SSWAHS and it's view of National Health Reform

SSWAHS created such a cute piece of spin for the Director-General of NSW Health to suggest what they might like to do with the Federally imposed carve-up of the current NSW Area Health Empires.

Here they used a powerpoint presentation to suggest the great achievements their Area based Clinical Divisions have launched in the old SSWAHS.

Take for example, their Population Health Area Network:

• Promoting Equity: Monitoring inequalities of health status and health service utilisation; targeted health promotion activities in disadvantaged areas.
• Focus on Primary Prevention: Critical mass enables health promotion activities to reduce risk factors.
• Regional Partnerships: Working with LGAs, Housing NSW, Landcom and other developers on urban development and regeneration.
• Promoting Evidence Based Practice: Healthy Urban Development Checklist.
  
• Population Health Based Service Planning: Population health principles incorporated into all service and facility plans.
• Capacity Building for Primary and Secondary Prevention: Health promotion traing course; Locational Disadvantage training course.

Now if anyone out there can translate that SSWAHS spin please let me know! But, can anyone see how this is meant to apply to the Southern Highlands with expanding and aging population? What does SSWAHS Population Health take us for - God's Waiting Room? And can anyone tell us what a "Locational Disadvantage training course" is meant to look like?

The other point to make is that it's been some years since we had anything like a health promotion staff member in the SSWAHS portion of the Southern Highlands. Again, a vacancy never to be filled. Is the Southern Highlands meant to be an urban or a rural area in the minds of the SSWAHS Executive, or is that little dot to the far south of the SSWAHS map on that cute presentation to the D-G still out of sight of Liverpool.

And here's the presentation of the achievements of the SSWAHS Mental Health Clinical Network:

• Improved Clinical and Corporate Governance: Standardised policies, procedures and care pathways/guidelines; Centralised application of specialist human resources across a whole network, achieving economies of scale; Timely implementation of state-wide initiatives.
  
• Improved Human Resource Management: Better recruitment and retention of staff because of clear identification with clinical specialty; Better support to registrar training especially since IMET initiative; Standardised education programs.
• Improved Service Delivery: Ability to support small community teams in rural areas; Access to intensive, Sub-specialist and Tertiary services which could not be resourced at the local or district level; Ability to promptly rotate staff to local services with urgent shortfalls; Improved planning of services and facilities to serve a regional population.

This one I really like (oh yeah!). Clinical and corporate governance. This is the SSWAHS clinical network who failed to answer the complaint of a local woman with terminal cancer until after she had died. Then said they'd tried to speak with her but unfortunately she was dead. Not laughable - just tragic.

This is the same Clinical Network who has still refused to answer some serious complaints about their failure to respond appropriately to complaints, about their service and their service providers, according to the NSW Health Code of Conduct.

This is the same network who, in 2009, had one of their Southern Highlands patients involved in the murder of another of their patients after both patients had been notified to the local service with a request to provide assistance.

Better recruitment and retention of staff is another bit of spin from SSWAHS. This is the organisation which spent an inordinate amount of time terminating, or getting resignations from, a number of clinical staff in their Area Mental Health Network.

Now, they have the temerity to say in their "Improved Service Delivery" that they have achieved the ability to support small community teams in rural areas, and their ability to rotate staff staff to local services with urgent shortfalls. Is that why they have made the Bowral Mental Health Service less effective by making part time their Welfare worker position, their Aboriginal Health worker position, and their Rehabilitation/Recovery Program Coordinator? Perhaps that fits into the plan for the SSWAHS Mental Health Network's "ability to rotate staff to local services with urgent shortfalls"! It certainly doesn't fit in with the SSWAHAS Mental Health Network's "ability to support small community teams in rural areas."

Again, from the "Improved Service Delivery" item the SSWAHS Mental Health Network states as an achievement "Access to Intensive, Sub-specialist and Tertiary services which could not be resourced at the local or district level." Well, I guess that if you mean by "access" that the local Southern Highlands Mental Health team still has to argue with Mental Health bed managers every time they have a need to transport someone with an acute mental illness to any of the inpatient facilities mentioned. The patient from the Southern Highlands could, currently, sit in the Emergency Department of Campbelltown Hospital for hours (or days) before being admitted to the hospital's Psychiatric Emergency Care Centre, or be shuffled around the other various facilities located at Campbelltown Hospital, or Liverpool Hospital, or RPH Hospital, or Concord Hospital.

However, don't think that's still a great response because if the proposed slice-up of the current SSWAHS Empire proceeds according to the LHNs that Southern Highlands mental health patient will only have access to the mental health facilities at Campbelltown and Liverpool Hospitals - so the wait just got longer and the Improved Service Delivery just went belly-up!

