More cooking the books in NSW hospitals

NSW Health appointed a nurse whose job was to massage triage data in the emergency department of a Sydney hospital to make it look favourable, emergency doctors say. The nurse, appointed just before the state election, was there specifically to ensure computer data met triage targets, the vice-president of the Australasian College of Emergency Medicine, Sally McCarthy, said yesterday.

This follows revelations in the Herald yesterday that managers at Gosford and Ryde hospitals were so under pressure by the health department to meet targets that some had falsified "time seen" data - the record of when treatment began on a patient.

On the nurse, Dr McCarthy said: "They had somebody looking at that, basically harassing other staff and putting in data themselves. That's not somebody to provide care for patients. That's simply someone to click off on the computer to basically show that patients were seen within benchmark times. It was really just an attempt to get the data looking good."

While the NSW Minister for Health, Reba Meagher, insisted the Gosford case was isolated, Dr McCarthy said the doctoring of data was more widespread and was made easier after the department about 18 months ago widened the definition of when treatment began to include nursing care in several instances. An emergency physician at Prince of Wales Hospital, who could not be named because she was prohibited from speaking to media, said yesterday that "there have been numerous verbal directives from hospital administrators to change data". "This is not an isolated instance. Most other hospitals, and I'm aware of Liverpool and Nepean hospitals being asked to do the same thing," she said. Another emergency physician said he witnessed the same thing at Blue Mountains Hospital last year: "There was a huge amount of pressure . to enter data to meet benchmarks."

Ms Meagher rejected the claims. "There is no evidence to suggest that inaccurate reporting is widespread," she said in a statement. "Hospitals in NSW have been performing well."

Triage data is highly political and used as one of the performance indicators of health bureaucrats. The chief executive officer of Northern Sydney Central Coast Area Health Service, Matthew Daly, admitted a manager at Gosford Hospital had falsified triage data early last year and had been disciplined. "She was altering figures that had previously been entered," he said. He said new recommendations had since been implemented "about the clarity of nurse-initiated protocols - when the clock starts". Mr Daly said no pressure was placed on her to alter data and it was "just absurd to do, and simply dishonest". Another recommendation was to limit access to data.

The director of performance improvement at NSW Health, Tony O'Connell, said it was an outrageous claim that data doctoring was widespread and due to pressure from the department. "There's no evidence that I have that it has happened anywhere else [other than Ryde and Gosford]," Dr O'Connell said. "It's really quite perverse of the college to say on one hand people around Australia should be seen within recommended times . and then turn around and say the department is bullying people to deliver them

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The DOCS saga continues

It seems that NOTHING can civilize this collection of prime bureaucratic assholes

A dying five-year-old girl who is chronically disabled has been left in the care of abusive foster carers who are banned from caring for any more children. A number of children have already been removed from the western Sydney couple, who at one stage requested only girls to foster. Both the New South Wales Department of Community Services (DOCS) and the police have investigated the carers, who have been categorised as dangerous, yet the State Government has done nothing to remove five-year-old "Susie" (not her real name) from their care.

The horrifying case comes after new statistics show 27 disabled children died under the care of DOCS in 2006. It also follows the death of Shellay Ward, a seven-year-old autistic girl who allegedly starved to death after being left with her parents, despite her younger sister having already been removed by DOCS.

The Foster Care Association's Michelle Irwin said four investigations have been held into Susie's carers, including three in 2005 and one in 2007 over allegations of verbal, physical and sexual abuse. "The department can't have it both ways, they can't remove some children and allow this defenceless little girl to remain there," she said. "Either clear (the couple) of the allegations or remove this child."

Susie suffers from a severe form of muscular dystrophy and has defied doctors who gave her just six months to live when she was born. A DOCS spokeswoman confirmed the investigations but was unable to explain the delay in finalising inquiries.

Ms Irwin said it was not clear whether Susie had suffered abuse but said "there have been very serious sexual allegations made against this family". "There hasn't been a thorough investigation into whether the little girl has been abused." A joint police/DOCS investigation has already led to the foster parents receiving a Category 1 and a Category 2 listing - meaning they pose a risk to children.

The Daily Telegraph understands the carers have fostered between five to 10 children over the last five years and at least one two-year-old boy was taken out of their care after witnessing a suicide attempt by a house guest.

Opposition disability spokesman Andrew Constance said DOCS put disabled children in the too-hard basket: "The Government's answer to these problems is typically to leave a child with the disability in harms way because they just can't find other solution." Community Services Minister Kevin Greene said he would look into the case. [DOCS needs to be abolished and a new body set up with none of the old employees]

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More bureaucrats who don't give a damn

They should all be fired

AT LEAST 13 Queensland Health bureaucrats - including the new boss of the Torres Strait district- allegedly received a damning report into staff safety that was left to gather dust. A briefing note prepared for Health Minister Stephen Robertson claims new district manager Cindy Morseu was emailed the Torres Strait Risk Assessment report early last year. The audit report was undertaken in late 2006, 16 months before a nurse was allegedly raped by an intruder in her living quarters on remote Mabuiag Island last month.

The inaction in implementing the report's recommendations and who was responsible have been referred to the Crime and Misconduct Commission. Mr Robertson forwarded the case to the CMC after former district manager Phillip Mills, the uncle of Ms Morseu, denied he ever saw the document because he was posted to Cairns at the time. According to the briefing note, Torres Strait workplace health and safety officer Tom Sanderson claimed the report was sanctioned by the region's director of corporate services, Ashley Frost. There are conflicting versions over events but Mr Sanderson told the department the final report was sent to the Torres Strait in January 2007. "As far as I know it went to Ashley initially as the requester," Mr Sanderson said in the briefing note.

