SSWAHS = SWSLHN + SLHN and the NSW State Election - 1

It looks as though the owner of that smiling face on the election posters popping up around the Southern Highlands is not prepared to commit herself, her Party or their proposed health policy to the people of the Southern Highlands. Here is her comment to a forum held at the Moss Vale TAFE on Monday February 21st and reported in the SHN by Ben McLellan today:

Goulburn Liberal MP Pru Goward could only point to her party's strategic land use policy, which she claims will stop mining in the Highlands, as the only real indication the electorate is on the Coalition's radar.

The opposition is pledging money for hospitals in marginal seats like Tamworth and Dubbo plus $133 million for Illawarra hospitals but not a single cent to improve waiting times or facilities at Bowral Hospital.

Ms Goward said mining not health was the main priority of the electorate.

"I think we have delivered a very good coal mining policy and my impression is that was the number one issue of concern here," she said.

"When it comes to Bowral Hospital there is a huge list of hospitals more run down than ours and I have to accept and Bowral has to accept that."

She said the Coalition's promise of more nurses would benefit Highlands residents.

"We are going to offer more nurses. A lot of the problem at that hospital (Bowral) is administration, not the building of the hospital itself," she said.

"It's the administration and the maintenance of the hospital. Those things will be addressed."

Oh dear! The electorate of Goulburn has just two public hospitals - Goulburn Base and Bowral Hospital. Neither of these hospitals, to my knowledge, has had any major capital upgrade that can increase their capacity to deal with their growing populations. Bowral Hospital's lifts have recently been fixed, Medical Records and Emergency Department have been given a tweak and a tuck here and there. But the Children's Ward and the Renal Unit are the product of some very serious fundraising work by the local community members, service clubs and businesses.

There have been no additional beds added to Bowral Hospital for more than a decade or two even though our population is not only growing as quickly as anywhere else, but also the number of seniors is increasing at a greater rate than the metropolitan and regional areas in NSW. The 72, or so, beds in the Bowral Hospital are expected to cater for maternity, medical and surgical, young children, aged care, intensive care, day surgery, and mental health patients.

Regional hospitals like Tamworth and Dubbo are important hubs for the medical and surgical needs of their regions. One would not deny that they may have a need for funding. However, there is some hint of pork-barrelling with those two hospitals when one considers that they are spoken of as being "marginal seats". And the Illawarra is already very resource-rich but clearly, the electorates down there could also fall into the category of being "marginal seats".

Does it follow then, that the Liberal Party, and Ms Skinner and Ms Goward, see the electorate of Goulburn as such a "safe seat" that they can afford to ignore what they have been told and what they have seen. Not all that long ago Pru Goward wheeled in Jillian Skinner to rouse the community about the delay in surgical cases. She also conducted a forum on what people wanted to see improved in the local health services. Were those meetings just for show? Where is the additional funding for the surgical waiting list? Where are the additional services for Bowral Hospital that local people are now expected to travel to the northern LHN hospitals to be able to access essential and life-saving health services?

So, what are we in the Southern Highlands being offered? More nurses and a change in administrative practices. Well Ms Goward what incentive is the Liberal Party going to offer those nurses to come to work at Bowral Hospital. The nurses are there - coming out of the universities every year. But given a choice almost every one of them will prefer to go to one of the metropolitan hospitals to work. Why? Because those hospitals have modern facilities and have a comprehensive range of specialties to offer those new graduates the experience they need to complement their academic training and future career path.

Are all the problems evident in Bowral Hospital attributable to poor management. You bet! But not necessarily with the Bowral Hospital management. As has been described many times in previous posts on this blog - Bowral Hospital was (and still is) the boil on the butt of a very large milk cow. The old SSWAHS Executive had a very hard job to remember it was there unless they sat down, or unless the residents in the local community stirred the pot a lot. Money was reluctantly thrown at Bowral Hospital only when there was a significant amount of pain being felt by the SSWAHS Executive.

The current General Manager and his Deputy have done their utmost to deliver the already limited health services required by the community, health services limited by the instruction, lack of funding, and insistence of the Executive of the old SSWAHS. To give them due credit the Bowral Hospital managers have been the most amicable of messengers asked to do the bidding of SSWAHS executives who, if they planned a visit, appeared to have great difficulty even finding Bowral Hospital. This is clearly a case of, Ms Goward, "Don't shoot the messenger".

