Australia Leaked SA Health emails reveal 'ageist' culture, advocates say, as Government defends position

12:21  01 october  2020
12:21  01 october  2020 Source:   abc.net.au

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a group of people in a room: The emails suggested doctors dissuade elderly patients from getting surgery. (Pixabay) © Provided by ABC Health The emails suggested doctors dissuade elderly patients from getting surgery. (Pixabay)

Advocates for older people have accused the South Australian health department of having an "ageist" culture, after leaked emails showed surgeons have been encouraged to "say no" to GP referrals for older and sicker patients.

A senior SA Health program manager emailed surgeons on Saturday saying health services needed to "tighten up … processes with regards to incoming referrals".

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The leaked email suggested surgeons "say no" to general practitioners referring patients who were elderly or had comorbidities (multiple health conditions).

"We also expect that where the person is old or has many comorbidities, you might suggest to the GP that is [sic] not necessarily in their best interests," the email read.

"Please use your wealth of consultant experience and start to say 'no' when clearly not sensible and high-value care."

Council on the Ageing chief executive Jane Massared said the correspondence showed "pure and simple ageism" within the health system.

"We hear that, importantly, clinicians say they look at people's whole health circumstances," she said.

"But age is not a health factor — age is a number.

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"It's very important that we call this out for what it is — ageism. It has no place in our public health system."

Emails 'a scandal': Labor

Opposition health spokesman Chris Picton said only doctors should be making clinical decisions, not hospital administration.

"I think that this is a scandal, and all South Australians would be shocked," he said.

"This has come about because a whistleblower in the health system — one of those specialists has raised the alarm bell over what's going on."

Professor Jane Andrews, the medical lead for surgery at the Central Adelaide Local Health Network (CAHLN), which is in charge of Adelaide's Royal Adelaide and Queen Elizabeth hospitals, defended the emails sent to surgeons.

She said they needed to be read in "context".

"The context of the email and the process is absolutely what we're doing in a lot of units already, which is we're making very conscious triage decisions," she said.

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"I think it can look threatening, when it's actually not threatening at all.

"It's about us making good medical decisions about who is more important to see at what point in time."

No interference: head surgeon

Professor Andrews said she did not believe concerns about hospital administration influencing clinical decision-making were valid.

"There is no inappropriate administrative interference in clinicians judging who should be seen for what and in what timeframe," she said.

"I think those people [who leaked the emails] could have raised that in a much more constructive way."

Health Minister Stephen Wade said he agreed the email was "clumsy" but said clinicians were the only ones making decisions about care within SA Health.

"It's always been the case that clinicians have to consider risk factors and comorbidities before they make a decision about patient care.

"But let me be very clear: in SA Health, decisions about patient care and clinical care are made by clinicians.

"I have no doubt that CAHLN will look very carefully at how to better communicate its processes."

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