Correcting the record: Australian prosecutions for manslaughter in the medical context

The failure to prosecute Dr Jayant Patel successfully for any of the deaths associated with his time as Director of Surgery at Bundaberg Base Hospital was received in some quarters as an abject failure of the criminal law to deal adequately with significant wrongdoing. The case itself, the multiple public inquiries and the significant expense to pursue, extradite and prosecute Patel, resulting finally in a finding of guilt on a number of minor fraud charges, seems to compound this sense of failure. This article argues otherwise. When placed within the far longer and forgotten history of the prosecution of manslaughter by criminal negligence in the Australian jurisdiction, this story of prosecutorial failure becomes instead wholly consistent with the case law over time. No adequate account of the history of prosecution in the Australian jurisdiction exists for this area of law. To present Patel in context, the article draws upon archival research to provide a significantly extended account of the history of prosecution for manslaughter in the health care context. The extension of the case law is significant, from four known prosecutions, case histories of another 33 inadequately acknowledged prosecutions are presented

Is health systems integration being advanced through Local Health District planning?

Delivering genuine integrated health care is one of three strategic directions in the New South Wales (NSW) Government State Health Plan: Towards 2021. This study investigated the current key health service plan of each NSW Local Health District (LHD) to evaluate the extent and nature of health systems integration strategies that are currently planned.Methods A scoping review was conducted to identify common key principles and practices for successful health systems integration to enable the development of an appraisal tool to content assess LHD strategic health service plans.Results The strategies that are planned for health systems integration across LHDs focus most often on improvements in coordination, health care access and care delivery for complex at-risk patients across the care continuum by both state- and commonwealth-funded systems, providers and agencies. The most common reasons given for integrated activities were to reduce avoidable hospitalisation, avoid inappropriate emergency department attendance and improve patient care.Conclusions Despite the importance of health systems integration and finding that all NSW LHDs have made some commitment towards integration in their current strategic health plans, this analysis suggests that health systems integration is in relatively early development across NSW.What is known about the topic? Effective approaches to managing complex chronic diseases have been found to involve health systems integration, which necessitates sound communication and connection between healthcare providers across community and hospital settings. Planning based on current health systems integration knowledge to ensure the efficient use of scarce resources is a responsibility of all health systems.What does this paper add? Appropriate planning and implementation of health systems integration is becoming an increasingly important expectation and requirement of effective health systems. The present study is the first of its kind to assess the planned activity in health systems integration in the NSW public health system. NSW health districts play a central role in health systems integration; each health service plan outlines the strategic directions for the development and delivery of all state-funded services across each district for the coming years, equating to hundreds of millions of dollars in health sector funding. The inclusion of effective health systems integration strategies allows Local Health Districts to lay the foundation for quality patient outcomes and long-term financial sustainability despite projected increases in demand for health services.What are the implications for practice? Establishing robust ongoing mechanisms for effective health systems integration is now a necessary part of health planning. The present study identifies several key areas and strategies that are wide in scope and indicative of efforts towards health systems integration, which may support Local Health Districts and other organisations in systematic planning and implementatio

Reading the High Court at a Distance: Topic Modelling the Legal Subject Matter And Judicial Activity of the High Court of Australia, 1903–2015

In this article we apply the method of quantitative textual analysis known as ‘topic modelling’ to a significant Australian legal text corpus: that of judgments of the High Court of Australia from 1903 to 2015. The High Court of Australia has been a perennial topic for study and analysis. It is the highest court in the Australian judicial hierarchy and the site of many of the most significant contests of legal doctrine and practice in Australian history. We find that the topic models generated by this research enable the development of a range of unique, novel and robust observations of the High Court’s judicial workload and the shifting make-up of its legal subject matter over time. Moreover, this article reveals the feasibility and value of topic modelling as a method for the study of legal texts and practices that might fruitfully complement other methods of legal scholarship

Multicomponent transport of alcohols in an anion exchange membrane measured by in-situ ATR FTIR spectroscopy

Multicomponent transport through membranes is encountered in many applications, including photoelectrochemical CO reduction devices that convert CO into alcohols. We report the use of in-situ ATR FTIR spectroscopy to quantify the permeability of Selemion AMV, a commonly used anion exchange membrane, to mixtures of alcohols. An in-situ ATR FTIR spectrophotometer probe inserted into a standard diffusion cell enabled straightforward measurement of membrane permeability in multicomponent transport experiments without the need to periodically remove aliquots from the diffusion cell. The solubilities of alcohols in Selemion AMV were measured using a standard sorption/desorption technique. The solution-diffusion model was used to calculate alcohol diffusivities in Selemion AMV from measured permeabilities and solubilities. The relative contributions of alcohol solubility and diffusivity to overall permeability are discussed, and changes in permeability, solubility, and diffusivity with changing composition in binary and ternary alcohol mixtures are described. 2

Chronic disease management support in Australian workplaces—low base, rising need