Perhaps, our current serving Liberal member needs to become more of an advocate for her electorate prior to this March election. Ms Goward, be proactive and insist that the promises made previously to the Southern Highlands community are fully funded in this term of parliament rather than in the "second term" for which you wish us to vote for you.

SSWAHS = SWSLHN + SLHN and the NSW State Election

Well one can't help but notice that the first of the electoral posters have begun to decorate the highways and the by-ways of the Southern Highlands. First of the candidates peering out at us commoners is the Liberal candidate, Pru Goward. Scraping in by just a few votes in the last election she was not quite the attraction the Liberal organisation had been expecting. Especially after she was parachuted into the safe seat to the dismay of some of the local Party contenders including the previous member's "gofor", and the CEO of the Southern Highlands Division of General Practice who, I'm reliably informed, had loftier aspirations.

While it's still early days and the Labor candidate is yet to be anointed the local field is showing a dearth of willing hands to nominate. Clearly, Labor is going to the Opposition benches in the next election and, on the basis of polls, the Liberals will make a meal of the electoral seats up for grabs. But should we break out the sparkling wines and cold beers (or even Southern Comfort!) to celebrate? After all what have the Liberals been offering to do for the health services to date: Well not much more than what has been done already by the Labor Federal and State governments.

When we have had public meetings about health services in the Southern Highlands, Pru Goward has wheeled in Jillian Skinner (Opposition spokesperson on Health) who has played to the crowd and whipped up their enthusiasm but then left them to charge the SSWAHS barricades. There has been very little follow-up by Jillian Skinner or Pru Goward to ensure that their support is felt in the local community. This does seem to suggest that, when in power, a NSW Liberal government's good intentions might just as likely disappear in the smoke and mirrors show produced by any incumbent government.

Yes, it is still early days, but so far we have heard and seen more about health changes from the current State Labor government than we have seen from the Liberal opposition.

Last election, besides the two major parties we had the Greens and the Independents. I recall that Pru Goward was nearly beaten by an Independent, Paul Stephenson, Mayor of Goulburn at the time.

So far, only one Independent candidate has been identified. Rob Parker, a local Civil Engineer has responded to John Hatton's call to have more parliamentary governance through Independent members in the NSW Parliament. With his wife being a local general practitioner I'm hoping that if Mr Parker does succeed in this electoral seat, he will have his wife nudging his elbow every time there is a need to do something to improve the local health service in order to be able to provide the optimal service for this community. A new hospital in the Southern Highlands to provide the range of health services provided elsewhere would be a great start!

This year, Socrates, like others in this community will be listening with interest to the promises that all budding politicians make. Having been around for a number of years and helped vote in (and out) several State and Federal governments over those years, I have acquired a nose for the smell of smoke and bullshit. This year's NSW State election could see me break with tradition and avoid casting a vote for either major parties in favour for the Independents or the Greens.

To all Party contenders and Independents: Show me what you are prepared to do for the Southern Highlands community in the next parliamentary term, rather than what you promised to do in the last one but didn't manage to achieve (because of the GFC or droughts or flooding rain). If you say you can deliver better health and better health facilities in the Southern Highlands in the next parliamentary term show the proof before the election date. Then, and only then, will I vote for you.

SSWAHS = SWSLHN + SLHN: 3

It was with some delight that I found that the organisational problems we are experiencing in the Southern Highlands have resonated with the GPs in the Bankstown Division of General Practice, a Division which I mentioned as being more progressive and demonstrating advocacy for health consumers than is evident in their silent counterparts in the Southern Highlands Division of General Practice.

In my previous posts I remarked on the different stance the Bankstown coalition of GPs and Divisions has presented to NSW Health (and to the Federal Government) for more manageable sized Medicare Locals which can adopt and provide health resources and programs for the health consumers within their target areas. This was in marked contrast to our own Division which seems to want to hold on to their autonomy as a "branch" of the Macarthur Division of General Practice. Does this mean that the Southern Highlands "Branch" retains the inept Board that we currently have? If so, it seems that there have to be questions asked as to how the current Chief Executive of the Southern Highlands Division can be retained when he lacks the confidence of many of the GP members of the current Division.

