Dr Michael Sedgley, AMA Chairman of Federal Council - Radio 3AK,with Kathy Bedford and Kevin Hillier

BEDFORD: Frightening, probably, is more the word. This is a study put together by the Australian Council for Safety and Quality in Health Care. They've found that hospital and medical errors cost the nation up to four billion dollars a year.

HILLIER: Can you go through the death statistics again?

BEDFORD: Monetary, medical mistakes found to be the underlying cause in the death of 177 cases, but there are concerns that this might even be under-estimating it because…

HILLIER: …just tipping your toe in the water, yeah.

BEDFORD: It comes down to how hospitals actually list these errors and they are all of the errors reported. There are some figures saying that there could be 18,000 patient deaths a year caused by error in hospital.

HILLIER: Frightening is the only word you could use with that - staggering.

BEDFORD: If you're going … if you were hearing that this morning and you're about to be…

HILLIER: …go under. I ran into a bloke yesterday whose father is having open-heart surgery today. Bang. How would you feel?

BEDFORD: Well, if he doesn't have his open-heart surgery, he's probably going to feel dead.

HILLIER: Yeah. Probably.

BEDFORD: But, you would be nervous.

HILLIER: Oh, you'd feel better about life, now.

BEDFORD: Yeah. It's a great pleasure to welcome to the program this morning the Chairman of the Federal Council of the AMA, the Australian Medical Association, Dr Michael Sedgley. Good morning, Doctor.

SEDGLEY: Good morning, Kathy.

HILLIER: Can we start with those mistakes?

SEDGLEY: If you'd like to.

HILLIER: Yeah.

BEDFORD: Obviously some frightening figures there, Doctor.

SEDGLEY: Yes. They are frightening. I have to say that I believe that they compute it at about two per cent of hospital admissions, which is around about the same as other places in the world, and I guess it's probably better than some. One of the things that people, or the twist that people try and put on it is that this is all because of medical error, or doctor's error. It's not. The real problems are systems errors. It's no more a doctor's error than an administrator's one, or a nurse's one.

HILLIER: But, in the end, doesn't it come down to the fact that people are dying?

SEDGLEY: Oh, yes, it does. And the purpose of all of this and these statistics and collecting the statistics is to find out exactly what is happening, and then why it's happening and then to do something about it. I mean, it's a very positive move. It's something that should have been done a long time ago. They've been studying it for about two years to get this study together.

BEDFORD: Now some of the areas they're looking at are things … accidents to do with incorrect drug dosages, combining drugs that shouldn't go together and surgical mistakes. What can we do about those three types of error for starters?

SEDGLEY: Well, the drug one's … they're matters of communication, communication between doctors, between nurses and between patients and we have to improve the communications in our hospitals.

BEDFORD: Is that mainly a nursing issue, would you say? Is that something where we need … could the nurses claim that they're being under-staffed at the moment?

SEDGLEY: Oh, I think they certainly could. Under-staffing occurs at all levels, I mean, the nurses at the moment, in Victoria at least, are wanting to impose ratios and this is because they are so … they've been so under-staffed. But, of course, young doctors feel very much the same at times, too. It's very costly to reduce these errors. They have to be reduced though. I mean, you can't accept that that number of errors could be occurring in our hospitals. But by looking at it and by doing something about it, it can be reduced, it can be got down to 1.5 per cent, down to 1 per cent. It will never be zero unfortunately. I don't think it can be.

BEDFORD: I guess that's the situation there, Doctor, where you say even doctors and nurses, but doctors in particular, you are human and mistakes do happen.

SEDGLEY: That's correct, yes.

BEDFORD: When people go into hospital for surgery, now, I know it's always a routine thing where they're explained that there is a risk, should we be perhaps hammering that home to patients a little harder?

SEDGLEY: Yes. Telling a patient about their operation, or about their admission to hospital, lots of patients go to hospital not to have an operation but to get cured in other ways, and letting them know about that and explaining it is crucial. This is a job for the doctors and to some extent for the nurses, too. But, it's quite important that it's done in the right balance and that's what the whole of your program is about at the moment, I think, is to say that, you know, although these mistakes occur, the overall benefit that you're going to get from this treatment far outweighs the risk.