Go figure it! Perhaps the SSWAHS Mental Health Network should have been concentrating more on which of their so-called "Achievements" would be lost to the Southern Highlands, Macarthur, Wollondilly and Liverpool LGAs and their residents.

SSWAHS and its abuse of correct procedure and policy. Caught out again!

Isn't this archival media just wonderful. Here is another gem that Socrates has found about the way in which SSWAHS has notoriously treated its staff when they wanted to downsize their organisation.

Employer's failure to follow policies unreasonable

Article written by Deacons.

"The Commission has ordered Sydney South West Area Health Services (SSWAHS) to pay an employee 26 weeks pay on the ground that his employment was terminated unreasonably during a process of restructure within the organisation. Despite the existence of a voluntary redundancy policy which applied in circumstances of restructure, SSWAHS failed to consider this as an option for the employee and instead attempted to coerce him into accepting positions of lesser grades. When the employee refused to accept these positions the SSWAHS purported to terminate his employment for reasons relating to performance going back 6 years."

This is not the first time that SSWAHS has used these immoral strategies to force people out of their positions. One instance Socrates has heard about was in late 2008 when one of their bullies (Mr SF) told an Allied Health Professional, who had arranged to see a private client after his work hours at a SSWAHS facility, that he'd be reported to ICAC and the AHP's Registration Board for Corrupt Conduct. The AHP chose instead to resign - never to be replaced!

Socrates also met another middle manager who worked in the child and adolescent mental health field in Campbelltown. That person was highly respected as a fair and reasonable manager. When a staff member made a complaint that she was "being bullied" by the manager (who was simply asking the person to do their work) the SSWAHS response was to send the same Mr SF to see the manager and threaten them with investigations and reporting to their professional registration board. The manager chose to resign - and, as far as can be ascertained - not replaced.

It seems that 2008 and 2009 was big year for "terminations" in SSWAHS. One senior manager stated confidentially that if they couldn't get them any other way it would be by using complaints and threats against their professional status, or the "discovery" of something inappropriate in the way in which they used the organisation's computer network.

Certainly, Ms J W, of SSWAHS was known to micro manage all the discharging and terminations of staff from the organisation. But that was her idea of Clinical Governance in SSWAHS.

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!

SSWAHS and its brush-off of concerns raised in the Southern Highlands

"Keep it short, make it simple, and say nothing" possibly epitomises the thinking of the senior executive members of any Area Health Service or Departmental bureaucrat. However, SSWAHS has learned to refine it to an art form. If it wasn't so serious an issue one might be tempted to stand and applaud the sort of misinformation and disinformation rolled out by the SSWAHS executive.

At any time an Executive which, having learned the hard lessons from Campbelltown Hospital, and seemingly so principled in the application of "clinical governance" would be expected to have transparency and haste to resolve any conflict they might have or generate. Not so with SSWAHS.

One patient from the Highlands who made a serious allegation of professional misconduct of a staff member was eventually contacted by a senior bureaucrat of the SSWAHS mental health service. That is, they tried to phone the patient, maybe once or twice. They then left a letter for the patient to be given it by the staff at the treating unit. The patient was so offended by the patronising approach of this bureaucrat that they failed to respond to the letter. SSWAHS carried out no investigation of the alleged misconduct while that person remained in their employment. When the staff member resigned SSWAHS then sent the patient a letter stating that since the staff member was no longer their employee they could not do anything about investigating the complaint. There was no reference of the complaint by SSWAHS to the registration board or the HCCC for their information or investigation. Some months later an advocate made a formal complaint to the HCCC about the allegation. The matter was sent to SSWAHS for investigation and comment.

The usual practice was for the SSWAHS to be required to respond to the HCCC within 60 days. At the end of the 60 days SSWAHS asked for an extension. At the end of the following 60 days SSWAHS asked for another extension. Within 14 days they were able to inform the HCCC that they could now finalise the complaint investigation.

Why, you might ask, did it take so long for them to investigate something that they had already investigated previously. Well quite simply, that 130 days was just how long it was for the patient, who had made the original complaint and allegation, to die from an inoperable lung cancer. The patient's terminal condition was well known to SSWAHS because they had been providing treatment and palliative care in Bowral Hospital and community nursing services. Unfortunately, HCCC agreed with SSWAHS that it was now too late for the matter to be resolved.

Call me a cynic.... and maybe there's a glass of hemlock waiting for me in some part of SSWAHS, but really.....! Come on SSWAHS, you certainly know a thing or two about transparency, timeliness and clinical governance.