However, the briefing note warns of a lack of evidence because of a policy to delete emails after a certain time. Ms Morseu has refused interviews but Mr Frost, now working for QH on the Sunshine Coast, last night said she was acting manager while her uncle was in Cairns. "I know it went to the district manager, whoever that was at the time, and then it would have ended up at the executive meeting . . . but I can't remember when I would have seen it," Mr Frost said.

Opposition Leader Lawrence Springborg questioned whether there was more damning briefing material. "The minister is either incompetent or dishonest so either way people should be very worried and so should the Premier," Mr Springborg said. Premier Anna Bligh said she could not guarantee work to upgrade security measures at centres would be completed before the nurses' union deadline this Friday.

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Cops fail integrity testing, but results remain secret



The wallet containing $285 handed in at the Katoomba police station was too tempting for Senior Constable Kate Michelle Howes to ignore - so she went shopping. That mistake cost the 27-year-old officer her career. Howes had no idea the lost wallet was a deftly targeted test of her integrity, orchestrated from within the NSW Police Force.

Her case is the only public evidence that the force still conducts integrity tests among its own ranks as part of its fight against corruption. But the results of these tests, a good barometer of the cleanness of the force, is not information the police want you to know. It is one of a growing list of matters sought by The Daily Telegraph under Freedom of Information that is being refused release by the force.

Last May, Howes pleaded guilty in the Mount Druitt Local Court to embezzlement. She was fined $1000 and placed on a three-year good behaviour bond. Worse was to come. On February 2 this year, Police Commissioner Andrew Scipione dismissed Howes, using his authority under section 181d of the Police Act 1990.

Integrity testing was a key reform arising from the Wood royal commission in the mid-1990s. But details of how the tests are done - and, more important, how many officers pass or fail them - are not for public discussion. The police have argued that to discuss any aspect of its program - even the release of statistics on how many are undertaken - would undermine its effectiveness.

In a ruling earlier this month, the Ombudsman backed this secrecy. "The public interest favours the continued successful operation of the integrity testing system and consequently continued secrecy regarding the numbers and conduct of integrity testing," investigation officer Maya Borthwick said.

In Howes' case, it was a clever sting. Foreign coins were tossed in with the cash to make it appear as though the wallet belonged to a tourist who would not be around to claim it. The person who handed it in appeared to be a member of the public. Howes succumbed to temptation and went shopping, apparently for clothing and manchester. She still had $150 left when she was charged.

Figures released in 1998 revealed that of the 40 sting operations carried out, just 18 officers passed. Despite this, a police spokesman yesterday ruled out releasing any details of the integrity testing program. "Police will not reveal methodology or how regularly integrity testing is conducted," the spokesman said. "However, police can confirm that integrity tests have led to criminal charges being laid." Not all officers who fail the tests are sacked. Some remain in the force but face internal disciplinary proceedings.

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Useless education degrees

Standards are so low anyhow that it is hard to imagine standards being too low for the authorities but so it seems

A TEACHING degree at a leading university has been refused accreditation for failing to properly prepare students in key primary school subjects, with some of its course units described as being more akin to TAFE-level study. Three other universities are also restructuring their 12-month graduate diplomas in primary education to meet new accreditation standards that emphasise content ahead of educational theory, with a year considered insufficient time to complete the mandatory subjects.

The four-year Bachelor of Early Childhood Education at the University of Wollongong is being restructured for next year after it was rejected by the NSW Institute of Teachers and a new set of standards agreed to by the states and territories. It is believed this is the first time a course has been rejected under the new system. Newcastle, Macquarie and the Australian Catholic University have also been forced to restructure their 12-month graduate diploma courses.

Wollongong's deputy dean of education Brian Ferry said the university had received "feedback" from the NSWIT that its four-year degree - which trains teachers for children aged up to eight in childcare centres, preschools and the first years of primary school - had failed to meet accreditation standards. But Professor Ferry said that was not the same as failing accreditation or the course being rejected. "The institute has just asked us to increase a bit more emphasis on the primary aspect of this program," he said. "We just have to make sure we cover the key learning areas in a little more detail."

Professor Ferry said the university had decided to recast the course from next year for teachers of children under five, to meet the demand anticipated from the federal Government's focus on the early years of life.

The Australian understands that the NSWIT panel found a large proportion of the course focused on children five years and younger, giving insufficient attention to key areas in the primary curriculum. It criticised the course for being of poor quality, saying a number of the early-childhood units were more at the level of TAFE study than university standard. But Professor Ferry denied the course had been described as TAFE-level.

It is understood the NSW Education Department, which previously approved courses, expressed strong reservations in 2006 about early primary teaching courses in general. The NSWIT accreditation standards require more content to be taught than under the previous system, and, critically, does not accept educational theory as content.

NSWIT chief executive Tom Alegounarias refused to comment on individual universities, but said it was always expected that not all courses would meet the new requirements. Mr Alegounarias said the higher standards had been negotiated in full co-operation with the universities. "We are in a difficult transition period where universities are deciding how to accommodate the new subject content requirements, and the literacy and numeracy requirements," Mr Alegounarias said.

NSW Education Minister John Della Bosca said Wollongong University's experience showed the new process was working and that universities were taking it seriously.

Macquarie University head of the school of education John Hedberg said the school's diploma of education was now a two-year course that undergraduates wrapped into their degree studies, such as arts.

Professor Ferry said the faculty was planning to extend the academic year, so that students started earlier and finished later with fewer breaks, to enable them to finish the required course content.

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