The executive at the centre of the Canberra Hospital data doctoring scandal has apologised for her actions but said she altered hundreds of emergency department records because of the pressure she and her colleagues were facing.
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In a statement to Auditor-General Maxine Cooper, the woman said she accepted ''full responsibility for all the data alterations'' and had acted ''foolishly and stupidly'' to protect herself and the staff she worked with.
''The environment in the executive at Canberra Hospital has increasingly become one where I felt fearful for myself and for other people that I work with,'' she wrote.
Reports by the Auditor-General and PricewaterhouseCoopers show that about 11,700 changes were made to emergency department records between 2009 and April last year and it was likely that more than one person was involved.
In one instance, waiting times results for triage category 3 patients were lowered from 89 minutes to 28 minutes.
In a further development, the identity of the hospital executive was revealed in documents handed to the media yesterday by the ACT government.
She was named in a letter attached to copies of the Auditor-General's report as Kate Jackson, the hospital's executive director of Critical Care.
Chief Minister and Health Minister Katy Gallagher said the letter had been mistakenly photocopied by Health Directorate staff along with copies of the Auditor-General's report that were given to the media.
''I think it's just a mistake by someone who's photocopied it and didn't notice. But it didn't happen in my office,'' Ms Gallagher said.
Ms Jackson's identity had been kept confidential while disciplinary processes were under way against her.
Ms Jackson was stood aside in April after taking responsibility for data changes.
Soon after, Ms Gallagher handed ministerial oversight of investigations into the matter to Deputy Chief Minister Andrew Barr because of a family connection to Ms Jackson.
''She is a friend of a member of my family,'' Ms Gallagher said last night.
In her statement to the Auditor-General, Ms Jackson outlined the pressure she felt to ensure the emergency department met performance targets.
''I did not alter the EDIS data with any thought of personal or financial gain,'' she wrote.
''Having been constantly told things like, 'Fix the numbers', 'I don't care if you have to go down and stand at triage yourself to make sure they are referring patients to the Walk In Centre, get it done', 'I have told the Minister that we will be at 70 per cent of patients being seen on time by December so make sure it happens' … I could see no way out.''
The Canberra Times was unable to contact Ms Jackson last night.
The Auditor-General's report found that managerial pressure was placed on Ms Jackson to improve the performance of the emergency department.
But it cleared Ms Gallagher and senior Health managers of placing any direct or indirect pressure on Ms Jackson to deliberately manipulate hospital records.
The report said Ms Jackson had breached the ACT Public Service code of ethics and the terms of her executive contract.
Ms Gallagher said pressure was no excuse for manipulating data.
''I would say there is a whole lot of other senior executives in the ACT public service who are under pressure - and significant pressure - about the work they do do, who don't choose to go down a path of making such a wrong decision,'' she said.
Ms Jackson admitted to making between 20 to 30 changes to hospital records each day but this fell short of the total number of changes made and the audit concluded it was likely other people were making changes.
The two reports into the data manipulation will be referred to police.
The Health Directorate has accepted recommendations from the Auditor-General to improve the security and integrity of electronic records.
Opposition Leader Zed Seselja said the data manipulation scandal was a sign of a ''sick culture'' within the Health Directorate and called for the establishment of a Royal Commission.
''We believe that the Health Minister should be recalled along with her officials to the estimates committee to answer questions and that questioning should go on for as long as is necessary to get to the bottom of how this was allowed to happen,'' Mr Seselja said.
Australian Medical Association ACT president Andrew Miller said it was disappointing that hospital staff appeared to have been so demoralised that they felt the only way they could make things better was to cheat.
''It looks like it wasn't anything other than just a response from people … stressed out and unable to cope with the load and they see this as a way of making things look better because they haven't been really given the resources,'' he said.