the imperative to press on. The hospital management was then placed in the unenviable position of making a choice between managing upwards, and therefore keeping the bosses happy, and managing downwards, and wondering what they would say to staff as problems arose. I gather that the number of perinatalogists or neonatalogists in proportion to the patient population in Camden and Macarthur hospitals is far less than that of hospitals in the more affluent suburbs of eastern Sydney. That is a very serious issue, and I am sure the documents called for will shed light on it.
The Walker inquiry has extremely narrow terms of reference. Indeed, Bret Walker, SC, has said that he must conduct the inquiry in a limited time frame—not only because of the terms of reference but because he is a leading Senior Counsel and he is therefore limited by the amount of time he is able to spend on the inquiry, and that surely must have an effect on the amount of evidence he is able to hear.
General Purpose Standing Committee No. 2 is inquiring into the complaints mechanism within the health service. A general purpose standing committee cannot look at all the problems associated with the health system, because it simply does not have the time to do so. The Committee on the Independent Commission Against Corruption is inquiring into corruption. Corruption is generally regarded as venality relating to the preference of one person over the preference of another, or money. It was interesting to hear the comment of one of the whistleblower nurses to the effect that "Corruption is when you are doing the wrong things for the wrong reasons and you have the wrong priorities."
People who work in the health system have told me that the problem these days is that they have to write risk assessments, and that that fundamentally means telling the people above them what is likely to make trouble for them politically. So large amounts of resources are now going into this risk assessment process, which, effectively, is managing upwards. People have said to me, "My boss wants to know if he is going to get bitten by this event that has happened. So I have to give him all the facts, and I spend half my time writing reports on what might go wrong for people upstairs in relation to things that happened in the past. In other words, I am managing upwards, and the amount of time I am spending on this means that I cannot actually do the work at ground level, which is what prevents the problems happening."
Often people have to make the choice between managing upwards and managing downwards. If a person is given a task to do but does not have the resources with which to do it, does that person say yes to the boss and plough on, knowing perfectly well that he or she does not have the resources to do it? And should the task go belly up, that person will get the blame. One wonders about the position of a person like Jennifer Collins in such a situation. Or does the person say to his or her boss, "Look, I can't possibly do it with these resources. Stick it up your jumper. I'll go and find a job somewhere else"? One shudders to think what effect saying that would have on the career of the person who said it. It is beholden upon the Government to be far more realistic and in touch, and to listen to what people at the bottom have to say.
I have been concerned about this issue since I was with the water board in the mid-1980s. At that time we had a flabby bureaucracy in terms of the number of people doing tasks. Promotion was based on seniority, and because people had come up through the ranks they knew exactly what the problems were below them and what needed to be done; they tended to manage for the people below them. Suggestions were placed on the much-satirised public service files, which were tied up with pieces of pink tape, the files were passed up to the managers, and they went up to the level at which a decision could be made, with comments from all levels. If a file went to another department, it went straight to the head of the department, with comments all the way up and all the way down again, and it came back after a period of months. But everyone knew exactly what was going on, and, despite all the faults, there was a connection—the top with the bottom.
In the mid-1980s there was sea change in which it was decided that the only degree worth anything was a management degree. It was thought that a person who had a management degree could manage anything and it was not necessary for managers to know about technical matters. When I was with the water board, all the people who did help—that is, the hygienists and me—were turned over to the technical health department, because we were regarded as technical people. It was almost a "boo" word. The managers said, "We are managing the real situation; you're just technicians out there. You just happen to know what is going on." The real management decisions were made by people who at that time had no training and no idea and, frankly, more ambition than goodwill in terms of what was actually delivered.
A new class arose—the managerial class—people who had not come up through the ranks. They were brought in from outside, and they were often favoured by nepotism from people in the socio-economic status system, higher up. Everyone started to look at what was happening upwards, and their management style was to keep the people above, rather than those below, happy. A parallel was the Australian health system in which I worked. There was a very small health bureaucracy at that time. In fact, it was my father's complaint as a surgeon in Wollongong years ago that the chief executive officer [CEO] of the hospital performed more operations than he performed as the senior surgeon. That is how connected the CEO was with the patients coming through that hospital. Indeed, the doctors' car park was eventually taken over and became the bureaucrats' car park. The hospital that had had one car space for the CEO ended up with 120 bureaucrats' cars.
The growth of this bureaucracy paralleled exactly what I had observed in Britain, where the bureaucracy had become so large that alternative preferences had to be adopted. The small hospitals and the car parks were taken over by bureaucrats, and the problems that could not be fixed were resolved for the bureaucrats, who, miles from where the patients were, studied their statistics and made silly decisions. I will not regale this House with the examples of bureaucratic stupidity I saw or stories about patients who died fundamentally because doctors were totally demoralised, although they did what they could, recognising that they could not get appropriate resources for the problems they had to deal with.
