Health system critical

MORE than 50,000 Victorians are waiting for elective surgery after a blowout in waiting lists in the first three months of the year.

Health Minister David Davis released five reports into the state of the health system yesterday as attention turned to Canberra for the Federal Budget.

The waiting list jumped more than 6 per cent from December 31, 2012 to March 31, 2013, an increase more than 10 times the rise of the previous quarter.

"The quarterly report shows a waiting list of 50,565 at the end of March this year, that is a higher waiting list and we're very conscious of the impact of that higher waiting list," Mr Davis said.

The Northern Hospital waiting list increased 20 per cent to more than 1800.

Sunshine Hospital's waiting list jumped 32 per cent and Western Hospital Footscray was up 40 per cent.

"We're aware of the challenge the west and the north and the southeast face in terms of population growth, and part of that is reflected in those," Mr Davis said.

He said the Federal Government's funding cut and subsequent return of money to Victorian hospitals was partly to blame. "We would have not had that confusion ... we would have had a lower waiting list, a significantly lower waiting list."

The audit of waiting times for patients to see specialists was also released, a year after it was handed to Mr Davis.

The independent report used data from June 2011 and found at that time 78,952 people were waiting to see a specialist for an initial appointment. The average wait time was 114 days.

The wait for patients to see a specialist for psychiatry and behavioural disorders was an average of 434 days.

Mr Davis had promised the report into "the waiting list before the waiting list" while in opposition.

Opposition health spokesman Gavin Jennings said more people were waiting longer than ever for surgery.

"Shockingly, the data also shows that in the March quarter, over 5000 people had their scheduled surgery cancelled," he said.

"In almost every measure, our health system is going backwards - this is what happens when you cut $826 million from the health system."

michelle.ainsworth@news.com.au

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Payroll a 'hospital pass', says health chief

FORMER director general of public works Mal Grierson says he viewed the task of implementing the failed Queensland Health payroll system as a "hospital pass" and knew "from day one" it was a "risky project".

The long-serving senior public servant has also told today's session of the Queensland Payroll Inquiry that canning IBM's contract was "not an option" even though others had made it clear they had "lost faith" in the IT giant's ability to deliver the system without major issues.

The inquiry on Tuesday heard that recurring problems dogged the development of the system throughout its lifespan, including constant disputes over the scope of the project, which left Mr Grierson "frustrated".

The payroll system left thousands of employees underpaid or overpaid after it went live in 2010, with the debacle estimated to cost the state as much as $1.2 billion.

Mr Grierson said it was evident that retaining the existing system and scrapping IBM's work was "the biggest risk" in the years before the go-live date.

He also admitted to having never actually read IBM's contract, saying it was "impossible" for him at the time to read and examine the countless contracts that involved his department.

He said he did not read the specific scope document and that he never definitively ordered a freeze on changes to the scope.

"There is a legitimate place for changes - if change happens, changes happen," he said, later adding: "I knew that you can never do that."

The inquiry heard that new changes would often emerge after a "lockdown" in scope.

"Certainly, I was frustrated," the former director general said.

Mr Grierson dismissed suggestions he should have done more to intervene directly during the process.

"I did take steps, I did take responsibility," he said.

By September 2009, a number of defects in the system had been detected, with advice provided to Mr Grierson claiming that it was "not uncommon".

He said those who did raise concerns about the defects were often not familiar with the process of developing an IT project.

"Nobody ever said to me that the code IBM were writing was of poor quality," he said.

Mr Grierson said terminating IBM's contract would have set back the system by "months, if not years", with its replacement likely to have to "start all over again".

He said he viewed the doomed project as a "hospital pass".

"I can recall that in a meeting with (former Queensland Health Director General Michael Reid) I referred to it as a 'hospital pass' - no pun intended - to get this thing," he said.

"It was a view that we hold... that we have... You get lots of jobs that you don't particularly want and I'm sure that Mick Reid didn't want this either. Payroll is not something that a director general normally regards as a key issue, it's a bread and butter issue in an agency."

