SSWAHS - Mr Scott Fanker and the NSW Health Care Complaints Commission

Socrates again looks at how a complaint from a dying Southern Highlands woman, supported by a concerned person, can be ignored by an unfeeling SSWAHS Executive - until after she had died. Then the complaint against one of their own was dismissed because the victim of the behaviour was now dead. How callous is that!

Mr Ian Thurgood

Director

Complaint Assessment Branch

Health Care Complaints Commission

Locked Mail Bag 18

Strawberry Hills NSW 2012

12 April 2010

Dear Mr Thurgood,

Thank you for your response to my complaint in which I act as an advocate for the late Ms B P. On the basis of the information provided in your response I wish to request a review of the decision the Commission has taken for not proceeding.

I must confess that I remain appalled at the way in which the SSWAHS has dealt with this serious complaint and the way in which it dealt with the original complaint made by Ms B P in 2007.

In respect of my complaint lodged with the Commission in November 2009 I made the following statement:

“In late 2007 or early 2008 the person affected and named above was a client of the Bowral Community Mental Health Service. She was being treated by a psychiatrist at the Browne Street Community Mental Health Service with whom she had elected to be treated while she remained residing in her home at Bundanoon. She had formed a good therapeutic relationship with that doctor who, nevertheless, requested care coordination and support be offered to the patient by the local Bowral Mental Health Service.”

In your response you note that I reported that Ms B P had reported her concerns about the alleged professional misconduct by Mrs T K, her assigned care coordinator in late 2007. I recall making a record of Ms P’s exchanges of text messages with me and placing a transcript of the messages in her file, at that time held at the Bowral Community Health Centre. I am unable to confirm the exact dates and the exact content of those text messages because I do not have access to her clinical file. I do note that I did enter the complaint in the NSW Health incident reporting system (IMMS) which would have made it available to the SSWAHS Area Executive and the Area Mental Health Service. A record of the incident and its subsequent management would be available on the electronic history of the incident held by the SSWAHS and NSW Health.

I suggest that if the Commission gained access to the clinical file of Ms BP and of the IMMS report of the alleged incident of professional misconduct they would have a better understanding and timeframe of the events associated with the original complaint made by Ms BP.

Mr Thurgood, there are some issues with the SSWAHS response which, singly and collectively, cause me great concern.

When the issue of the alleged professional misconduct was first raised by Ms B P and lodged with the electronic incident monitoring system, Mrs T K was still employed by SSWAHS. I can confirm that she was asked by me to withdraw from her role as care coordinator to Ms B P as a result of my receiving the texted information which was recorded in the clinical notes. Mrs T K was advised that this was due to a complaint received although she was not informed of the substance of the complaint. She was, however, informed that the complaint would be investigated. Subsequently, Mrs T K resigned from her position in April 2008 and commenced working for the Southern Highlands Division of General Practice, providing clinical services as a registered nurse and psychologist to the present day.

I believe the complaint made by Ms B P to the General Manager’s Unit of Bowral District Hospital on 13 August 2008 was, in part, due to the reluctance of Ms B P to continue to be care coordinated by the Bowral Mental Health Service. The fact that she may have again raised the matter of the earlier allegation of professional misconduct would be, to a reasonable person, indicative that she was not satisfied of the actions of the SSWAHS Executive in general, and of Mr Scott Fanker of the SSWAHS Area Mental Health Service in respect of her earlier complaint.

There was a meeting scheduled by the General Manager of the Bowral District Hospital in late 2007 in response of her earlier complaint. This would suggest that Ms B P’s complaint was seen as having some urgency and there was an attempt then to deal with it before Mrs T K resigned in April 2008. It does not surprise me that Ms B P postponed that meeting due to the fact that she was both emotionally and physically unwell and that she had the support of her treating psychiatrist Dr Kim Nguyen of the Browne Street Mental Health Service in Campbelltown.

With the subsequent diagnosis of the inoperable large cell lung cancer in late 20 08 or early 2009 it could be reasonably assumed that Ms B P would be less preoccupied with the complaint originally made in 2007 and the apparent lack of diligence on the part of Mr Fanker and of SSWAHS and the Area Mental Health Service to deal with the issue of an alleged serious professional misconduct made against Mrs T K.

Mr Thurgood, you note in your response that there was an emailed response to my letter to Ms B P in November 2009. You report her statement about her inoperable cancer and that she had other things to occupy her mind than pursuing the complaint. The email also indicated that her mental state was more stable and that she had been living at her home in Bundanoon since the diagnosis was made. She also makes a pointed statement about her perception of Mr Scott Fanker of the SSWAHS Area Mental Health Service and his actions and attitude to her complaint. A reasonable person could suggest that with her diminished confidence in the processes of complaint resolution in SSWAHS she would be unlikely to take up any offer made by Mr Fanker.

Finally, I find it extraordinary that SSWAHS, with its access to Ms B P’s clinical record and the electronic incident monitoring system could not respond to the Commission’s request for a response in a period of four months, but could only do so a short time after they knew of Ms B P’s death in early February in Bowral District Hospital. A reasonable person would have some difficulty in seeing any serious intent on the part of SSWAHS to deal in a timely way, with diligence and transparency with the Commission’s request for a response and for bringing some appropriate resolution to Ms B P’s first complaint in late 2007.

In summary then, I wish to make the following observations as the basis for my request for a review:

Ø It may be appropriate for the Commission to question why the SSWAHS was unable to respond any earlier than after the death of Ms B P when they appeared to have ready access to the limited information and facts that they appear to have provided to the Commission.

Ø The Commission may wish to ask the SSWAHS Area Mental Health Service why they did not use the services of their Patient Advocate, Mrs Gillian Holt, to visit Ms Pickersgill at her home or to gain further information about the complaint of 2007 and 2008. Mrs Holt lives in the Southern Highlands, is a Carer of a person with a mental illness and has regularly worked with people with a mental illness. This option of interviewing Ms B P does not appear to have been considered by SSWAHS even up to the time of Ms B P’s death in February 2010.

Ø The Commission may wish to consider whether or not SSWAHS attempted to use Ms B P’s treating psychiatrist, Dr Kim Nguyen, a SSWAHS employee who was a person of confidence to Ms B P during her treatment between 2007 and 2009 and possibly to 2010, in order to elicit an understanding of the complaint made by Ms B P.

