Political furore over Manning Hospital GM's letter


MANNING Hospital is the focus of a political furore and investigation following the revelation this week in NSW Parliament of a letter signed by general manager, Tricia Bulic that states in part, that there has been "a number of major avoidable catastrophes involving obstetric services" and, "I will not accept another avoidable death due to petty personality issues and inter professional disputes".

The existence of the letter dated April 28, 2014 came to light this week during a meeting of the General Purpose Standing Committee No.2 as it examined proposed health expenditure in a budget estimates hearing with the NSW minister for health, Jillian Skinner.

During the meeting at NSW Parliament in Sydney on August 18, Greg Donnelly MLC, provided the minister with a copy of the letter that was directed at all Manning Hospital maternity staff and visiting medical officers.

Minister Skinner informed the committee that she had not seen the letter. The key aspects of the letter signed by Ms Bulic follow:

"I write to inform you of the directions to be taken at Manning Hospital in response to a number of major avoidable catastrophes involving our obstetric service. These events have prompted major investigations in the form of Root Cause Analyses and have brought our hospital into disrepute and caused much anguish both for the affected patients and the staff who cared for them.

These rigorous investigations have made evident, amongst other things, the following:

o Poor adherence to co-ordinated care and collaboration caused by distrust and resentment between our various staff, especially between some of our midwives and some of our obstetricians.

o The guidelines for management of obstetric patients are at the same time incomplete, variably compiled with and sometimes lacking altogether.

o There is a lack of agreement on the correct way to manage patients, both between midwives and obstetricians and between obstetricians, which all staff find confusing, to the detriment of our patients.

o There has been a disconnection between those services supplied privately and those supplied in the hospital setting and this disconnection has caused harm."

The letter also states that Ms Bulic, Dr Jim Wills director clinical services and director emergency department, Jodi Nieass director of nursing and midwifery met with Dr Henry Murray, clinical lead for the women's health and maternity services for the Hunter New England Local Health District (HNELHD). The outcome of the meeting that they agreed on the following:

o That a collaborative model of care is development and practiced at all times and is well supported by clear policies, guidelines, processes and practices.

o That all staff who deliver a service into our maternity unit comply and co-operate with this model of care without exception.

o That any breach in professional standards or failure to comply with this direction is dealt with through appropriate disciplinary action.

At the time of going to print, the minister for health, Mrs Skinner advised that she "had no knowledge of this letter prior to the budget estimates hearing on Monday, August 18".

"Nobody raised any concerns of this nature with me on April 4 during my visit to Manning Hospital," Mrs Skinner said.

"I have made inquiries since the budget estimates hearing and am satisfied the local issues raised in the letter are being addressed by Hunter New England Local Health District, in conjunction with the Clinical Excellence Commission."