Mr Grierson said he was concerned with "getting a new payroll in and getting on with life".

The inquiry continues.

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Health payroll woes had long history

THE Queensland Health payroll appeared to be in danger of constant collapse long before the IBM contract debacle began in 2010, the Payroll Inquiry has heard.

The old system would actually stop working as up to 500 public servants scrambled to meet pay deadlines for up to 90,000 employees.

The inquiry, headed by former Supreme Court Judge Richard Chesterman, QC, is examining why IBM got the payroll contract in 2007, and whether those involved acted with propriety.

The payroll system imploded when it was contracted out to IBM in 2007 and rolled out in 2010, underpaying and overpaying employees in a financial debacle set to cost the Queensland tax payer $1.2 billion.

Damon Anthony Atzeni, who was the Queensland Health client representative inside the government-run IT outfit CorpTech in 2007, said the old system run by government with the aid of contractors would simply stop working.

"What was the result in terms of peoples' salaries?" asked Mr Chesterman.

"They (the workers) were able to run a back-up process and work very hard to get the data that was lost back into the system."

Between 400 and 500 staff were constantly working in the system, he said.

Mr Atzeni said he had grown concerned about government payroll systems after watching the payroll for the Housing Department develop serious complications.

"Housing was a very small and uncomplicated agency compared to Queensland Health," Mr Atzeni said in statement provided to the inquiry.

"Given the problems in Housing, I expected much greater problems for the same type of solution in Queensland Health."

The inquiry continues.

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IBM and Health project staff in contact

A FORMER public servant who helped evaluate the Queensland Health payroll contract exchanged emails with successful bidder - technology giant IBM.

But Shaurin Ranjanikant Shah, who was employed as an Implementation Project Manager with the State Government outfit CorpTech, says the exchanges were made before the formal evaluation process was under way.

The email exchange was just one in a series of revelations about the contract process made in the payroll inquiry, which will continue hearing evidence in the Brisbane Magistrates Court next week.

The inquiry, headed by former Supreme Court Judge Richard Chesterman, QC, is examining why IBM won the contract which left Queensland Health with a deeply-flawed payroll system expected to cost up to $1.2 billion.

Counsel Assisting Peter Flanagan, SC, has told the inquiry the spotlight will be put on a range of key figures in the contract process, including former IBM employee Terry Burns, who worked with the State Government in securing the contract.

Yesterday morning, Mr Flanagan spent some time cross-examining Mr Shah, who was part of a large team overseeing the contract process, on the email from IBM.

"Why would a representative from IBM be emailing you directly?" Mr Flanagan asked.

"I don't know why he (the representative) chose to write to me," Mr Shah replied. "I can only say that I have a very clear recollection that I didn't provide any email addresses . . ."

Mr Shah later clarified the matter, saying there was some contact with the companies involved in the contract.

"There were some exchanges with me and the guys and the vendor," he said.

But once the formal process of contract evaluation was under way he was directed to stop writing to people individually, and have all contacts go through a superior.

Gary Uhlmann, owner of Arena Consulting - expected to give evidence next week - was asked to review government technical programs which were experiencing time delays and cost blowouts.

That review was part of the process which led to the decision to outsource the health payroll system in a tender which went down to a two-horse race between IBM and Accenture.

Mr Uhlmann said it was during the review process he met Terry Burns, who was working as an unpaid consultant for the State Government.

Mr Uhlmann said he surmised Mr Burns might have been working for no pay to establish his credentials in the technology field.

"I formed a positive opinion of Mr Burns' experience and capability," he wrote.

The inquiry continues Monday.

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'Shame on the parasites' at health lunch

PEOPLE attending a Brisbane function to announce the Newman Government's much anticipated health blueprint were met by hundreds of protesters as they arrived.

One protester yelled "parasites" at cars as they drove into the Sofitel Hotel on Wednesday for the lunch, and others screamed "shame" as people arrived.

The rally was attended by members of various unions, including the Queensland Nurses Union and Together Qld.

They carried placards, such as one which read: "Hands off Our Public Health System".