Ø The Commission may wish to ask SSWAHS why they did not report the alleged professional misconduct of Mrs T K to the Nurse’s and Midwive’s Registration Board and to the Psychologist’s Registration Board as required by the reporting requirements of NSW Health Code of Conduct (9.1).

Ø The Commission may wish to ask the SSWAHS why Mr Scott Fanker and the SSWAHS did not show fairness in dealing with Ms B P’s complaint of 2007/2008 consistently, promptly, transparently and fairly as required by the NSW Code of Conduct (6.1).

Ø The Commission may wish to ask Mr Scott Fanker (SSWAHS)whether his decision and/or professional behaviour to Ms B P was lawful; is in line with the policies of SSWAHS; and whether his decision or behaviour can be justified in terms of public interest and whether it could withstand public examination (NSW Health Code of Conduct 1.1.1; 1.1.2; 1.1.6).

Yours sincerely,

Kevin O’Neill

Socrates reports this information for the information of all who might be concerned about the way in which this Area Health Service treats complaints by the consumers of their health services. You be the judge!

SSWAHS - Dr Victor Storm and the NSW Ombudsman's response

Socrates understands that the Southern Highlands complainant did everything requested by the NSW Ombudsman's office to try and deal with his complaints by referring them to the CEO of SSWAHS, Mr Mike Wallace, and Ms Carmel Tebbutt MP, NSW Minister for Health. With no response after 6 months what else can the complainant do but respond to the NSW Ombudsman's office and say "sorry, no response! How long should one wait?"

Following the sending of the following letter a very unsettling telephone conversation followed from a woman in the NSW Ombudsman's office. It went something along the lines of: "Although you might have a legitimate complaint against SSWAHS you no longer work for them and we have to use our limited resources on more important complaints." Okay, so what could be more important than serious complaints about senior executive staff of an Area Health Service like SSWAHS. One has to wonder whether someone higher up the food chain has leaned upon a statutory authority like the Ombudsman's Office.

Team Leader

Community Services Division

NSW Ombudsman

Level 24, 580 George Street

Sydney NSW 2000

12 April 2010

Your ref: C/2009/7806

Dear Sir/Madam,

RE: My complaint about the Sydney South West Area Health Service (SSWAHS)

I refer to my earlier correspondence and complaint lodged with the NSW Ombudsman on the 5^th and 9^th November 2009.

Having followed the recommendation provided by your office in its response from Kim Kenny on 12 November 2009 I communicated my complaints about officers in SSWAHS to the CEO of Health NSW and to the CEO of SSWAHS I have remained awaiting some informed response for the past six months. I understand that the CEO of SSWAHS has indicated that a Mr Graeme Slade would provide me with a written response upon the completion of any investigation. To date there has been no further communication from SSWAHS and nor has Mr Slade spoken with me.

I also wrote to Ms Carmel Tebbutt MP (Minister for Health), and Mrs Barbara Perry MP (Minister assisting the Minister for Health – Mental Health and Cancer) on 4 November 2009 in which I made comments about the same and similar complaints. To date I have not even received an acknowledgement of the receipt of the letters nor, obviously, any action they may have taken. In regard to the letters of complaint I was advised to forward to the CEO of Health NSW again I received no acknowledgement that they had even been received or actioned.

On 23 December 2009 I did receive a brief response from one of the persons about whom I had complained. The content of the letter from Dr Victor Storm did not demonstrate any transparency nor did it suggest that anything was done differently to that which he advised he would do in May 2009. I gained no confidence from the content of Dr Storm’s letter of 23 December 2009 that the matter of my complaint had been fully investigated objectively.

I have enclosed copies of my complaint and the responses in the hope that the NSW Ombudsman will consider the outcome worthy of further investigation.

Yours sincerely,

Kevin O’Neill

Socrates simply offers the above for your information. You be the judge!

SSWAHS, Mr Dodds and his leadership style - a sychophant in the making?

Socrates again simply publishes the response of the complainant. Of course there has been no response from SSWAHS in general, or Ms Whalan in particular.

Ms Jan Whalan

Director of Corporate Services

SSWAHS

Locked Bag 7017

Liverpool BC 1871

31 December 2009

Dear Ms Whalan,

RE: Mr Peter Dodds

Thank you for your recent response to my letter of 16 October 2009 in which I directed comments to Mr Peter Dodds and Mr W M in respect of his reported statements about the referral of a patient to myself as a private practitioner.

To be blunt, I have to say that if Mr Dodds denies making any such statement to the staff of the Bowral Mental Health Service then the veracity of his denial is questionable. Also if the matter had been investigated by SSWAHS in any transparent and independent fashion I would have expected, at least, a conversation with the person conducting the investigation. The fact that I did not disclose the person or persons from whom I received the information about Mr Dodds’s statement is perhaps understandable given my recent experience of investigations by SSWAHS.

I will, however, state that the comments were made on a Tuesday morning when the rostered members of the Bowral Mental Health Team were present and in the company of Dr R W. As I understand it, it was Dr W who first made the suggestion that a particular client be referred to my practice. I suggest that the person responsible for investigating my original complaint revisit the matter and speak with staff other than person upon who the complaint is based.

Whilst I note the supposed NSW Health policy insists that the Mental Health Service has a ”long-standing practice of providing clients who require private sector services with the names of a range of clinicians who practise in a geographical area”, I strongly doubt that this is done without “commentary or opinion...... in relation to the skills of any of the clinicians listed”. If adherence to that NSW Health policy was the case why does Dr Angelo Virgona (SSWAHS) specifically refer his patients directly to individual private practitioners in the Bowral area, when other consultant psychiatrists employed by SSWAHS have been advised that they are not to do so?

I will contact Mr M for a copy of the list of private practitioners that is used by the Bowral Mental Health Team upon his return from leave.

Yours sincerely,

Kevin O’Neill

Psychologist and

Credentialed Mental Health Nurse

SSWAHS - Dr Victor Storm - Mr Scott Fanker: A case of smoke and mirrors?

Socrates has been informed that the complainant from the Southern Highlands did make the following response to Dr Victor Storm just ten months after he first made the complaint. Socrates can't help but note that the December response from Dr Storm bore a remarkable similarity to the one he made in May 2009 when he announced that he'd ask Mr Fanker to investigate himself!