Bureaucracy as a percentage of the total people working in the health system has increased, and more paperwork is needed for the higher turnover. I believe things have gone too far. This increasing managerialism has led to a disconnection between the people doing the job and those who make the decisions based on a bunch of statistics, which are inherently able to be manipulated. Although there are three inquiries impinging upon Macarthur Health Service, I do not believe that any of them are comprehensive. The documents called for may give grist for my opinion or the opinions expressed by the Hon. Patricia Forsythe and the idea that the Camden services were in place in order for the Labor Party to win the election, rather than because there was a real capacity to deliver those services where they were supposed to be. I think this is all part of a jigsaw puzzle.
I am currently working on a project on how the health system can be fixed. Certainly the problems in the health system are multifactorial but I think the Government has to develop a far more honest approach if it is to get the answers to these problems. The Government has to be far more honest with the people and it has to have direct connection. I believe that the old hospital boards should be reinstated, whereby local citizens looked at how the hospital was going and had an input at the highest level. The Government seems to have the idea that all the problems can be hidden and that all our efforts should be used in writing memorandums for the Minister so that he is never embarrassed. The Minister has to say, "Things are wrong. We are going to change them and we are going to be a lot more honest." This motion partly does that but I think we still need to have a far more open and honest look at health.
Certainly if the Howard Government wants to take over health, that may be a response to the fact that Mark Latham is doing very well in the polls, as the commentators have said. Having worked briefly as a bureaucrat in the Department of Veterans Affairs I observed that the most commonsense suggestions from people in New South Wales were totally mucked around with by people in Canberra who were technically at a lower grade but who, being closer to the kitchen, had a lot more say in how the dough was baked. They would basically kill good ideas because they had not thought of them or pinched them, or because they were involved in some other crazy project that bore no relation to what was needed on the ground.
So I think it is a dubious proposition that Canberra can manage the health system. Because of the problems between Federal and State governments and the blaming and the distorting effect on resource allocation that cost shifting is having within the health system, there is a need for health financing to come from a single source so that Medicare, the inpatients system, and the community-based system are all funded from the same pool. Such a system could be looked at far more openly and transparently and with resources optimised to lessen the impact of intensive care. I am not saying that all the faults in health are the fault of the State Government—that would be quite wrong. I believe that the private health insurance industry, the Federal Government, the payment structure for doctors whereby some procedures are paid immensely well and some are not and, of course, the lack of prevention are all factors in this problem.
I believe we need a far more open culture in terms of information within the health system, and this motion is just another step in prying out information about one hospital system and about an incident of euthanasia in another hospital. We need a far more managed downwards philosophy; we need less of a managerial structure and a far more hands-on approach; and we need far more honesty from this Government in the health area as well as in other areas. We need a health system that is managed by a single funding point with a commitment to funding health on the basis of health need, not on the basis of how wealthy people are—another aspect of health policy that is not directly related to this motion.
I support the motion but I think in the broader context the Government should take a more honest approach overall and perhaps have an overarching inquiry. Even after the current three inquiries and, indeed, the information that will be gleaned from this motion, I am not confident that we will be in a position to make a more universal and sensible recommendation about the future of health in New South Wales.
Reverend the Hon. FRED NILE [4.01 p.m.]: The Christian Democratic Party supports this motion, which particularly refers to Camden Hospital and to the alleged euthanasia of Audrey Hamilton at Liverpool Hospital in 1999. These are serious matters and I believe it is correct for these papers to be made available so these matters can be further investigated.
The Hon. AMANDA FAZIO [4.02 p.m.]: I oppose the motion. The reason for doing so is that I believe that it shows how little attention the Opposition pays to the process and what happens in this Parliament. In fact, this is the second day in a row the Opposition has called for papers. We all know from the past history of what happens in this House that when there is a call for papers, whether it is from the Opposition or from the minor party representatives—particularly the Greens—copious amounts of papers are delivered to the House, but half the time Opposition members do not even bother going through them. It is a complete waste of time.
The documents that are the subject of this motion have already been provided to the Opposition. The Opposition has these papers; it is just a stunt. The documents fall within the scope of a previous call for papers and a freedom of information request by the Leader of the Opposition. It is not that the Opposition does not have these papers, it is because it wants to make a public show of demanding them. It wants to make out that there is some reason why these documents will not be provided. The simple fact is that the documents have already been provided to the Opposition. If members of the Opposition have not seen them I suggest they ask the Leader of the Opposition in the other House for them. I suggest they go to John Brogden's office and ask him whether he will show them the papers, rather than hijack the time for Government business and demand that these papers be provided.