Yes, the Tweeter on Twitter who captioned my last blogs as "Southern Dis-Comfort" got it perfectly correct: the current structure of the Southern Highlands Division of General Practice is giving us health consumers very little comfort. Looking at the strategies which have been driven by Dr Warwick Ruscoe and the Board they seem remarkably self-serving and for the purpose of self-aggrandisement, rather than for the benefit of the local community.

When push came to shove in the promotion of improved surgical theatre lists, and in the improvement for local treatment of renal disease, and the refurbishment of the Children's Ward at Bowral Hospital - the Board of the Division has been stoic in their silence and always absent in their presence. When the SSWAHS barricades needed to be charged it was left to the community's aged and the infirm and just one or two specialist medicos to lead the way. A Medicare Local that does not need to worry about biting the hand that feeds it would be of benefit to any community, none more so than the community in the Southern Highlands.

SSWAHS = SWSLHN + SLHN and the Medicare Locals - 2

The difference between the advocacy of the Chair of the Bankstown Division of General Practice and the deathly silence of her counterpart in the Southern Highlands Division of General Practice is extraordinary. For one, Dr Susan Harnett made a submission to the NSW Health in respect of the Carla Cranny and Associates Report about the Medicare Locals boundaries. The Southern Highlands Division's report was notable for its absence in the process.

Secondly, Dr Harnett wrote eloquently about the diversity and cultural mix of the communities their GPs served and expressed the general feeling that they could be effective advocates for their patients with the local hospitals, ancillary services and allied health providers. Whereas, the silence of the Southern Highlands Division of General Practice would suggest that their own interests are more paramount than the interests of their patients.

Here is the full text of the submission made by Dr Susan Harnett. It gives a clear explanation of the plans for the Medicare Locals and provides a sensible alternative to the mega Medicare Local with which we now appear to have been given.

Submission by Dr. Susan Harnett (Chair, Bankstown GP Division Inc.)

Principles for determining boundaries or catchment areas for Medicare Locals, including potential differences between metropolitan, rural and remote areas (eg size of catchment populations, natural catchment areas)

"We believe that three distinct Primary Health Care Organisations in south west Sydney will provide the optimal configuration for state and federal primary health care policy implementation over the next 10 years to 2020 and potentially beyond.

"As outlined in the NSW Health and Commonwealth discussion papers, the three PHCOs will be based on Local Government Area (LGA) and Sydney South West Area Health Service borders, current patient flows, transport corridors, demographic congruence, and projected population growth. Based on these characteristics the evidence indicates that the three PHCOS should be:

i. A Central Sydney PHCO based on the existing Central Sydney Division of General Practice.

"This PHCO will cover the relatively affluent areas extending from the CBD across the inner west. This includes the border suburbs of Lakemba and Canterbury and similar where local tailoring of services for specific areas of need can be appropriately managed by this PHCO, without creating a massive challenge for efficient administration or governance, which would result from a larger area.

ii. A South Western Sydney PHCO based on the amalgamation of the existing Bankstown and Fairfield- Liverpool Divisions of General Practice.

"This PHCO will focus on providing services to the well established urban communities in the Bankstown- Fairfield- Liverpool corridor which have a very high proportion of CALD residents and specific areas of health disadvantage due to their relatively low-SES and related factors.

iii. A Macarthur-Southern Highlands PHCO based on the current Campbelltown - Bowral area LGA’s as defined by the Divisions for future PHCO boundaries.

This Campbelltown-based PHCO will focus on establishment and provision of primary health services in a growing region of Sydney, including part of the South West Growth Centre, Campbelltown, Camden, and adjoining suburbs with outreach to the border limits of the current Southern Highlands Division.

"The National Health and Hospitals Reform Commission’s Final Report, A Healthier Future for All Australians recommended that PHCOs “be of an appropriate size to provide efficient and effective coordination (approximately 250,000 to 500,000 population) depending on health need, geography and natural catchment”.

