The ACT Auditor-General has slammed the management of the waiting list at Canberra Hospital's gastroenterology and hepatology unit, blaming inadequate governance for blowouts.
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The performance audit report, which was sparked by a September 2013 allegation of maladministration in the unit since 2012, found patients were not treated within recommended time frames and did not receive access to treatment based on their individual medical need.
Auditor-General Maxine Cooper said the unit had capacity to see more outpatients and that poor management – not a lack of resources – was to blame for the problems.
The report showed 1500 patients had been included on waiting lists in 2012, 2013 and for the early part of this year.
In May 2013, total waiting list numbers reached 2000 people – up from 621 in March 2012.
A gastroenterology and hepatology expert was engaged to review 35 patient referrals from Canberra GPs and their triaging by the unit.
The expert found a total of four of the reviewed patients should have been triaged at a higher level and seen earlier by staff.
The report showed consultations with patients did not occur according to medical need, and recommended that a patient’s symptoms be the basis for their priority treatment rather than their referral type.
Dr Cooper said not all adverse events, including poor referral, triage or scheduling practices, were adequately reported and there was a lack of communication between key staff and the ACT Health Directorate.
The report said that with 3000 patients being processed a month, it would take five months to see all outpatients currently on waiting lists, without new patients being added.
Dr Cooper said a plan to reduce outpatient waiting lists should be developed with defined targets. She said there should be an increased use of electronic referrals and patients should be given an indication of probable waiting times for treatment.
She also called for findings from a pilot program to be used to improve services and for the development of key performance measures.
ACT Opposition Leader Jeremy Hanson said it was likely patients had suffered because of the failures.
"When you have failures in governance and when you have breakdowns in communication as this report identifies, like patients receiving treatment outside the time frames that are recommended, it’s difficult to see how that wouldn’t have an effect on patients and mean that their treatment in some cases would be less than optimal," he said.
ACT Health deputy director-general Ian Thompson said there was no evidence of adverse impacts on patients by the poor management.
"At the moment we have interim management arrangements in place with the executive of the hospital more directly involved with the management of the unit," he said. "As we work through the response to the report, we will make a decision on long-term arrangements."
He said a comprehensive review of administration structures was nearing completion.
"We have absolutely no concern about the medical record keeping within the department," he said.
Mr Thompson acknowledged it was uncommon for the executive of the hospital to be directly involved in the running of individual units.
A spokesman for ACT Health Minister Katy Gallagher said the government would respond formally to the report in the next few months.
"The [Chief Minister] has been briefed by the Health Directorate over the steps that have been taken to improve the areas identified by the audit," the spokesman said.
