Recently released South Australian coronial findings in the matters of Ryan and Walton address amongst other things the risks associated with admission of high risk patients for surgical procedures at small private hospitals. Two recommendations are of particular interest.
Recommendation 3 deals with potential financial incentives for medical practitioners to recommend admission to a particular facility:
That the Medical Board of Australia consider formulating a code of conduct which stipulates that medical practitioners who practise preferentially in a facility in which they have a financial interest, should disclose that fact to the patient appropriately and specifically raise the issue concerning suitability of that facility with other specialists to whom they refer the patient for pre-admission assessment;
Recommendation 1 deals more broadly with patient selection criteria.
That the Minister for Health, the Australian Commission on Safety and Quality in Health Care and the Australian Council on Healthcare Standards, consider as a requirement of accreditation that small private hospitals like Sportsmed which have no on-site medical practitioners overnight, and no ICU backup, develop robust pre-admission processes in which higher risk patients are screened to ensure that they are not accepted for overnight admission unless they have been assessed as suitable for that facility by a medical specialist or anaesthetist, well in advance of the planned admission date;