Dr Victor Storm Clinical Director
Area Mental Health Service
Sydney South West Area Health Service
Concord Hospital,
Hospital Road
CONCORD NSW 2139


31 December 2009


Dear Dr Storm,

I refer to your letter of 23^rd December 2009 and note the brief statement in its content.

Please be advised that I do not accept your response as an adequate explanation of my complaint and, following the advice from the NSW Ombudsman, will take the matter to a higher level.

Notwithstanding the above, I believe that the headings of dispute with your finding are as follows and are evident within the NSW Health Code of Conduct:

1.1.Personal and professional behaviour: (p.10)

• Openness, honesty and accountability.

• My decisions will be fair and impartial.

1.2.Good faith: (p.10)

• I will undertake all my duties in good faith and in the spirit of honesty, correct purpose and with the best motives.
  
• I will ensure that my actions are appropriate and totally within the area of my authority.

1.3.Personal relationships with patients or clients: (p.11)

• I will not have personal relationships with patients or clients that result in any form of exploitation, obligation or sexual gratification.

1.4. Managing conflicts of interest: (p.12)

• I will avoid situations that give rise to conflicts of interest.

• I will report any actual, potential or perceived conflicts of interest to my immediate supervisors, my Health Service Chief Executive or his or her delegate at the first available opportunity, preferably in writing. A decision can then be made as to what action should be taken to avoid or to deal with the conflict.
• If I’m not sure whether a conflict exists, I will discuss the matter with my immediate supervisor to try and resolve the matter.
  

1.5.Fairness in decision making: (p.18)

I will:

• Deal with issues, cases or complaints consistently, promptly, openly and fairly.

• Act fairly and reasonably when using any statutory or discretionary power that could affect individuals within or outside of NSW Health.
• Avoid any unnecessary delay in making decisions or taking action.
• Take all reasonable steps to ensure that the information I act or decide on is factually correct and relevant.
  

1.6. Appealing decisions: (p.18)

• I will promptly inform individuals who are adversely affected by or who wish to challenge a decision, of their rights to object, appeal or obtain a review.
  
• I will also inform them how they can exercise those rights.
  

With respect, your own delay in providing a formal response to a complaint made on 23 February (with a reminder in May 2009) is appalling to say the least.

It certainly flies in the face of Fairness in decision making and Appealing decisions noted above in the NSW Health Code of Conduct.

Yours sincerely,

Kevin O’Neill

Again, Socrates does not wish to do anything other than make the case for the person who feels that there has been no clear process followed by Dr Storm and SSWAHS in dealing with complaints - a process that is clearly established by the NSW Health for all its Health Services administrators to follow.

Ms Barbara Perry MP and the SSWAHS Executive response to complaints

Mrs Barbara Perry, MP
Minister assisting the Minister for Health (Mental Health and Cancer)
Level 33, Governor Macquarie Tower
1 Farrer Place Sydney NSW 2000

13 April 2010

Dear Mrs Perry

RE: Complaint against the Sydney South West Area Health Service – Mental Health I write in reference to my correspondence of 4 November 2009, a copy of which is enclosed, in which I expressed some serious concerns I had about the state of the safety of staff working in the mental health services of the Sydney South West Area Health Service.

As the Minister responsible for Mental Health assisting the Minister for Health I thought it would be appropriate for me to draw these matters of concern to your attention. It is disappointing, therefore, to have not received a response or even an acknowledgement from your office that you may share these concerns and consider that some appropriate action be taken to address the issues of a safe working environment for staff working in mental health assessment and treatment services, particularly in a rural or regional area.

Yours sincerely,

Kevin O’Neill

Psychologist and
Credentialed Mental Health Nurse

As was the case for the NSW Minister for Health, Ms Carmel Tebbutt, Socrates is aware that Mrs Barbara Perry, the NSW Minister assisting Ms Tebbutt, also failed to respond to this second letter from a complainant in the Southern Highlands. Where is the duty of care and the Ministerial responsibility expected by the voters of New South Wales?

Do SSWAHS and the NSW Minister for Health really care about complaints?

Having been back from his leave for a week Mr Graeme Slade, the SSWAHS Designated Senior Complaints Officer, has continued to show his disdain about providing the written feedback to a series of complaints made almost 12 months ago. Socrates has no knowledge of Mr Slade and, possibly, he could be a diligent individual who takes his job seriously. He could, however, be somewhat constrained by a more senior figure in the SSWAHS Executive. So in the interest of ensuring that others might be willing to draw their own conclusions, Socrates has undertaken to ensure that the truth be told. I take the view that, in a democratic society, the freedom of speech is still possible.

Ms Carmel Tebbutt, MP
Minister for Health
Level 30, Governor Macquarie Tower
1 Farrer Place Sydney NSW 2000

13 April 2010

Dear Ms Tebbutt

RE: Complaint against the Sydney South West Area Health Service

I write in reference to my correspondence of 4 November 2009, a copy of which is enclosed, in which I expressed some serious concerns I had about the state of the safety of staff working in the mental health services of the Sydney South West Area Health Service and of the clinical governance exercised by the Area Executive.

As the Minister responsible for Health I thought it would be appropriate for me to draw these matters of concern to your attention. It is disappointing, therefore, some six months later to have not received a response or even an acknowledgement from your office that you may share these concerns and consider that some appropriate action be taken to address the issues I relayed to you, among others, of a safe working environment for staff working in mental health assessment and treatment services, particularly in a rural or regional area.

Yours sincerely,

Kevin O’Neill
Psychologist and
Credentialed Mental Health Nurse

SSWAHS and the NSW Government response.

Socrates now gives the second of the letters to the NSW Health's Minister for Cancer and Mental Health, who assists Ms Carmel Tebbutt, the NSW Minister for Health.

Mrs Barbara Perry, MP
Minister assisting the Minister for Health(Mental Health and Cancer)
Level 33, Governor Macquarie Tower
1 Farrer PlaceSydney NSW 2000
4 November 2009

Dear Mrs Perry

Complaint against the Sydney South West Area Health Service – Mental Health

I write to you on advice from the NSW Anti-Discrimination Board as the specifics of my issues do not fall within their jurisdiction. My complaint relates to senior executive staff of the Area Health Service and in particular members of its Division of Mental Health.