"In this context, the proposed South West Sydney PHCO (Bankstown-Fairfield-Liverpool) would have approximately 300 practices (~560 GPs) serving a population of approximately half-a-million residents (570,000 calc)

Suggestions about the optimum number of Medicare Locals in a particular state, territory or region, including potential boundaries in each area

"The report commissioned by AGPN (Carla Cranny 2010) provided options for PHCO sizes and configurations which were focussed on massive population numbers and assumptions of scale that were not evidence-based beyond aggregating numbers for LGAs, Divisions and PHCOs as massive regions.

"Whether the number in NSW is 15, 16 or more or a total of 49 Primary Health Care Organisations (PHCOs) across Australia is not the question, since the number should be determined as a consequence of enagement of local populations to meet local needs. As quoted by AGPN CEO David Butt who said the final number of PHCOs would be the product of careful consultation with divisions on regional need.

“There is no right answer as to what the number should be,” Mr Butt said. “There are obviously different options... taking into account different criteria.”

http://www.medicalobserver.com.au/news/agpn-maps-future-of-49-divisions

"Such PHCO combinations as “Inner Western Sydney & Canterbury Bankstown” covering huge areas of Sydney with massive populations (Ashfield, Bankstown, Burwood, Canada Bay, Canterbury, Leichhardt, Marrickville, Strathfield and part Sydney with a project population by 2021 of 763,164 people) are expected to be unmanageable, and doomed to repeat the current ‘downsizing’ exercise from NSW Health re: super-sized Area Health Services being regionalised so they can respond more effectively to local needs.

Specific comments on the Carla Canny & Associates report (where relevant)

"Amongst government announcements in the lead up to the election, there have been two public discussion papers that have proposed options for redrawing health care boundaries in the Bankstown and Fairfield –Liverpool areas:

1. Permanent dissolution of the Bankstown, Fairfield, and Liverpool Divisions into a Campbelltown-based Macarthur -Southern Highlands PHCO. This option was outlined in the document titled “Discussion Paper on Implementing the National Health Reform in NSW” (NSW Health August 2010). Under this option, Bankstown GP Division would be forced into amalgamation with Fairfield-Liverpool under an expansion of the current Macarthur -Southern Highlands Divisions, to which there is considerable local GP resistance.

2. Permanent dissolution of Bankstown into a Central Sydney PHCO, based on the current Central Sydney Division. This option was outlined in the document titled “Framework for development of Primary Health Care Organisations in Australia” (Carla Cranny and Associates May 2010). Also under this option, Fairfield-Liverpool would become the northern margin of a giant Macarthur -Southern Highlands PHCO, to which there is considerable local GP resistance.

"These two documents made different recommendations, and have created significant confusion in south west Sydney.

"Further, under both scenarios 1 and 2 there is a significant risk that the local influence on primary health care decisions will be lost across much of south west Sydney. Health professionals in Bankstown, Fairfield and Liverpool may be inappropriately (& permanently) relegated to the periphery of decisions made in central Sydney or Campbelltown, under options proposed by Carla Cranny and Associates, and NSW Health. That is, health professionals and communities in some of the most complex and disadvantaged urban LGAs in Australia, will effectively be silenced, and permanently disengaged unless the Bankstown-Fairfield-Liverpool alliance is allowed to develop.

Comments on Local Hospital Networks

"NSW Health has determined it will be using the term “Local Health Networks” (not Local Hospital Networks), apparently as it has a large stake in community health services which may not be part of the Commonwealth health reform process. This is potentially a disaster for PHCOs in NSW unless service-provider agreements are created between the LHN and the PHCO. The Commonwealth should determine through COAG the process for developing policy that binds Commonwealth & States/Territories to the health reform agenda, so that every jurisdiction is able to progress with these National reforms.

"An example of such PHCO-LHN collaboration policy would be the requirement to have at least 1 (but not more than 2 for example) cross-Board memberships of these two entities. Currently it is unclear what the LHN/PHCO clinical and administrative governance practices will be and to whom such issues as complaints will be referred."

Does not this submission make one wish that Dr Susan Harnett was the Chair of the Southern Highlands Division of General Practice? At least she had something to say before the shotgun marriage took place. Our Division seems to have lost its voice!

