Page 46 - Week 01 - Tuesday, 15 February 2011

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Hospitals—waiting lists

MR DOSZPOT: My question is to the Minister for Health. I refer to the Auditor-General’s report, Waiting lists for elective surgery and medical treatment. The Auditor-General found:

However, the classification of clinical urgency categories did not always reflect ACT Health’s policy and procedures, and therefore raised doubts on the reliability and appropriateness of the clinical classifications for patients within the waiting list.

Minister, how can the Canberra community have confidence in the classification of clinical urgency categories given the doubts about the reliability and appropriateness raised by the Auditor-General?

MS GALLAGHER: This is a discussion that surgeons have at length about whether categories 1, 2 and 3 capture exactly the circumstances that they are trying to deal with when allocating classifications to particular patients presenting with a range of different conditions. I think there is a national discussion at that clinician level about the adequacy of categories 1, 2 and 3. However, that is the national system that we work under at this point in time, and it is very important that those categories and classifications are appropriately used for patients, because that allows a fair triaging of the elective surgery access.

I have been in meetings where doctors have told me recently that they categorise non-category-1 patients as category 1 patients and then, when they cannot do them within their time, they will consider reclassifying them downwards to allow other category 1 patients to come in and be treated.

These classifications are audited. Reclassification is two per cent of the waiting list or the throughput that goes through without question. I think that, for the large part—and I have no reason to doubt this, and the audit had no reason to doubt—the waiting list is managed in accordance with the policies. The reclassification issue or the recategorisation issue is a very small component but it is one that has not been managed well by any side involved. It needs to be fixed and it has been fixed, to the extent that it will not occur with all aspects of the policy being followed. You can talk to a doctor; they say category 1 is life threatening, category 2 is painful and category 3 needs surgery but would need it within a year. They are, roughly, the different categories. I have certainly impressed upon surgeons the need to follow those categories when they are classifying patients so that those patients are classified appropriately.

The audit then goes on to say that if there is to be any change or clinical review of those patients, upwards or downwards—if their condition deteriorates or improves—through clinical review, then the opportunity is there to make sure they remain in the correct category. I think the Auditor-General’s report will help to improve the overall management of this particular area. As to whether this audit will deliver one more operation to any Canberran, I have my doubts. But in terms of following our processes, it will improve them.

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