The integrity of ACT Health Directorate data related to emergency department response times has been the subject of intense scrutiny in recent years – justifiably so given the deliberate manipulation of Canberra Hospital records that emerged in April 2012. Now, following confirmation by the Barr government of further irregularities in the ED statistics, the Canberra Liberals have called on the ACT Audit Office to inquire further into the management of this data.
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In a letter to Auditor-General Maxine Cooper, Opposition Leader Jeremy Hanson suggests the errors (which cover the period July-December 2013), involve the same data set investigated twice by the Audit Office since 2012, and that "the discovery of these errors in itself is serious enough, but is all the more damaging when viewed in the light of your recent findings".
Those findings, it will be recalled, were highly critical of the Health Directorates' systems, procedures, training – and of its top-down, results-driven culture. The first audit, released on July 3, 2012, identified a single individual – an executive with the directorate – as principally responsible for the falsification of records. The executive was aided and abetted in her mischief-making – which took place from 2009 until early 2012 – by the "very poor systems and practices" then in place to report and record performance information". The audit noted also that "managerial pressure was placed on the executive to improve the performance of the emergency department".
A subsequent audit, tabled in the Legislative Assembly on June 19, 2015, noted that data integrity had improved as a result of "considerable efforts by ACT Health over the past two years". However, Dr Cooper cautioned that "there is more work to be done ... especially in the non-admitted patient areas".
The irregularities motivating Mr Hanson's call for another audit do indeed relate to data previously examined by the Audit Office. However, Health Minister Simon Corbell disputes the gravity of the mistake, suggesting that "what has happened here is a processing error in two isolated instances". That the incorrectly reported data occurred over a six month period only, and made the hospitals' performance worse than it actually was, tends to support Mr Corbell's argument. He's said moreover, that the Directorate has undertaken to subject future data releases to further checks and verifications.
The 2012 scandal badly tarnished the Health Directorate's reputation for providing reliable, accurate and trustworthy ED statistics – and, as the 2015 audit showed, it was tardy in moving to repair the damage. However, all indications are that it has devoted the necessary time and resources to ensuing change and improvement.
What is sometimes overlooked in the debate about ED response times – shaped as they are by need to avoid penalties or qualify for funding bonuses – is that the overall standards of public hospital care remains high. Overcrowding and timeliness of treatment remain an issue, but political point-scoring and posturing do little to imbue public trust in what is overall a quality system.