The following are the facts as I stated them previously to the ADB. Please excuse the length of this letter.

On May 4^th 2009 my employment with the Sydney South West Area Health Service was terminated by letter from the organisation’s CEO Mr Mike Wallace. At the time of my termination I was Manager of the Bowral Community Mental Health Services.

I believe that I have been discriminated against in my employment and that I have been victimised by the persons named above. However, the primary issue is that the organisation failed to provide myself and other staff adequate protection against the aggression and violence directed towards me by a client of the organisation, contrary to the prescription of NSW Health and it’s “Zero Tolerance” Policy.

The reason for my termination, following an investigation, was on “the balance of probability”, and because it was thought that I was “involved” with others in responding to a client’s defamatory comments on his internet blog. I believe that the presumption of my guilt prior to the commencement of any investigation and the lack of clear evidence of that guilt was discriminatory. As was the failure of the SSWAHS to provide adequate support and protection of myself (and other staff) from the threats of death, violence and aggression and actual defamatory comments posted on the internet all perpetrated by the organisation’s client.

Previously in 2009, I lodged an ADB complaint against the client of the organisation, due to his continued attacks and public vilification against me. I was informed that the complaint could not proceed but that I could consider a complaint against the organisation due to its lack of due diligence in providing a safe working environment and for failing to institute the NSW Health policy of “Zero Tolerance against Violence”. I also spoke with a legal firm that specialises in employment-related law. I was advised by them that, in the absence of any evidence that the organisation did anything procedurally incorrect with regards to the termination, I was unlikely to succeed in any legal case seeking reinstatement.

As a result of the SSWAHS investigation and decision to terminate my employment, on May 11, 2009 I was reported by Ms Jan Whalan to the NSW Nurses and Midwives Registration Board, and the NSW Psychologists Registration Board. It has only been resolved by both Boards and the HCCC in October 2009 that no action against me, by the relevant Boards, will follow the lodgement of those complaints by the SSWAHS. While the SSWAHS might suggest that they had an obligation to inform the Boards of the outcome of their investigation, their action has produced an outcome that has seriously hindered my capacity to develop meaningful employment in my professions in both the public and private sectors.

In regard to the failure of the organisation to exercise due diligence to protect their staff: During early 2008 the client provided the service with a copy of his blog entry dated 13 March 2007 and titled “Triage”. This article purported to give an account of the way in which the Bowral Mental Health Service responded to their clients. It was posted to the internet and could constitute defamation. It was shown to the Clinical Director, Mental Health SW Cluster Dr Angelo Virgona whose only response was to laugh.

On December 22, 2008 I provided the Operations Manager Mental Health SW Cluster, Mr Scott Fanker with the content of a tape recorded message by the client in which he defamed the person and reputation of an elderly staff member of Berrima Cottage (the rehabilitation unit). To date no action has been taken to provide advice or support by the organisation to that staff member. On the same date (December 22^nd), I requested Mr Fanker to offer a response to my question: “Does the Area Mental Health Service accept the “Zero Tolerance to Aggression” policy issued by NSW Health? If so, how does it intend to protect the staff of the Wingecarribee Mental Health Service from ‘Paul C’?” His response was: ”Um, no this is an interview with you, not an interview with us so I’ll read those questions and we can speak about that um outside of the interview process, anything else you want to say?” At that interview I was also asked by Mr Fanker “What would you like us to do” about the threats of violence against staff (and myself) made by the client? I responded by asking the organisation to take out an AVO against the client to restrict his access to staff while he was intoxicated or otherwise threatening. I was told by Mr Fanker: “That will only inflame the situation”.

Between December 22, 2008 and May 4, 2009 Mr Fanker had opportunity to respond to my questions posed in the interview of December 22, but never did so. Mr Fanker also claimed to have had no knowledge of the ongoing nature of the attacks, both verbal and written by the client about the staff members and the service over a 2 year period. However, in early December the client stated in an email that he “had more than 30 hours of discussion with Mr Fanker about his issues with the staff and service. And that Mr Fanker had read all his notes, documents and history”. Mr Fanker, also in an email in early December 2008, to a person being verbally attacked by the client, stated that he’d gone thoroughly through all the blog postings of the client. Those postings had commenced in early March 2007.

On Monday, January 12^th 2009 I spoke with Mr Scott Fanker about a blog posting by the client which was titled “O’Neill” and dated Sunday 11^th January. In this blog my full name was advertised in capitals, I was called (among other things) that “DOG O’NEILL”, “JOKE O’NEILL” and “that cunning sly dog O’Neill” . I asked Mr Fanker if he had seen it. He opened the blog and read it while we spoke and stated that he would attempt to have the client remove it from his blog. Subsequently, I received an email from Mr Fanker stating: “Now is not the time to ask him (the client) to remove the blog posting”. It remained on the internet for a number of days until the client’s brother removed it.

On February 24^th, 2009 I spoke by telephone with Dr Victor Storm, Clinical Director SSWAHS Mental Health, in respect of a formal complaint I was lodging against Mr Scott Fanker. I did so and emailed it to Dr Storm’s organisational email address that same day. It is my understanding that all complaints or incidents to any NSW Health organisation have to be managed on the electronic incident monitoring and management system (AIMS or IMMS). This allows senior executive staff in the clinical governance unit to note it, and also to allow for a timely response. It would appear (perhaps by his own admission) that this protocol was not followed by Dr Storm. On April 30^th 2009 I again emailed Dr Storm (with an attached copy of my complaint) stating that I had not heard from the SSWAHS about any outcome in respect of my complaint against Mr Fanker. I received a response by email from Dr Storm on May 4^th in which he stated: “Please be advised that Mr Fanker has been provided with a copy of your complaint and is being given an opportunity to respond.” This does not indicate that the usual procedure for dealing with a complaint or incident was being followed by Dr Storm. His final paragraph stated: “I will inform you of the outcome of my enquiries, in due course.” To this date I had no further response from Dr Storm as to the outcome of his enquiries. On March 19^th 2009 while on sick leave from the organisation I sent an email to Ms Jacqui Clark the Acting Manager of Human Resources – SSWAHS to express my concern that personal information about myself, including the fact that I was on leave from my position, was made known to the organisation’s client who was harassing me. The client began to publish comments on his internet blog that directly conveyed his intimate knowledge of my being on leave, but also the nature and duration of that leave. The client went so far as to publish the fact that the investigation was almost at an end (of which I had not been informed), that the outcome would be negative for me, and that I would most likely be offered retirement or the capacity to be allowed to plead work related stress. I received no response from the SSWAHS Human Resources Department about any breach of my confidentiality by persons from within the Area Health Service to the organisation’s client.

