Neil Douglas to chair King Edward Memorial Hospital inquiry

23/5/00
On 14th April this year I announced that it was my intention to establish an inquiry into certain matters concerning the provision of clinical services at King Edward Memorial Hospital (KEMH). The decision to do so was the result of serious concerns that have been expressed about some past events at the hospital. These concerns resulted in the Metropolitan Health Service appointing Dr Andrew Child of New South Wales and Ms Pauline Glover of South Australia to conduct a review of the obstetric and gynaecological services at the hospital.
In the course of conducting their review from 20 March to 3 April, Dr Child and Ms Glover interviewed 41 people and made 23 recommendations. In the time available to them, I believe Dr Child and Ms Glover have provided valuable information and addressed many important issues. However, they did not have the opportunity or the legal powers to be able to inquire into some issues to the full extent or to afford to those who may be affected all of the usual processes of natural justice.
Dr Child and Ms Glover advised that some matters should be further inquired into and this view is shared by the Commissioner of Health and the Chief Medical Officer of the Health Department of WA.
Accordingly, Cabinet has approved the establishment of an inquiry into obstetric and gynaecological services at King Edward Memorial Hospital. The inquiry will be constituted under both Section 9 of the Hospitals and Health Services Act 1927 and Section 11 of the Public Sector Management Act 1994. The former Act provides for the establishment of an inquiry in relation to any matter concerning a public hospital and the latter Act, particularly through schedule 3, provides maximum protection for those conducting the inquiry and those providing information to the inquiry.
The Terms of Reference (attached) for the inquiry will enable the incidence of adverse clinical outcomes at the hospital to be considered and will allow for any relevant changes to be recommended.
The inquiry will consist of a panel of three people and will be chaired by Mr Neil Douglas, a legal practitioner. So as to provide appropriate clinical expertise, the other members will be Professor William Walters, Professor of Reproductive Medicine at the University of Newcastle and Chairman of the Division of Obstetrics and Gynaecology at the John Hunter Hospital in Newcastle New South Wales and Associate Professor Kathleen Fahy, Master of Midwifery Course Co-ordinator in the Department of Nursing at the University of Southern Queensland.
The purpose of the inquiry will be to establish the facts regarding the concerns that have been expressed and to allow people to provide information in a fair and balanced way. It is important that those who may be the subject of assertions have the opportunity to respond according to the usual principles of natural justice.
The decision to establish the inquiry has not been an easy one or taken lightly. However, it is important to clear the air and the best possible outcome would be to indicate that there is no considered basis for any serious concerns.
I also make the point there is no doubt that those who are involved in the practice of obstetrics are working in a field which is very demanding, often difficult and stressful and sometimes unavoidably traumatic.
As KEMH is the tertiary referral centre in Western Australia, the cases which staff need to deal with are often more complex than elsewhere. There are many highly qualified and dedicated staff at KEMH who do the very best they can for patients. The services there need to be seen in this context.
INQUIRY INTO OBSTETRIC AND GYNAECOLOGICAL SERVICES AT KING EDWARD MEMORIAL HOSPITAL
I, Richard Fairfax Court, Premier and Minister for Public Sector Management, pursuant to section 11 of the Public Sector Management Act 1994 and I, John Howard Dadley Day, Minister for Health, pursuant to section 9 of the Hospitals and Health Services Act 1927, direct and appoint Mr Neil Douglas, Legal Practitioner, as Chairman of the Inquiry, Professor William Walters, Professor of Reproductive Medicine, and Associate Professor Kathleen Fahy, Associate Professor of Nursing, to inquire into the provision of obstetric and gynaecological services at King Edward Memorial Hospital during the period 1990 to 2000 in accordance with the terms of reference set out below.
TERMS OF REFERENCE
1. To consider whether the incidence of adverse clinical outcomes at the hospital is acceptable and appropriate for a hospital that handles the most difficult obstetric and gynaecological cases in Western Australia;
2. To recommend any changes to accountabilities, policies, procedures and practices that may assist in reducing the incidence of adverse clinical outcomes;
3. To proceed by examining representative cases and in choosing such cases to respect the views of patients who are unwilling to be involved in such an inquiry;
4. To proceed with expedition;
5. In particular, to consider the adequacy of clinical:
(i) records;
(ii) reporting systems;
(iii) policies, procedures, practices; and -
(iv) peer review.
The Inquiry is required to report its findings and recommendations to the Minister for Public Sector Management and the Minister for Health by 29 September 2000.
Should any allegations of gross carelessness, incompetence or improper or unprofessional conduct on the part of any healthcare professional come to the attention of the Inquiry, which the members of the Inquiry consider may warrant further investigation or inquiry, they are to refer such allegations to the appropriate professional or other bodies.
In these terms of reference and for the purposes of the Inquiry:
"Adverse clinical outcome" means a death or permanent or serious injury or incapacity which was attributable to the provision of obstetric or gynaecological services to a patient of the hospital.
"Healthcare professional" means a medical practitioner, a midwife, a nurse or other related professional.
"Patient" includes an unborn child.
Dated 23 May 2000
Richard Court
Premier
Minister for Public Sector Management
John Day
Minister for Health