SSWAHS = SWSLHN + SLHN and the Medicare Locals

Well it seems that it's not just the natives who are rebellious within the re-branded monoliths of the Sydney Local Health Network and the South West Sydney Local Health Network, but the northern GPs are up in arms because they appear to have been forcibly married to the southern GPs in this redevelopment of the health services. The article to follow comes from a meeting of the northern coalition in November 2010.

On the other hand, the Southern Highlands Division of General Practice has been remarkably silent about the transition, appearing now as they do as a "branch" of the Macarthur Division of General Practice which, effectively, now extends from Fairfield through to the Southern Highlands.

There have been no announcements on the Southern Highlands Division's website about the proposed liaison with the Macarthur Division. One wonders whether the Southern Highland's 63 or so GPs have had any say in the matter of where they want to be lodged and how they want to be represented on the Board of the Macarthur Division of General Practice.

The normally vocal Chief Executive and the Board Chairman of the Southern Highlands Division have been remarkably coy about what they are planning. Perhaps, it has become secret Board business. The Division's "Highland Doctor" has not been published (publicly) since July 2010 so either the area's GPs are being kept in the dark, along with rest of us, or they have felt the local Division has been so ineffective that they don't care about what happens to it.

Obviously, those GPs in the far north of the new Medicare Local do care and this is what they have to say:

GPs reject giant health bureaucracy in South West Sydney

by the South West Sydney Health Coalition - 05/11/2010

A report, prepared by Cranny and Associates proposes a giant bureaucracy in south west Sydney, ranging from Bowral to Bankstown.

Under proposed changes, family doctors influence over local issues would be silenced, putting at risk the promised benefits of government reforms to family medicine.

On the evening of November 4, over 150 GPs, health,and community leaders met at the Bankstown Sports Club to launch the South West Sydney Health Coalition, to call on the government to reject the proposal for a single giant health bureaucracy.

Mr Alan Ashton MP and Mr Tony Stewart MP attended the launch.

Community leaders included Dr. Ken Cho, from the Fairfield Liverpool Association of Medical Practitioners, Dr. Vinh Bin Lieu of the Vietnamese Australian Medical Association, Mr. Harry Allie, of the ATSI Advisory Committee Bankstown City Council, Mr. Si Banks of the Pharmacy Guild, Ms. Randa Kattan of the Arab Council of Australia, Dr.N.C.Patel of the Australian Indian Medical Graduates Association, Ms. Gunjan Tripathi from the Cancer Council, as well as the CEO of the Macarthur Division of General Practice, Mr. Rene Pennock.

At the launch, Dr Jim Gillespie first spoke about proposed changes to hospitals and family medicine. He described how communities now have an opportunity to shape their future health.

The Coalition was then launched by Dr. Sue Harnett, Chair of the Bankstown GP Division.

“We have real concerns that Bankstown, Fairfield and Liverpool are going to miss out on the benefits of family medicine reform,” said Dr. Harnett.

“The Cranny Report proposed much smaller locally connected organisations, “Medicare Locals,” in the wealthier parts of Sydney, and a giant disconnected Medicare Local for the economically deprived, ethnically diverse and fastest growing south western Sydney region,” she said.

“A single giant bureaucracy won’t fix the health problems in Bankstown, Fairfield and Liverpool - some of the most diverse and disadvantaged parts of Sydney.”

“Two smaller Medicare Locals are the only solution – a South West Sydney Medicare Local covering the natural grouping of Bankstown Fairfield and Liverpool, and a Macarthur – Southern Highlands Medicare Local, serving the fast-growing suburbs south of Liverpool”, said Dr. Harnett.

“Given that the government is now looking for local ideas, we have a once in a lifetime chance to change health for the better,” said Dr. Harnett. “This means family doctors working more closely with hospitals, other health professionals, local government, and actively engage the strengths of our many diverse community organisations.”

“We now call on families, individuals, health professionals and community organisations to join us, to contact their local MPs, and together, to shape the future of health in south west Sydney.”

This raises an interesting point for the residents of the Southern Highlands. Do they want to be in a Mega Medicare Local (from Fairfield to Bundanoon) in which the population is so skewed in age as well as in cultures, or do they think it would be any better to be connected as a branch with the Macarthur Medicare Local in which the population is equally skewed in age and cultures.

