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Monday, April 04, 2011

Review of deaths in emergency departments raise public interest issues

  Drop off rate of interest
An editorial  in The Courier Mail on 30 March (no link but extracts below) gives the paper's point of view about a decision by Right to Information Commissioner Smith against Queensland Health (QH) that the agency has now taken to QCAT, a review right available on error of law grounds. The decision, that documents that detail reviews of in-unit deaths in emergency departments at specified hospitals during a defined period (excluding identifying particulars of patients and medical staff), are not exempt from disclosure, will be of interest to those in the health sector in Queensland and beyond.

RTI Commissioner Smith found that QH's Death Review Process was a system or procedure for the protection of persons [26], but that "there is no reasonable basis to expect that disclosure of the Information in Issue could prejudice" that system or procedure, the grounds necessary for an exemption claim under Schedule 3 section10(1)(i) [ 42]; and disclosure on balance would not be contrary to the public interest [43-63]. On this point the Commissioner said disclosure could be expected to promote open discussion of public affairs and enhance the Government’s accountability:
  • "to the extent that information reviewing the quality and safety of emergency care in Queensland public hospitals contributes to open discussion about QH’s service delivery, in accordance with proper professional standards and its timeliness, access to such information is important "[46]
  • "disclosing the details of the reviews of specific emergency department incidents where a death occurred will enhance the accountability of QH. Disclosure will reveal actions taken and factors relevant when delivering emergency public health care, and the precise steps taken when evaluating those actions and factors following a death in an emergency department. Such disclosure enhances QH’s accountability because it demonstrates the practical operation of the Death Review Process and sheds light on critical issues arising in emergency departments and how those critical issues are managed"[47]
  • "Disclosure of the Information in Issue will provide details of the type and scope of review of specific emergency department incidents. It will better inform the public about review practices when deaths occur in public hospitals and contribute to debate on the performance of QH emergency departments. In this regard I note that the word ‘positive’ is construed broadly in the context of access to information legislation and encompasses various effects that disclosure might have including enlivening public debate, generating criticism or leading to legal process" [48]
The Courier Mail made these observations about the long drawn out process:

"The Courier-Mail is engaged in a long-running fight with Queensland Health over a Right to Information request submitted on July 30, 2009. Among several requests on that day was one made for "documents which review in-unit deaths in emergency departments during the period 1 July 2008 to 30 June 2009". The scope of the request has since narrowed, including the newspaper's request to remove the names of all patients and medical staff in a bid to clear the way for the documents. The Courier-Mail is more interested in knowing the events surrounding the incidents and not the names of anyone involved. Queensland Health fought the request before RTI Commissioner Clare Smith ended the negotiations by ruling the information should be given to The Courier-Mail. That should have been the end of the matter, but Queensland Health has defied the commissioner and taken legal action in a bid to prevent the release of the documents. This is the first time the Government has defied a ruling by the commissioner. It is a worrying move and one The Courier-Mail intends to fight. Health Minister Geoff Wilson issued a statement to say that he was trying to find "middle ground". There is no middle ground in this issue. The Right to Information process is governed by legislation and not by negotiation. As part of his statement, Mr Wilson said: "I support this Government's drive to improve transparency and free access to public information." The statement was a waste of time and a further sign that Queensland Health has lost touch with reality. Mr Wilson has not been in the job long, but this is his first step down the same sorry path travelled by his predecessors Paul Lucas and Stephen Robertson. The last word should be left to Premier Anna Bligh, who lauded the introduction of the Right to Information Act, which replaced Freedom of Information laws, during a statement issued in June 2008. Ms Bligh said: "The most fundamental shift is a recommendation that any new laws should `push' information into the public eye rather than waiting for people or organisations to use the law to `pull' information from government and other organisations." And that comment says it all about The Courier-Mail's battle with Queensland Health. The commissioner has ruled the Government should "push" the information to Queenslanders. The Government does not agree and is using the law to "pull" it from public view."


  1. Andrew8:48 am


    You and the parties involved may find it helpful to read page 10 of the New Zealand Ombudsmen's annual report for 2007/8, here:

    The Ombudsman's investigation resulted in a decision by District Health Boards to proactively publish reports of 'serious and sentinel events' (as they're known in NZ). The earlier reports can be found here:

    and the more recent reports can be found here:

  2. Andrew9:37 am

    An example of media reporting of the 'serious and sentinel event' reports can be seen here:
    and here:

    The New Zealand Nurses Organisation commented favourably on the most recent disclosure of the information:
    "NZNO professional nursing adviser Kate Weston praised the release of the reports, which had led to significant improvements in quality and safety over the last four years. “The information in the reports details where and why these events occurred. This level of transparency is essential if we are to continue to enhance the quality of patient care and improve patient outcomes,” she said. “This approach is not about ‘blaming and shaming’. It is about learning from these events to put in place systems that reduce the chances of them happening again.” "

  3. Andrew,

    Thanks for those links-NZ leads again!