The Newman Government's health blueprint promises public, private and not-for-profit partnerships to improve the health system and "meet the needs and choices of Queenslanders".

The blueprint also sets out a streamlined awards and entitlements system for health staff.

There are currently nine separate awards, six agreements and 189 human resources policies covering more than 80,000 staff.

It will also include plans to boost health services in small country towns through the creation of a Rural Telehealth Service.

Those attending the lunch included private pathology firm Sullivan Niccolaides, Springfield Land Corporation and the Commonwealth Bank.

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PM's health cut threat a 'sad, sick joke'

NEW LOW: PA Hospital will cancel surgeries. Picture: Liam Kidston Source: The Courier-Mail

PREMIER Campbell Newman has described a Gillard Government threat to withhold further health funding or take it out of other programs as a "sad, sick joke".

"The Feds have owned up that essentially they had cut the (health funding) money," Mr Newman told 4BC.

"What they are doing now is even more outrageous. It's just a sad, sick joke."

Mr Newman said he had no problem with Federal funding going directly to the State's hospitals.

"What isn't acceptable is that they are saying 'what we'll do is take the $103 million out of other programs in Queensland' and who knows what that means," he said.

Mr Newman said his government had increased its health funding in the last budget.

'My government takes responsibility for the things that we have had to do over the last 12 months in Queensland in terms of the task of repairing the State's finances, but we actually in the health sphere increased the budget by $817 million."

Health Minister Lawrence Springborg has accused Prime Minister Julia Gillard of treating the state's patients as "second class citizens''.

He said Federal Government claims the clawback of funding was based on revised population estimates were flawed, given the Commonwealth statistician's figures that Queensland's population increased by 67,000 last year.

Ms Gillard last night announced she would reverse a decision to retrospectively cut $107 million from hospitals in her home state of Victoria, but threatened to cut even more money from the Newman Government if the funding "game playing'' didn't end.

She said the Victorian money would be paid directly into the state's Local Hospital Networks, redirecting funds "from areas where Victoria might otherwise have received Commonwealth funding''.

Mr Springborg described the Gillard Government's handling of the issues as "completely bizarre and absolutely erratic''.

"Basically, we've got the Prime Minister of Australia saying: 'Cease and desist, shut up or we're going to punish you financially,'' Mr Springborg said after addressing an Australian Medical Association Queensland breakfast today.

"I think it's probably what you see from a government in its death throws.

"The Prime Minister needs to understand that this is not just a concern of Queensland and Victoria. Every single state health minister, regardless of their political colour, are concerned about these retrospective cuts to health funding."

Mr Springborg accused the Gillard Government of playing politics in an election year.

"Labor are obviously under pressure in Victoria and by the fact they've now spurned and ignored Queensland, they've obviously written off Queensland for the next Federal election,'' he said.

AMAQ president Alex Markwell said the average patient "didn't care where the money comes from''.

"They just want to know that when they go to hospital, they'll get the treatment they need,'' Dr Markwell said.

"I think most people were disappointed and surprised to see that Victorian hospitals have had their funding returned, but not Queensland."

Metro South Health chief executive Richard Ashby said yesterday his district's federal cut of more than $18 million had forced a "total surgery'' reduction at Brisbane's Princess Alexandra Hospital of about 10 per cent until the end of the financial year.

"This will be achieved by postponing non-urgent category 3 elective surgery, such as hip and knee replacements and spinal surgery involving prosthetics,'' Dr Ashby said.

"It is important to note that this decision will have no effect on trauma, emergency and cancer surgery, and other urgent services."

Federal Health Minister Tanya Plibersek accused the Newman Government of a "dishonest campaign to shift responsibility from its own savage cuts to health services''.

"If you live in Queensland, you either know someone who's been sacked, your local hospital has been affected or a relative's nursing home has been closed down as a result of Newman LNP Government's cuts,'' she said.

Earlier, it was reported that elective surgery has been slashed at one of Queensland's biggest hospitals and others could follow suit as a stoush over health funding deepens.