I find it abysmal, though not surprising, that Dr Warwick Ruscoe and Dr Vince Roche and their fellow Board members of the Southern Highlands Division of General Practice have not bothered to see what local residents have to say about this marriage they propose. Surely the patients who are the health consumers do have a right to make their views heard. Where has there been any public discussion about a significant effect that such amalgamations will have on their patients. Dr Ruscoe your silence has been deafening.

SSWAHS = SWSLHN + SLHN: Will it be different for the people of the Southern Highlands?

Well, apart from two rural LHNs, the Premier and Health Minister have decided upon who will be the Chief Executives of the other 16 Local Health/Hospital Networks.

At this time it is still unclear to the community members as to what will happen to the old SSWAHS Clinical Divisions and, more importantly, whether the people of the Southern Highlands will have the same access to the specialist inpatient beds which they had in the past. Or will the old Central Sydney AHS now re-branded as the Sydney Local Hospital Network (SLHN), manage to set up the barricades again?

Dr Victor Storm must be rubbing his hands with glee that he is back in his old stamping ground with control of his new, beaut "asylum" (you know, the one he said we should do without) the Concord Centre for Mental Health. I wonder if his vision of mental health (and treatment of the mentally ill) still extends southwards to Bowral Hospital and the Southern Highlands.

It's yet too early to get the information as to "who's who in the zoo" when it comes to the lesser mortals in the new 18 Local Hospital/Health Networks. One of the other persons mentioned in this blog, notably for her prolonged silences, appears to have slipped off the radar when it comes to the top jobs. Surprisingly, Jan Whalan appears to have also slipped off the Christmas card list for the Premier and the Minister as she did not get one of the Chief Executive positions published by NSW Health to date. I guess she could still manage to swing into one of the two remaining rural LHNs - if she hasn't trodden on too many toes! Perhaps, (hopefully) Ms Jan Whalan is making a return to running a pharmacy somewhere!

One bright spot in the shuffle of chairs is that the new Chief Executive for the SWSLHN which, according to the blurb, runs from "Fairfield to Bowral" is none other than Ms Amanda Larkin.

Amanda Larkin started her rise up the ranks by being the General Manager of Bowral Hospital for a number of years. She was then asked to manage the Campbelltown/Camden Hospitals when there was a shake-up in the system there a few years ago. She presided over the Macarthur-Wingecarribee health services until the recruitment of the General Manager for Macarthur Health Service took place and then took up the permanent position of General Manager of the Macarthur Health Service, thereby allowing the hardworking Denis Thomas to be appointed to the Bowral Hospital as General Manager. Even though she may be relocating to the Liverpool Hospital campus in her new position as Chief Executive of the SWSLHN I'm happy to report that, unlike her predecessors, Amanda Larkin does know where Bowral is and where the rest of the health services in Southern Highlands happen to be.

Nevertheless, as residents of the Southern Highlands we cannot become complacent about the state of the health services being offered in the Highlands. There are still issues of a more appropriate use of the operating theatres at Bowral Hospital to reduce the waiting list for elective surgery. And while Bowral Hospital is given a tick for renal dialysis does it really happen as much as it should?

Let's keep vigilant about our health service and remember - the NSW State election is only about 43 days away!

SSWAHS and Estoppel

It was interesting to use my holiday break to explore the internet for more of the misadventures of SSWAHS and its Executive members. Sure enough another SSWAHS fiasco was buried away in the cyberworld. This time they raised the ire of the Government and Related Employees Appeal Tribunal (GREAT) in November 2003. Ah! and guess who came in for some of their ire? None other than Ms Jan Whalan, who was then Deputy to Mike Wallace in the old Central Sydney Area Health Service.

In the short version of the matter (Appeal 252 of 2003) a professional employee of the CSAHS took the Health Service to the Tribunal over the decision to reduce her pay and conditions. At the hearing the Area Health Service was represented by Mr Garry De Courcey, Solicitor Advocate for the Crown Solicitor while the employee represented herself. A very David versus Goliath scenario!