Between May 4^th 2009 and July 2009 I was forwarded a constant stream of emails sent by the client directed to myself and others, the content of which was constantly denigrating and threatening to myself and others. Those emails from the organisation’s client were simply forwarded on by myself to the key senior Executive members of the SSWAHS already involved in the investigation. This was an attempt on my part to alert the organisation that the activities of their client remained harassing and threatening to myself and others in the community. The only response came from Ms Jan Whalan, Director of Corporate Services – SSWAHS who, on June 9^th 2009 sent me an email which stated: “Dear Sir, I am adding your email address to my junk email address list. I am not going to read or reply to emails from platwood@hinet.net.au. I have advised Victor Storm, Angelo Virgona and Scott Fanker to do likewise. Jan Whalan”. The same message was received by me on June 15^th 2009 from Dr Angelo Virgona. The harassment of myself and others in the local community from the organisation’s client continued unabated until the end of July 2009. It also included calls made by the organisation’s client to the home phone of myself and others.

I believe that the foregoing indicates that the SSWAHS discriminated against me in my employment with them, and in my capacity to perform my clinical duties subsequently. I believe that the SSWAHS did not provide the safe working environment to myself usually expected by from an employer by an employee. In that they did not offer support to me when it was reported to them by other staff that the client of the organisation was seeking me “to blow my head off”. This threat was conveyed to me while I was in the presence of Dr Angelo Virgona. This stated threat was also repeated to my immediate line Manager Mr William Midson, and to Mr Scott Fanker and to Ms Belinda Woolley on more than one occasion.

An attempt by me to gain some personal duress security alarms for myself and my staff in about 2006 was terminated by Ms Jan Whalan. I was advised by Dr Angelo Virgona that the reason for not providing them was that Ms Jan Whalan reportedly said that every community based nurse would want access to one. The fact that Mr Scott Fanker also heard the client, with whom he was very familiar, recording defamatory and threatening comments about an elderly female staff member should have indicated to a senior executive member of the Mental Health Service that the client of the organisation presented a real danger to staff of the service. Yet nothing was done by SSWAHS to lessen that potential danger.

I believe that I have been diligent in reporting all threats of violence, real and potential, towards myself and other staff through the electronic incident monitoring and management system. There had been only one aggression reduction training session provided to the staff of the service. There has been no offer of a personal duress alarm system, given to community based mental health staff, which is provided routinely for all inpatient mental health staff. This I believe is discriminatory. The organisation’s client has provided evidence that he has improperly received details of a personal nature about me from within the organisation. The fact that the client himself identifies Mr Scott Fanker as the person with whom he was in most frequent contact, and whose opinions he has published in his blog postings, would suggest, on the balance of probability, that there was a possible disclosure from that senior Mental Health Executive member, thereby breaching my confidentiality.

Since my termination from the SSWAHS I have been reported to the HCCC and to the NSW Nurses and Midwives Registration Board and the NSW Psychologists Registration Board by Ms Jan Whalan (Director for Corporate Services-SSWAHS). I have responded willingly to the HCCC and to the registrations boards and have been informed by them that they are satisfied that I remain a fit and proper person to practise my professions. However, the path to developing my private practice has been set with many hurdles, primarily due to the behaviour of the Area Health Service staff in dealing with the issues of staff safety, confidentiality and support.

The purpose of this letter, therefore, is to:

• inform you of those issues endemic in the mental health services in SSWAHS;

• seek an apology from SSWAHS for the emotional hurt and harm they have done to me and my professional reputation; and,

• address the shortcomings in the SSWAHS mental health service, particularly in this rural area.

Yours sincerely,
Kevin O’Neill

SSWAHS and the writing on the wall. Time's up!

Socrates has been informed that there has been no response to the series of complaints made by one resident of the Southern Highlands to SSWAHS and NSW Health more than 11 months ago. It would appear that even the email to Mr Graeme Slade, the SSWAHS Designated Senior Complaints Officer, appears to have been unanswered. Well, Socrates suggests that any reasonable citizen of the old Athenian culture would suggest that time is of the essence in the delivery of the democratic responsibilities of government, whether it be of an organisation, or a State.

For this reason the complainant has now made available some of the complaints made to the NSW Ministers for Health, about one year ago, and as yet unanswered. Socrates suggests that reader can make their own determination as to whether these complaints were justified concerns.

Ms Carmel Tebbutt, MP

Minister for Health

Level 30, Governor Macquarie Tower

1 Farrer Place

Sydney NSW 2000

4 November 2009

Dear Ms Tebbutt

RE: Complaint against the Sydney South West Area Health Service

I write to you on advice from the NSW Ombudsman’s office as the specifics of my complaint should be first forwarded to you as Minister for Health. My complaint relates to senior executive staff of the Area Health Service and, in particular, to two senior members of its Division of Mental Health. The following are the facts as I stated them previously to the NSW Ombudsman.

1. On February 24^th, 2009 I spoke by telephone with Dr Victor Storm, Clinical Director SSWAHS Mental Health, in respect of a formal complaint I was lodging against Mr Scott Fanker. I did so, and emailed it to Dr Storm’s organisational email address that same day.
2. It is my understanding that all complaints or incidents to any NSW Health organisation have to be entered and managed on the electronic incident monitoring and management system (AIMS or IMMS). This allows senior executive staff in the clinical governance unit to note it, and also to allow for a timely response to it.
3. It would appear (perhaps by his own admission) that this protocol was not followed by Dr Storm. On April 30^th 2009 I again emailed Dr Storm (with an attached copy of my complaint) stating that I had not heard from the SSWAHS about any outcome in respect of my complaint against Mr Fanker.
4. I received a response by email from Dr Storm on May 4^th (the day of my termination) in which he stated: “Please be advised that Mr Fanker has been provided with a copy of your complaint and is being given an opportunity to respond.” This does not indicate that the usual procedure for dealing with a complaint or incident was being followed by Dr Storm. His final paragraph stated: “I will inform you of the outcome of my enquiries, in due course.”
5. To the current date I have had no further response from Dr Storm as to the outcome of his enquiries.

