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Document
Excerpt from Health Care Complaints Commission letters to complainants. HCCC Commissioner Ms Amanda Adrian.
15 September 1999
Dear Mrs Kerrison
Your complaint against HealthQuest
I refer to your letter of complaint lodged with the Commission concerning your assessment by HealthQuest and the outcome of your Medical Appeals Panel (MAP) Appeal. I also refer to the letters from Mr Ehl and McGuinness who wrote to the Commission on your behalf.
Your complaint was earlier referred by the Commission to the Independent Commission Against Corruption (ICAC). The ICAC has advised that your complaint was not going to be formally investigated by them.
The Commission has reviewed a number of complaints concerning HealthQuest and decided to refer issues concerning HealthQuest and the Medical Appeals Panel (MAP) to the Director General of Health. The Director General has agreed to convene a working group to review the following issues identified by complainants:
- Inadequate information provided to people attending a fitness to work assessment including possible consequences of non-cooperation with the assessment. Complainants noted that they did not receive adequate information to prepare for the assessment or to understand the processes and consequences of assessment. In light of the inadequate information complainants could not give informed consent for the proposed assessment.
- Inadequate processes to ensure people receive the letter from HealthQuest informing them of the assessment and rights of appeal.
- The finalisation of assessments and recommendations without reviewing the employee ’s leave summaries and statement of duties.
- Basing assessments on employer written reports was considered inappropriate. Concerns were also raised about the practice of accepting written summaries prepared by employers rather than obtaining reports and statements containing first hand observations. Lack of access by the complainants to this information prior to assessment is an issue.
- The use of verbal information provided by the employer without confirmation in writing was considered unsafe. Lack of access by the complainants is an issue.
- The need for MAP to provideapplicants with a list of all documents considered during the appeal.
- The noting of reasons for arriving at a particular diagnosis in HealthQuest medical records was not apparent to complainants who obtained their HealthQuest records under FOI. Sufficient information is required to support a diagnosis and the relationship between the diagnosis and the elements of employment that HealthQuest considers the employer cannot perform.
- Adequacy of policy and procedures in place to ensure the information provided by employers is comprehensive and contains sufficient information to justify a medical assessment by HealthQuest.
- Adequacy of policy and procedures relating to providing people undergoing assessment by Healthquest with an opportunity to respond to information provided to employers or other parties during this assessment process.
- Inadequate appropriate processes to cover interim decisions made prior to assessment.
- Onerous practices of HealthQuest expecting the patient to pay for reports required for the assessment in advance or to pay the difference between the specified fee and the charged fee if the employer declines to pay. This practice suggests confusion as to whom the service is provided.
- Lack of safeguards used by HealthQuest when assessing people who identify as whistleblowers.
- Inadequate safeguards in place where
decisions to declare people unfit for work occur:
- Without first identifying the diagnosis and prognosis.
- Without adequate consideration of reasonable accommodation.
- That have been based on a short assessment interview and reliance on information provided by employer.
- Inadequate appeal mechanisms when people are declared unfit for work.
- The practices employed by MAP were not considered transparent or fair.
- The particular issues raised in Mrs Kerrison’s complaint.
The Commission considered your letter of complaint when drafting the issues for review by the working group. To assist the consideration of issues by the working group a copy of your complaint has been provided to the Department of Health.
Whilst the review won’t necessarily resolve your particular concerns, as it will focus on systemic and processes, it is anticipated that actions arising from the review will benefit people referred to HealthQuest in the future.
I will contact you again when the Commission has received a copy of the Department’s report on the outcome of the review. I anticipate the report will be available in approximately 6 months.
Should you have any queries I may be contacted on 92197592.
Yours Sincerely
[signature]
Bruce Greetham
Manager
Patient Support Office