Last night the Gillard Government threatened to withhold another $234 million in health funding from the Queensland Government this financial year.

Accusing the state of playing games over hospital budgets, Prime Minister Julia Gillard flagged the Commonwealth would consider bypassing the Newman Government and paying the money directly to hospitals.

Queensland has already accused the Federal Government of shortchanging the state

The State Government claims a shortfall of $103 million this financial year because of "flawed" adjustments to population estimates.

Making the threat in a letter to Premier Campbell Newman last night, Ms Gillard made no mention of the $103 million shortfall.

Hours earlier, she had caved in to Victoria's demands and promised an extra $107 million would be paid directly to her home state's hospitals.

The Prime Minister threatened to force the states to pay upfront for health services and then claim the money back from the Commonwealth, which would put more pressure on their budgets.

State Health Minister Lawrence Springborg described the Federal Government's threat as "a scandalous discrimination against Queensland Health workers".

"It sets a new low in Australian politics," he said.

The stoush comes as Brisbane's Princess Alexandra Hospital revealed 10 per cent of "total surgery" had been cancelled until at least the end of the financial year because of the federal budget cuts.

This morning, Federal Health Minister Tanya Plibersek accused the Newman Government of cutting $3 billion from its health budget and then trying to blame the Commonwealth for the shortfall.

Ms Plibersek said the Federal Government would essentially take control of public hospital funding and pay the money directly to hospitals in the state unless " the Queensland Government behaves".

"Where state governments are ripping money out of the health system we have to act," she said.

"We're going to take money from the Victorian Government...if we have to do that in Queensland, I'm open to doing that."

"It's not something I'm keen to do, it might be something I'm forced to do."

She said the state had received an extra $155 million this year, a 6.2 per cent increase.

"If we give more money to Queensland Health, how can they possibly be doing less with it?"

She said thanks to Australia's strong dollar, the cost of running health systems was expected to be lower this year.

"You have to ask if we give more money to Queensland Health, how can they possibly be doing less with it," Ms Plibersek said.

She was unable to pinpoint a deadline for the Queensland government to improve its health system.

" We'll see how the Queensland government behaves in the short term," she said.

Metro South Health chief executive Richard Ashby said yesterday the Princess Alexandra Hospital had reduced surgery by 20 out of 200 operating theatre sessions per week to help meet an $18.8 million reduction in Federal Government funding.

Dr Ashby yesterday said Metro South Health had no choice but to reduce non-urgent elective surgery in the short term, after the "unexpected and unprecedented" Federal Government budget reduction.

He said the cuts would be made by postponing category 3 elective surgery, such as hip and knee replacements and some spinal surgery.

"Our first priority is to communicate with patients affected by these changes to advise of expected delays," Dr Ashby said.

"Patients may wish to speak with their general practitioners about other referral and treatment options."

Many other Queensland public hospitals are also battling severe budgetary shortfalls and have announced drastic job cuts.

Princess Alexandra Hospital urology department director Ross Cartmill said he expected the cuts to category 3 surgery to drag on for at least another year.

"If you're a category 3 patient in Metro South, you're not going to be treated in the forseeable future," Dr Cartmill said.

"The PA has already been told its budget for next year is only increasing by 1.2 per cent so that means in real terms, we're going backwards."

Federal and state governments have spent months blaming each other for the latest health job cuts sweeping Queensland.

The Gillard Government slashed Queensland health funding last December by $103 million when it revised population estimates.

But in her letter to Mr Newman, Ms Gillard insisted Labor was giving Queensland hospitals $234 million more this year than what they would have received under the Howard government.

"The Federal Government expects State and Territory Governments to abide by the agreement they have entered into," she wrote.

"The alternatives to the agreement being upheld and abided by are ... the termination of the agreement.

"The extra funding that would have been delivered by the Federal Government to States and Territories will be delivered direct to hospitals and other service providers."

Mr Springborg is due to speak today via a telephone hookup to a Senate inquiry into the impact of the cuts.

Additional reporting by Brittany Vonow, Sarah Vogler

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