Since my termination from the SSWAHS I have been reported to the HCCC and to the NSW Nurses and Midwives Registration Board and the NSW Psychologists Registration Board by Ms Jan Whalan (Director for Corporate Services-SSWAHS).

I have responded willingly to the HCCC and to the registrations boards and have been informed by them that no action against me will be taken and that they are satisfied that I remain a fit and proper person to practise my professions. However, the path to developing my private practice has been set with many hurdles, primarily due to the behaviour of the Area Health Service staff in dealing with the issues of staff safety, confidentiality and support.

A more detailed letter concerning those issues has been forwarded to the Hon. Mrs Barbara Perry, MP for her consideration as Minister assisting you in matters of Mental Health and Cancer.

The purpose of this letter, therefore, is to:

• inform you of those issues suggesting the inappropriate way a complaint is dealt with in the SSWAHS;
• indicate the lack of response to a serious complaint related to the Code of Conduct against a senior manager of the SSWAHS;
• seek an apology from Dr Storm and the SSWAHS for the delay in his/its investigation of my complaint.
• seek an independent review of the complaint that I made against Mr Scott Fanker and the conflict of interest and improper conduct of his investigation of allegations made against me by a client of the organisation.
• seek an explanation from Dr Storm as to why he failed to implement usual NSW Health protocol for dealing with complaints, that is, electronic documentation and lodgement, and review by independent persons within the organisation of SSWAHS.
• seek an apology from SSWAHS for the emotional hurt and harm they have done to me and my professional reputation; and,
• address the shortcomings in clinical governance in the SSWAHS mental health service, particularly in this rural area.

Yours sincerely,

Kevin O’Neill

SSWAHS and its response to complaints from the Southern Highlands: Part 2

Socrates, you might recall, posted a copy of the following email sent by a very rebellious native of the Southern Highlands, who had been waiting (and staying alive) diligently to be able to obtain a report into a series of complaints that the Health Care Complaints Commission and the Ombudsman's office thought should dealt with by the Sydney South West Area Health Service. The email is explanatory enough, one would think, and although it might be considered to be a bit tart in its consumption, is most likely appropriate given that the complainant has been waiting 11 months for the offered response, even though the investigator has never bothered to even speak with the complainant.

Today Socrates was informed that Mr Slade has been on holidays for a month (back next week), but the source at SSWAHS says that all his emails had been forwarded to Dr Bellamy, his boss, during his absence. Now that name did ring a temple bell or two in the mind of Socrates! Ah, yes!
That's the same Dr Bellamy that the tabloids in Sydney (and referred to in an earlier post), had much to say about some of her clinical practices, and who the SSWAHS Executive were so happy to appoint to the position of Director of Clinical Governance in SSWAHS. My, how the temple pool has become so cloudy up at Liverpool.


Mr Graeme Slade
Designated Senior Complaints Officer
SSWAHS

Dear Mr Slade
I have your letters addressed to me and dated 18th and 19th November 2009 in which I am assured by you that the matters about which I "complained were being, and would be, investigated and a written response would be provided to me upon completion of the investigation."

I write to inform you that I have not yet received a written response to my complaints, nor have you even made any form of contact with me, the complainant.

Mr Slade I find it surprising that this has not happened given that in the NSW Health Code of Conduct there is specific mention that complaints such as mine (or indeed from any complainant) should be dealt with in a timely manner.

I also draw your attention to the SSWAHS Policy Directive: Complaints: Management of a Complaint or Concern about a Clinician - Document No: SSW_PD2007_035, which describes the procedures to be followed in the matter of all complaints received by the SSWAHS oganisation, and in particular, the role of the Designated Senior Complaints Officer.

I can assure you that as I was not anonymous in my complaints nor did I consider them to be frivolous in nature I did anticipate that there would be some action and some response as you had stated.

The fact that there has been no apparent action or response leads me to believe that SSWAHS is failing in its adherence to both the NSW Health Code of Conduct and its own Policy as stated above.

The alternative may be, however, that you, Mr Slade, have died, been terminated, or simply decided to part company with SSWAHS. Perhaps, if you are neither dead, nor been terminated, but still work for SSWAHS you might consider responding to this email. For myself I can assure you that I am not dead, and I still want to have a written response to those several complaints.
Yours sincerely,
......................................

SSWAHS and its Professional Staff retention: It must be taking training from Texas

September 21, 2009

Two Texas Nurses Arrested Over Shady Physician Practice Report

Posted by Tye under Ethics, Medicine | Tags: Austin American Statesman, herbal medecine, Kermit, prosecution, Science Based Medicine, standard of care, Texas, Texas Medical Board, Texas Nurses Association |


This weekend I was reading about how two nurses from Kermit, Texas were indicted with a third-degree felony for “misuse of official information.” The real charge should be “victim of a witch-hunt” as these two nurses did nothing but hold up the Nurse’s Code of Ethics.

A physician at their hospital was encouraging patients to purchase dubious herbal “medicines” that he happened to profit from because he was the seller. They also thought it was improper that the physician tried to steal materials from the hospital to test patients at their home (the hospital administrators stopped this before it happened). Once the physician found out a complaint had been launched against him he filed a harassment charge to the Winkler County Sheriff’s Department. Through what may have been the most thorough investigation in the history of the county’s sheriff’s department the two nurses were identified and charged with a crime that could result in 2-10 years in prison and up to a $10,000 fine.

The Texas Nurses Association has created a legal defense fund in support of the two women and the Texas Medical Board has written a letter to the attorneys detailing the impropriety of prosecuting the nurses. From what I’ve read the trial should be happening this month but I can’t find much information about it.

There have been some excellent state commentaries on this situation as well as national coverage on the well read medical blog “Science Based Medicine”. Here are some of my favorite excerpts from the reports.