The outcome was that the Tribunal dismissed the Area Health's challenge to the appeal by their employee. The Tribunal then directed the Registrar to list the matter for conciliation and to re-list the the matter for a hearing if the Area Health Service failed to conciliate.

Most interesting is the procedure adopted by the GREAT Tribunal to make the determination against the Area Health Service.

" 70. At paragraph 24 of these reasons therein is set out a report of a meeting involving Ms Torok and a number of other people. The report states that the appellant was told by Ms Mills that she could not discuss the matter elsewhere and she must pursue appropriate internal channels. Ms Mills is said to have nominated Ms Neville, Area Director, Human Resources as the appropriate person. It is significant that Ms Mills was one of the person’s involved in the investigation, according to the evidence provided in Ms Neville’s letter of 24 July 2003 to the appellant. In that letter Ms Neville does not suggest that there is no further appeal or that any appeal time has elapsed. Ms Neville did not conduct an appeal even though the appellant requested her to do so. After further correspondence Ms Neville referred the appellant to Ms Whalan on 6 October 2003 in a letter. The issue Ms Neville refers to is “your request to appeal my review of the investigation conducted by Mr Feliks Lewandowski.”

71. It is the evidence of Ms Neville that Mr Lewandowski was one of the three people who comprised the investigators being himself, Mr Bathur and Ms Mills. There is no suggestion that Ms Torok has no right of appeal. In her all her letters Ms Torok asserts her right of appeal.

72. I find that the respondent continually advised the appellant that she had appeal rights and has continued up to this time by referral to Ms Whalan. The evidence clearly establishes the respondent’s officer induced the appellant to believe an internal appeal would take place. At all times the appellant has challenged the
appropriateness and procedural fairness of the procedures adopted by the respondent’s various officers. I find that the respondent has induced in the appellant a belief that she could exhaust her internal review mechanisms in appeals prior to having to take an external appeal to GREAT, if dissatisfied. To suggest otherwise, as contended by the respondent is not consistent with the evidence. At any time it was open to the respondent’s officers to say fairly and squarely to the appellant, either orally or in writing, there are no further avenues of appeal; we will not entertain an appeal from you; our decision is final; or you must go to the Government and Related Employees Appeal Tribunal; or something else to that effect. It is clearly as suggested in the decision of Walton Stores21 at p6, at [16] that the employer has been aware of the mistake that the appellant laboured under but has done nothing to correct that, even though it was the duty of the respondent to do so. The respondent’s policy required timely and accurate advice about appeals .

73. The respondent would contend, if it had relied on Harvey 6, that the decision of Harvey 6 binds the Tribunal. That decision can be distinguished for the reasons I have given. Also that decision must be considered in the light of the ultimate authority of the High Court of Australia prevailing over the NSW, Supreme Court, Court of Appeal. This is not a failure to advise or a refusal to advise about appeal rights in circumstances where the respondent has no duty to advise but the respondent has gone further through the actions of Mr Lewandowski, Ms Mills and Ms Neville to misrepresent what the appeal procedures are and induce a belief in the appellant about those appeal procedures by failing to give a full and accurate
disclosure of the situation. It indeed would be unconscionable to allow the respondent (CSAHS) to profit from its own inaccuracy, obfuscation and confusion."

Obviously, the GREAT Tribunal was not amused by the attempt of CSAHS to hide its "unconscionable ..... inaccuracy, obfuscation and confusion" in dealing (or not dealing) with the complainant/plaintiff: their employee, Ms Torok.

Below is a definition of that which the CSAHSs Ms Jan Whalan appears to have mastered in her role as Deputy CEO of CSAHS and SSWAHS: Estoppel

"Equitable Estoppel
Unconscionable conduct is the touchstone for the operation of equitable estoppel but requires more than a mere failure to fulfill a promise. It denotes a creation or encouragement by the defendant in the other party of an assumption that a contract will come into existence or a promise will be performed and for the other party to have relied upon that assumption to his or her detriment to the knowledge of the first party (Waltons Stores (Interstate) Ltd v Maher (1988))."

One wonders whether the people from the Southern Highlands who are still waiting for responses to their complaints delivered some 18 months ago are able to mount a legal challenge against SSWAHS on the basis of the legal construct of Equitable Estoppel. Hmmm! a case for the local lawyers?