Frankly, if the Opposition were honest—and I think it is about time it was—it would say that this is nothing more than a stunt. The Opposition should be ashamed of itself for wasting the time of the House. If they are really serious about being in Opposition, members should not demand papers day after day that they already have just so they can make a public show about it. If Opposition members were fair dinkum they would not do this sort of thing. But they are obviously not fair dinkum, they are just going to continue down this track rather than seek any positive outcomes from the three inquiries into the Macarthur Area Health Service. I urge all members to think carefully before they vote on the motion, and to oppose it.
Ms SYLVIA HALE [4.06 p.m.]: The Greens support this call for papers. I find the remarks of the Hon. Amanda Fazio to be somewhat outrageous. I am sure she will be pleased to know that after we finish with this motion I will seek to move a motion to have a development application produced to the House because although that development application was lodged on 30 January the Sydney Harbour Foreshore Authority is refusing to make it available to residents or to North Sydney Council. This is just one example of how this Government thrives on secrecy and cover-ups—and, as we all know, secrecy and cover-ups are the bases of corruption. That is the hallmark of this Government. It was its hallmark in relation to council amalgamations and it was the hallmark in relation to Sydney Water and the extraordinary efforts we had to go to to get access to the report of Sydney Water. That has certainly discredited the Government. With the crisis in our health system we can see the secrecy and the cover-ups that are occurring there.
The Greens have no hesitation in endorsing this call for papers and for supporting the Hon. Dr Arthur Chesterfield-Evans in saying that we really do need a wider inquiry into just what is wrong with our health system. What we are seeing in regard to the health system is the chickens of spin, hype, and budget surpluses all coming home to roost. The public is now paying the price of a prolonged Government failure to adequately maintain and fund essential public services and essential infrastructure. The Government has failed to do that with the railways and it has failed to do it with the health system.
Almost every day we read in the newspapers about one further scandal, one further thing that has occurred but has been obscured and hidden, including the incident on 13 January at Goulburn Base Hospital when an operation had to be finished by torchlight, the blow-out in waiting lists, and the cuts to community mental health services. In a question I asked in the House today I said that funding of community mental health services is lower in New South Wales than in any other State.
We read in the media about the tragic results of failure to adequately fund mental health services, with the dismissal of chief executive officers of area health services, the $7 million budgetary blow-out of the Southern Area Health Service, rising levels of hospital infections, overworked doctors and nurses putting patients at risk, inadequately staffed and resourced units, and the Government's cynical attempts to run a political agenda of cover-up, spin, hype and secrecy. The latest revelations relate to the Health Care Complaints Commission, yet what is the response of the Government? It admits the crisis and rearranges the desks of bureaucrats, as it did with the railways and TAFE.
The Government splits up a centralised service, and when the system does not work three or four years down the track because of inadequate funding, the Government centralises it again. When that fails, it splits up the system again. This masterstroke of bureaucratic rearrangement, failure to address genuine problems confronting the system, and a reluctance to provide necessary funding are the result of the Government's preoccupation with a budget surplus at all cost, despite its disastrous effect on the people of this State.
I shall give just one example of the ridiculous level to which our health services have descended. This morning my office was informed that Nepean Hospital is so short of funds it can no longer provide cooled water to its outpatients. We did the right thing and checked the accuracy by asking the hospital, "Are there bubblers at Nepean Hospital?" The answer from the Director of Services was, "Sorry. You will have to checked with the Minister's office." It is extraordinary that we have to check with the Minister's office to get an answer to that simple question! It is a perfect prescription for cover-up and secrecy. Certainly, it demonstrates that those who work within the New South Wales hospital system have been cowered and stood over and are too frightened to speak up. One need only consider how long it took nurses at Camden and Campbelltown hospitals to speak out and their subsequent intimidation. It is time the documents were at last made available for inspection for the benefit of all the people of this State. The Greens support the motion.
The Hon. PATRICIA FORSYTHE [4.13 p.m.], in reply: I thank all honourable members who have spoken in the debate and I thank the crossbench members for their support. Formerly when the Opposition sought the tabling of certain documents, the Government used to use the line that that would take up the resources of a department. The new approach is that we already have all the documents.
The Hon. Amanda Fazio: That is true.
The Hon. PATRICIA FORSYTHE: No, we have the documents that the Government deems are necessary to meet the spin it is so good at, not documents that go to the heart of the matter. The Government will not answer questions that are asked in Parliament or put on notice. The only way to get to the facts is to read file notes et cetera. If the Government has nothing to hide, it will support the motion. I thank honourable members and commend the motion to the House.
Motion agreed to.