From the Austin American Statesmen:

The Texas Medical Board sent a letter to the attorneys stating that it is improper to criminally prosecute people for raising complaints with the board; that the complaints were confidential and not subject to subpoena; that the board is exempt from federal HIPAA law; and that, on the contrary, the board depends on reporting from health care professionals to carry out its duty of protecting the public from improper practitioners.

This situation shouldn’t happen anywhere, but it especially shouldn’t happen in Texas, which hassome of the toughest whistle-blower and patient advocacy protections for nurses in the nation, thanks to the leadership of Texas Nurses Association.

ADVANCE for Nurses:

Jim Willman, general counsel/director of government affairs for TNA, cited a Texas case in 1983, Lunsford v. Board of Nurse Examiners, 648 S.W.2d 391, 395 (Tex.Civ.App. 1983), where the court held that “[a] license to provide medical services is a covenant to serve the people.” The judgment determined “nurses have a duty to act in the best interest of their patients, and . this duty is not superseded by hospital policies,” explained Willman.

TNA fears the legal precedent the nurses’ indictment sets. The message it sends to nurses and other healthcare practitioners will have adverse affects on the health and safety of patients, Willman added.

“The two nurses had concerns about whether a physician was practicing below the accepted standard of care and reported those concerns to the TMB,” he said. “The NPA recognizes their right to report and their duty to patients requires them to do so. The criminal indictment cannot help but discourage other nurses from reporting a physician, another nurse or a hospital for unsafe patient care.”

The TMB also objected to the criminal prosecution of the nurses, and sent a letter to the Winkler County district attorneys stating the nurses’ complaint was allowed under state and federal law. The board argued “it is improper to criminally prosecute people for raising complaints with the TMB.” It also noted since the complaints were confidential they were not subject to subpoena and that “under federal law TMB is exempt from HIPAA requirements.”

“In my 8 years with the board, I have never seen a complainant charged with a felony for making a complaint to the board,” said Mari Robertson, JD, TMB executive director. “I don’t know that I’ve ever seen a criminal prosecution for providing information to the medical board.”

And from SBM:

This case is bad. Real bad. Nurses and other health care professionals are reluctant enough as it is to report a bad doctor or a doctor peddling dubious therapies as it is. What makes this case particularly outrageous is not only because it appears to be a horrible abuse of power by Sheriff Roberts, but, even worse, it sends the clear and unmistakable message to nurses in Texas: Don’t get out of line or the medical powers that be will make you pay. They will find out who you are, no matter what it takes to do so, and then they will do everything in their power to retaliate. They’ll even try to throw you in jail if they can figure out a rationale to do so, legal or not.

SSWAHS Executive bites the hand that tries to help it. Please explain!

Bowral Hospital renal unit going to waste - SHN - TRAVIS HOLLAND - 02 Apr, 2010 11:17 AM

GOULBURN MP Pru Goward and local renal patients have labelled Bowral Hospital’s Renal Unit a waste.

“The hard fought for renal dialysis service at Bowral Hospital is a patient-free area, sitting idly in the Short Stay Ward,” Ms Goward said.

“What a shocking waste of expensive equipment, not to mention the hard work that went into raising $500,000 to provide this service,” she said.

Highlands resident Michael Richardson, who is in need of renal dialysis three times a week, said he had been “barred” from using the facility.

Mr Richardson was self-dialysing at Bowral until recently, when he developed complications and needed medical supervision.

Since then, the problems had been resolved and Mr Richardson had hoped to return to the local hospital.

But he was upset he had to travel to Campbelltown because he was “not wanted” at Bowral.

Ms Goward said Mr Richardson was the only local patient who had ever been able to use the facilities, despite the unit operating for two years.

In Februrary, the News reported the case of Barbara Clarke, who was forced to travel to Concord Hospital for treatment.

Southern Highlands Renal Appeal chairman Bob Barrett said the community raised $650,000 in the past eight years to establish the renal unit at Bowral Hospital.

He said the Sydney South West Area Health Service (SSWAHS) had asked for only $105,000 of the funds.

“We are rather anxious for them to take the rest,” he said.

Mr Barrett wanted only to see - the funds put to use, paying for equipment that would be used.

“They are turning patients away and saying ‘do it at home’,” he said.

Ms Goward questioned why the Health Service could not provide a renal nurse to staff the unit.

“The Health Minister needs to explain why she will not sanction training for nurses to enable them to assist dialysis patients at Bowral Hospital”, she said.

“There is clearly a need yet, for some reason, the Minister would rather allow expensive equipment to go to waste while patients drive three times a week to Campbelltown for dialysis.”

Mr Richardson’s mother, Margaret, said renal patients such as her son needed medical support from a nurse even if they were able to self-dialyse.

“If an alarm goes off, she’s got to know what that alarm is and what to do,” Mrs Richardson said.

Mr Richardson said patients also needed support to recover blood sugars and liquids during and after the procedure.

Mrs Richardson said lives were being put at risk by the need to travel to Liverpool in emergencies.

“There is no emergency plan for renal patients in the Southern Highlands,” she said.

She questioned why a nurse could not travel from Campbelltown on set days in a trial for local patients.

“They say it is too far for a nurse to travel,” she said. “If it’s too far for a nurse, it’s too far for a patient.”

A SSWAHS spokesman said patients were better off travelling because of the care available at other hospitals.

“Bowral and District Hospital is networked with larger hospitals like Campbelltown, where patients can receive their dialysis in a dedicated unit staffed by renal physicians and specialist nurses.”

Socrates says: "I wonder if the SSWAHS spokesman has ever travelled between their Liverpool SSWAHS base and Bowral. Great reality check for SSWAHS that comment by Mrs Richardson in her final quote above."

SSWAHS: Another good reason why the Southern Highlands should avoid Liverpool!

Lady loses leg, health service loses records

BEN MCCLELLAN AND GEMMA KACZEREPA

13 Jul, 2009 10:21 AM - Southern Highland News

"EVERY morning is a constant reminder.

The pain shoots up her body as she fumbles to put on her prosthetic leg. Gwen Illingworth should be making the most of her old age in the garden or out shopping with friends, but her life was turned upside down when she checked into Liverpool Hospital in November 2006 to have a blood clot treated and ended up losing a leg.

Every time she puts on her leg she remembers her time at Liverpool.

The Mittagong senior citizen’s story is strikingly similar to that of Colo Vale man Gregor Gniewosz.

