Dr Mukesh Haikerwal on Ch 7 Sunrise, 30 August 2006 - Mistakes in Hospitals

MELISSA DOYLE: Mmm, but what causes these problems? And most importantly, how can they be stopped? Dr Mukesh Haikerwal is president of the Australian Medical Association. Good morning to you. Thanks for joining us.

DR HAIKERWAL: Good morning Mel and Mark. How are you?

MELISSA DOYLE: Good, now these claims are coming out of the Bulletin magazine today. It says that 16 per cent of patients experience some kind of medical mistake. Of those, 10 per cent will have permanent disability or death. Do these mistakes really happen in these numbers? It's just staggering.

DR HAIKERWAL: Well Mel, this information in today's Bulletin is about 11 years old. It's come from a 1995 report. When that report came out, there were concerns about the way it was put together anyway. Yes, there are mistakes in the hospital system. Let's not make any bones about that. But the world has changed in 11 years. We now have about 230 million services (clinical contacts with patients) in our health system; we have seven million hospital admissions, and about 4.2 in the public sector. And it's worth about $12 billion in terms of health expenditure. We have a system that's as safe as it's been in our evolution; and of course, we do many more things to many more people, often, who are sicker; often, who are older; and often, who have significant other medical conditions.

Things do go wrong, and we need to make sure we work out why they go wrong, and deal with them. Most of the problems, of course, are with the system; and we need to make sure we get the systems right. And the real drivers in this whole process are the people that work in the health system; the medical workers, the nursing staff, and the other people, the other clinicians who are striving for excellence.

And it's really important that we support them in those activities, to get the activities right.

MARK BERETTA: Mmm. Mukesh, when you talk about the staff, we often hear about nurses and doctors - young doctors in particular - who work these exhaustive hours. How much of a factor would that be, do you think?

DR HAIKERWAL: Certainly, in '95, there was a significant problem with long hours. They (the problems) have diminished quite significantly with things like the AMA's safe work campaign, and the AMA's flexible training campaign, as well as the AMA's safe rostering campaign.

So we've been very much the organisation to make sure that our doctors are well supported. There are still shortcuts taken by some employers and some hospitals, and some of our junior doctors are still working stupid hours; and that's something that we're addressing, case by case, and state by state.

That's unacceptable. You don't allow truck drivers to drive long hours any more. Airline pilots have rest times; so to should our medical and nursing staff.

MELISSA DOYLE: This investigation's alleging that millions of dollars have been spent, thousands of reforms have been made, but the mistake rates are believed to be unchanged. So if you're saying that things have improved, do you have any, sort of, stats? I mean, if we were saying here, 18,000 Australians are dying every year from mistakes, do you know what that figure might be?

DR HAIKERWAL: It's hard to compare, because the whole environment has changed. But I'm astounded that the claim has been made that things haven't changed since 1995. I mean, the world has changed, the ... we've had four elections, we've had significant reforms, we've had a much more open environment where people talk about these things. And we've got the clinicians, all of us, striving for excellence and quality, and to make sure that we do our level best to improve that. Now, one mistake is one mistake too many. One error is one error too many. And we've got to make sure we get those completely eliminated from the system. And there's a whole environment to making sure that actually happens.

MARK BERETTA: Yeah. Mukesh, just on that, can patients play a role in that? I mean, if you feel that maybe you are being treated incorrectly, I mean, in the past, we tended to take blind faith in doctors. I mean, quite often you sit there and you accept what's being said and what's being done to you. Should a patient speak up?

DR HAIKERWAL: Oh look, absolutely. The way of dealing with health these days is a team affair; and the patient and the doctor and the rest of the team work well if they actually, you know, pick up on potential problems. There's a whole regime of review within the hospital system, with the patient advocates; the health care complaints commissioners, in each of the states; and ultimately, the medical boards, and so on.

So there's a whole raft of different measures out there that people can actually get some other answers from, because they're not particularly concerned. Obviously, it's important that you have some faith in the people that you're seeing. If you're concerned, second opinions are always very useful. And just ask somebody else who works within the system. Those sorts of people can certainly be good guides. But it's absolutely a team affair. The patient, the doctor, and making sure that people in the health care team are working in the same direction.

MELISSA DOYLE: Good advice. Dr Mukesh Haikerwal, thanks for your time this morning. Appreciate it.

DR HAIKERWAL: Thank you. Good morning.

Ends