HILLIER: Now, Doctor, can we talk about another story that's around this morning, about literally having a professional roadworthy test for doctors, to make sure that you're up to specs on all the new things that are happening?

SEDGLEY: Yes. We can certainly talk about that. It's something that's under consideration by the Australian Medical Council at the moment, is that right.

HILLIER: Quite obviously, yes, it is.

SEDGLEY: Yes.

HILLIER: And it's quite obviously a very good idea, I would have thought.

SEDGLEY: It sounds like a good idea. It's a question … it needs to be very carefully put in place. I don't know that … it's not something that's simple to do. I mean, the standards of practice are measured by the teaching colleges in medicine really, not by so much by the Australian Medical Council.

BEDFORD: But once you become a member, say the Royal College of Surgeons, once you become a member, they don't actually make you … you could be a surgeon for 20 years without having to be retested, is that right?

SEDGLEY: That was the case. Of course, you say without having to be retested, I mean, most surgeons work in public hospitals at least some of the time and have a lot to do with teaching and training of young doctors and students. It's pretty rare to have a doctor who's not updated at all. But nowadays, they are having … there are programs being introduced through the colleges and they have mandatory sort of points, you have to get so many points every three years to keep yourself registered. So you have to do a certain amount of continuing education.

HILLIER: So, you are accountable to be updated in the system?

SEDGLEY: You are accountable to … not all of the colleges have done this yet. My college, which is the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, have had it in place, I think, now for about 10 years. But these sorts of programs are coming in across the board. And they're very good because, not only do they give the public the assurance that the doctors are upgrading themselves, but it also gives the doctors themselves a lot of confidence in what they're doing and it puts it on the colleges to have to provide good programs to do this.

BEDFORD: Should people be nervous if they're going into hospital, Doctor? I think we're looking for a little bit of reassurance this morning. I'm reading a story, this … out of the same Safety Council Report that came up with those horrific figures about accidents in hospitals, a story that one woman had a healthy breast removed, another that a man was mistakenly given a vasectomy.

SEDGLEY: Yeah. That's appalling.

BEDFORD: I'm nervous.

SEDGLEY: I mean, you do see these stories from time to time and you can't help being nervous. But you've got to say that these incidents are very … are actually pretty rare, that sort of both incident. I mean, the type of mistakes that are being talked about here are quite often things like people being too long on waiting lists and put on waiting lists where they've had to wait and they've got sicker, or even died while they were waiting for something. I mean, those … they're not all straight out errors. Some of them are due perhaps to the illness itself. But you've got to be very careful that you don't alarm people to the point where they don't have treatment that they need to have.

BEDFORD: Exactly. And, I guess, ultimately you are there about helping people and a lot of people get better than those who get worse.

SEDGLEY: That's right.

BEDFORD: Let's hope. I don't think that's a very likely scenario.

BEDFORD: Doctor, while I've got you on line, this is going to put you on the spot a little bit.

SEDGLEY: Oh, yes.

BEDFORD: But, Kevin was stirring the pot this morning about waiting times and especially going to see his GP and being made to wait. Now, what is it with GPs, are you overbooking, you know, the number of patients you see, and is it okay to ring ahead and see how the waiting list is going?

SEDGLEY: I think that it's a good … the general practitioner, of course, should be the point of primary care, that's where you go if you feel sick. Now, you've got to find a general practitioner that you get along with and, I mean, everybody works in different ways and everyone has different responsibilities. There will be some general practitioners who are procedural. There might even be some left - not many, unfortunately - who deliver babies. So they'll have emergencies that come up. They have to do their home calls and so on. But, if you're going to someone where they're always late, well, you might reconsider whether you'd want to go and see somebody else. Or you might, as you say, if it's someone that you trust and like, then you might just ring up to make sure from the receptionist to see how they're going.

HILLIER: No, I trust him and I like him, but I think his clock is set on Adelaide time, unfortunately, because his ten o'clock is my ten-thirty, for some stupid reason.

SEDGLEY: I see.

HILLIER: Yeah. There you go.

BEDFORD: Doctor, we'd better let you go so that you're not running late and then holding up your patients.

HILLIER: Exactly. Good on you, Doctor, thanks for talking to us.

SEDGLEY: Thank you.

Ends