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Instant fixers

Martin B Van Der Weyden
Med J Aust 2008; 188 (6): 321.
Published online: 17 March 2008

Following the release of reports from the New South Wales Government Joint Select Committee and the Deputy State Coroner on patient care at Royal North Shore Hospital, the NSW Government has announced yet another inquiry into the state’s public hospitals.

Déjà vu?

Initiating inquiries into our public hospitals is a well worn political response when things go wrong with quality and safety. The predictable political reflex has been to launch an inquiry and, if need be, another, and another.

In the wake of the Bundaberg Hospital scandal, the Review Team’s report was followed by a Commission of Inquiry. This in turn was followed by the Queensland Public Hospitals Inquiry — not one, but two! Western Australia also witnessed this inquiry merry-go-round after alleged clinical mishaps in clinical services at King Edward Memorial Hospital (KEMH).

Paradoxically, all these inquiries yielded little beyond already known causes of “fault lines” in public hospitals: poor clinical governance, poor interprofessional communication, inconsistent monitoring of staff performance and patient outcomes, and dwindling manpower — coupled with decaying infrastructure and inadequate funding.

Without a doubt, we need more effective ways to fix crises in hospitals. A crisis team of seasoned and respected clinicians could visit a beleaguered hospital to carry out a focused and urgent exposition on the problem(s) and recommend instant fixes.

There is a precedent for this. A crisis team addressing community loss of confidence in Camden and Campbelltown Hospitals recommended relevant reforms well before the Walker Inquiry’s report. A similar approach occurred at KEMH. This blitzkrieg professional approach could well eliminate the cavalcade of politically inspired inquiries, which tend to rediscover the same root causes of poor health care delivery.

We need to question whether we get worthwhile outcomes from prolonged and costly inquiries, which consult the same pool of expertise. We know enough now to establish teams of “instant fixers”.

  • Martin B Van Der Weyden


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