© 2017 Australian Health Promotion Association Issue addressed: This study investigates the current nature, levels and perceived need for workplace support among mature age Australian workers with chronic illness. Methods: A cross-sectional population survey was conducted via a double opt-in panel sample of Australian workers aged 45 years and older with one or more of six major chronic diseases (diabetes and/or chronic heart, kidney, lung, mental health and/or musculoskeletal conditions). Results: Three hundred and fourteen respondents reported being in the workforce and having at least one of the chronic conditions under investigation, of which almost one third reported having more than one of the conditions. The findings reveal a number of considerable gaps in Australian workplace support for employees 45 years and older with chronic illness, including workplace flexibility, supportive policies and co-worker support. Conclusions: This research adds to a scarce existing literature base on workplace support for workers with chronic illness in Australia. Future research is needed to identify opportunities for effective public policy and implementation of workplace interventions to better support this cohort. So what?: If timely progress is not made in this area, the projected increase in the aged population and scheduled public policy changes impacting retirement age will multiply potential adverse effects on the health of employees with chronic illness and Australia's labour market productivity

Cancer patient experience measures: An evidence review

© 2016 Taylor & Francis Group, LLC. Objectives: This research investigates the instruments currently available to measure the cancer patient experience of health care. An investigation of the number of instruments, the domains covered by the instruments, and the structure and psychometric performance of instruments is undertaken. Methods: A narrative synthesis approach is used to gather evidence from multiple studies and explain the findings. Purposely broad search terms and strategies are used to capture studies with cancer patients at all stages of disease and across a range of cancer types and health care settings. Results: The majority of identified instruments were originally designed for the oncology field. Twelve of the studies developed new cancer patient measures; eight studies adapted existing or utilized items from existing instruments, and seven studies assessed the psychometric properties of existing instruments or assessed validated tools under different conditions (e.g., cross-cultural adaptation). The number of instruments assessing cancer patient experience that have sound psychometric properties across items was found to be low. The properties least tested are test–retest reliability, construct, convergent and discriminant validity, scale variability (floor/ceiling effects), and interpretability. Conclusion: This review examined 10 years of research on the development of instruments to measure the cancer patient experience of health care. It found that research in this area is still in early stages of development. Further inquiry based on development and validation of cancer patient experience measures is required to support improvements in cancer care based on the perspective of cancer patients

Serious Crime Prevention Orders

Successive reforms in New South Wales (‘NSW’) have established far-reaching powers to curtail the liberties of those who were once convicted of various serious sexual and violent offences. Now, these powers have been significantly expanded, with the Executive Government asserting the ability to control the free movement, speech, association and work of NSW citizens and businesses via Serious Crime Prevention Orders (‘SCPOs’) under the Crimes (Serious Crime Prevention Orders) Act 2016 (NSW). This Comment surveys substantive and procedural aspects of SCPOs. We situate the orders as part of a continuing expansion of administrative detention and supervision regimes of a hybrid, quasi-criminal nature. We question whether the powers go too far by increasing the State’s powers to surveil and control a person’s or business’s activities under the justification of preventing crime. We also canvass the possibility that SCPOs will operate in a punitive (not merely preventative) manner

Attestation by Governing Bodies: Literature review

Preface This preface was written by the Australian Commission on Safety and Quality in Health Care (the Commission) to provide context and background to the report which follows, Attestation by Governing Bodies: Literature review. The Commission contracted the University of Technology Sydney (UTS) to prepare the literature review, as part of the review of the Australian Health Service Safety and Quality Accreditation (AHSSQA) Scheme. Background The Commission’s role is to lead and coordinate national improvements in the safety and quality of health care. The Commission works in partnership with the Australian Government, state and territory governments and the private sector to achieve a safe and high-quality, sustainable health system. In doing so, the Commission also works closely with patients, carers, clinicians, managers, policymakers and healthcare organisations. The Commission is responsible under the National Health Reform Act 2011 for the formulation of standards relating to healthcare safety and quality matters and for formulating and coordinating national models of accreditation for health service organisations. The Commission developed the National Safety and Quality Health Service (NSQHS) Standards in consultation with the Australian Government, state and territory governments, technical experts and stakeholders. They aim to protect the public from harm and to improve the quality of health service provision. To become accredited, health service organisations must pass assessments to show they have implemented the NSQHS Standards. The assessments are conducted by independent accrediting agencies approved by the Commission as part of the AHSSQA Scheme. However, state and territory regulators and chief executives of health service organisations have raised concerns about several aspects of the accreditation process. The Commission is undertaking a review to update and improve the accreditation process. In May 2017, the Commission contracted four literature reviews to provide an evidence base to inform the Commission’s review of the AHSSQA Scheme. The reviews explored the potential use of the following methods to improve the veracity of health service organisations: • Attestation by a governing body • Short-notice and unannounced surveys • Patient journey and tracer methodologies • Safety culture assessment. The report that follows this preface presents the findings of a literature review that explored the potential use of attestation by governing bodies during accreditation of health service organisations. Key findings The report on attestation by governing bodies includes a definition of attestation, a review of the evidence of the effectiveness of attestation by governing bodies as part of accreditation in healthcare, and examples of the use of attestation in practice