Like Mr Gniewosz, Mrs Illingworth contracted the staph infection MRSA during her stay at Liverpool and had to have her left leg amputated below the knee.

Ms Illingworth doesn’t want an apology from the hospital but she does want someone to be held accountable so that patients of NSW’s health system don’t suffer the same fate.

It is not just losing her leg that has upset Mrs Illingworth.

Her medical records from December 2006 to January 2007 - the period when she was diagnosed with MRSA and had her leg amputated - are missing and the Sydney South West Area Health Service (SSWAHS) is yet to find them.

The mother of three said that during her stay at Liverpool she was treated poorly by staff and was not given a wheelchair until two days before she was checked out, leaving her bed ridden throughout her stay.

Daughter Louise Veenman said she had to steal an office chair for her mother to get around the hospital.

After seven months waiting for modifications to her bathroom, Mrs Illingworth took her complaints to the NSW Ombudsmen.

Almost immediately, the health service sprang into action and her bathroom was modified within weeks.

More than two years after she stayed at Liverpool Hospital Mrs Illingworth isn’t any closer to achieving a resolution.

Her complaints were referred to the HealthCare Complaints Commission (HCCC), but her case was considered not worthy of investigation.

Instead it was referred to a resolution officer.

Still unsatisfied, Mrs Illingworth said she was considering legal action to get justice.

In a letter she wrote in July 2007 but never sent to the SSWAHS, she outlined her complaints:

• Queries and questions about her condition and health were ignored or brushed off;

• Liverpool Hospital staff were often rude, unsympathetic and unsupportive;

• Staff were not monitoring her condition efficiently or listening to her concerns;

• The infection spread to the bone;

• MRSA was not identified until too late and insufficient monitoring by hospital staff helped this infection go undetected and spread;

• After the infection was detected, Mrs Illingworth wasn’t moved to an isolated room but stayed in a room with three other people;

• Liverpool Hospital did not effectively communicate her condition and requirements to Camden Hospital.

Mrs Illingworth said when she was discharged from rehabilitation at Camden Hospital in 2007 she was given a walking frame 5cm too small, which resulted in injuries to her spine.

When she complained, she was told it was because of the way she was lying.

But Mrs Illingworth hasn’t lost faith in all hospitals and said her stay at St Vincent’s in Darlinghurst in 2008 for a hysterectomy was a completely different story.

“They couldn’t have done enough,” she said.

“I am never going back to Liverpool.”

Being neglected during her two-month stay in Liverpool is Mrs Illingworth’s major gripe.

“If there was a bit more care given, it wouldn’t have happened,” she said.

“If you have an amputation, you don’t leave someone on pure oxygen because you have something else to do.”

The SSWAHS said it treated any concerns from patients very seriously but would not comment on Mrs Illingworth’s stay at Liverpool.

“This matter was referred to the HCCC. The SSWAHS has been co-operating fully with the HCCC to resolve this matter,” a spokesperson said.

“It would be inappropriate for the hospital to provide any further comment at this time.”

Mrs Illingworth said when she was told she was going to lose her leg she felt like she was going to die.

She led an active life before November 2006. Having lost her husband Harry in 2003 she has been left alone to battle on with no explanation why her records can’t be found or why an operation to treat a blood clot saw her lose her leg, mobility and her quality of life."

Interestingly, this story does have a similarity to one of Socrates earlier posts about the Bundanoon woman whose complaint was not responded to HCCC by SSWAHS until after the woman died from a lung cancer. Then HCCC said that it was too late for them to deal with it.

One has to wonder just how serious something has to be before HCCC investigates a health related complaint? Death or amputation of limbs don't seem to be good enough reasons it would seem. I wonder if Mrs Illingworth ever got to hear about her records or her complaint from the Ombudsman's office or SSWAHS? I guess for the SSWAHS Executive, who are great at backslapping each other, the loss of limbs or life in their patients is just collateral damage!

SSWAHS and it's own internal investigations - is that really "governance"?

It's been said about many government departments that the practice of the organisation investigating complaints about it's own senior or other staff is open to abuse. Try referring the complaint to the government watchdog - the Ombudsman's office - and you will simply get a response like "you don't appear to have asked the Area Health Service or the Department to investigate the matter". There is generally a suggestion that you send the issue to the CEO of the organisation or Department (or both) and wait for a response. When a non-response or disputable response comes back, the Ombudsman's office simply suggests that they don't wish to use their scarce resources on such matters. Sound like a brush-off? Well it really happened that way earlier this year. So the question needs to be asked if the Ombudsman's office is really structured to protect the public interest.

On 24 February 2009 a complaint was lodged with a Clinical Director of one of SSWAHS clinical streams. The complaint raised a number of issues related to the perceived conflict of interest and improper conduct by a senior administrator who carried out an investigation in which the administrator appeared to have an inappropriate relationship with the person making a complaint about a SSWAHS service and personnel.

The SSWAHS Clinical Director did not follow usual protocol when receiving the complaint of conflict of interest and improper conduct, instead they ignored it until they were reminded of it on 30th April. On 4th May the Clinical Director wrote to the complainant stating "please be advised that Mr .... has been provided with a copy of your complaint and is being given an opportunity to respond." That was followed by deafening silence until the matter was raised again by a direct approach to the SSWAHS CEO. I wonder how many staff of the SSWAHS get the opportunity to read the complaint made against them and are given the chance to just ignore it? The final comment of the Clinical Director in his 4th May response was: "I will inform you of the outcome of my enquiries, in due course."

The eventual outcome was that the Clinical Director did respond - in December 2009, at which time he repeated that the complaint had been investigated by the person being complained about and they had convinced the Clinical Director that they had not breached the NSW Health Code of Conduct. Oh really?! Perhaps we can save a lot of time and money by simply asking people committing illegal acts if they would like to investigate themselves and determine what sentence they'd like to impose on themselves. Think of the police, judicial and corrective service savings the community would gain. Perhaps the savings could be applied to upgrading Bowral Hospital to reflect the age and growth of the Highlands population.

Anyone can view the NSW Health Code of Conduct on their website. One thing it states is that complaints must be dealt in a transparent and timely manner. Yes SSWAHS, that sounds like the way it was done, doesn't it!