11 December 2015

Accidents and Ambos

'ACT Workcover and the Failed 1997 Implosion: A Case Study of the Role of the Inspectorate' (National Research Centre for OHS Regulation Working Paper No. 91) by Patricia Healy comments
The failed implosion of the old Canberra Hospital buildings on Sunday 13 July 1997 resulted in an explosion which blasted masonry and steel debris beyond the 200 metre exclusion zone to where thousands of spectators stood watching on the shore of Lake Burley Griffin. A young spectator, Katie Bender, was killed instantly when struck by a fragment of that debris.
At the Bender Inquest the Coroner, Mr Shane Madden, described the implosion project as having failed systemically. He attributed the failure to: the Project Manager’s and contractors’ lack of appropriate competencies; the absence of input from independent engineers and explosives experts; inappropriate action by the ACT Chief Minister’s Office and Department in promoting the implosion as a public event; and failure of the regulatory agencies to properly discharge their functions.
It is clear, in retrospect, that the wholesale underestimation of the risk to public safety was a significant factor in this litany of failures. The public safety risk inherent in the implosion project as it was implemented, was unrecognized, discounted or underestimated by all the parties involved at all stages of the project. This study, with the great benefit of hindsight, examines why this occurred and how it affected the role of ACT WorkCover and those inspectors directly involved. Specifically it examines how the particular circumstances of the implosion project combined with the situation and practice of WorkCover to influence the inspectors’ assessment of the inherent risks and the exercise of their regulatory enforcement powers.
The 2nd Reading Speech for the Transparency in Government Bill 2015 (Vic) meanwhile states
This bill is an important step towards promoting regular public reporting of performance data by Victoria's ambulance and fires services, and Victoria's public hospitals. It establishes a new statutory framework to facilitate the regular release of ambulance and fire services' response times to emergency incidents; the mandatory annual release of important performance agreements, known as a statement of priorities, between the government and the boards of Ambulance Victoria, public health services and denominational hospitals; and the regular release of performance data by public health services and denominational hospitals.
The bill will deliver upon the government's commitment to ensure greater  transparency in the delivery of public health and emergency services. It will also address the need to improve the public reporting of emergency services' response times, as outlined in the 2015 Victorian Auditor-General's Office Emergency Service Response Times report..
The information required to be reported under this bill is about the performance of public services that are of critical importance to Victorians. Victorians have a right to clearly understand the performance of these services, and have a right to do so without having to go through a Freedom of Information process to access this information. This bill will ensure the enduring and easy access to this information for the public..
This  government is committed to providing greater transparency about the way that these crucial services operate. The men and women who work in these agencies perform an invaluable service for our community and we are grateful for it. The need for greater transparency arises precisely because their service is of such importance to Victorians. Victorians are entitled to understand how their critical services are performing..
The bill provides a framework for the release of three different kinds of information:
  • Response times for Ambulance Victoria, the Country Fire Authority (CFA) and the Metropolitan Fire and Emergency Services Board (MFESB); 
  • Statements of priorities agreed to by Ambulance Victoria, public health services and denominational hospitals; and 
  • Performance data for public health services and denominational hospitals against the performance indicators in their statements of priorities.
Response times for Ambulance Victoria, the CFA and MFESB will be published online every quarter for prescribed emergency incidents, providing the 50th and 90th percentile response times to an emergency incident in a municipal district or local government area and thereby ensuring "that Victorians have an accurate impression of historical response times in their community". Total response times will be included, providing an understanding of the time it takes from the point at which the Emergency Services Telecommunications Authority (ESTA) receives a call for assistance to the first arrival at the scene by the relevant agency. 
The government acknowledges that response times are not the sole indicator of how effective or how well an agency is performing and that a range of factors can affect an agency's response time performance, such as geographical and seasonal variations. For this reason, the bill expressly clarifies that further information can be included in these reports, to promote greater transparency by contextualising the information and providing meaningful commentary. This will ensure that, if necessary for the public to clearly understand response times in their context, agencies will be able to provide the necessary contextual information to the public.
The bill recognises that there are likely to be times when the resources of an emergency service are devoted to addressing a major emergency, such as major bushfires during the fire season. In such circumstances, the  bill allows the minister to delay the publication of quarterly reports until a major emergency has been sufficiently addressed before reporting is resumed. The bill also recognises the potential impact of sustained and prolonged industrial action on the ability to collect and prepare response time data, and also allows for delayed publication in such circumstances. The  bill ensures that there is transparency when these exceptions are relied on by requiring the minister to publish a statement so that the public is aware that a report will be delayed.
The Speech indicates that the Bill will introduce
 a requirement for all statements of priorities for Ambulance Victoria, public health services and denominational hospitals to be published online by 1 November each year.
Statements of priorities are important documents that outline an annual agreement between the board of a health service and the relevant minister. They set out strategic priorities and agreed objectives for each financial year in terms of financial sustainability, services access and performance, safety and quality and service delivery, with accompanying performance indicators and performance targets.
Denominational hospitals are not legislatively required to agree to a statement of priorities, but where they choose to do so, the bill also requires their publication.
If a statement of priorities is not agreed in time to be published by 1 November for the relevant year, the bill ensures that the minister will publish reasons for the delay, and will ensure the publication of the statement of priorities as soon as practicable after agreement is reached.
Public health services and denominational hospitals with statements of priorities will be required to publish quarterly performance reports against specificperformance indicators in those statements.
These indicators are to be chosen from the prescribed performance categories, such as safety and quality performance or access and timeliness performance. In some cases, it will not be practical for certain performance indicators to be reported against on a quarterly basis. For example, data for a particular performance indicator might be collected by an independent contractor on a yearly basis. The bill enables the minister to specify an alternative reporting timetable, and requires publication of the reasons for the variation.
Where a public health service or denominational hospital has not agreed on a statement of priorities, the bill facilitates the reporting of health performance data by allowing the minister to publish a quarterly performance report against the performance indicators specified in the notice issued by the minister. If the public health service or denominational hospital later agree to a statement of priorities, the minister will publish a quarterly performance report based on the performance indicators in the agreed statement of priorities and that have also been specified in the notice issued by the minister.
The devil is in the detail, with the Speech indicating that minister responsible for administering the Health Services Act 1988 (Vic) will be permitted to delay reporting of hospital performance data in cases where it would unreasonably divert resources from a major emergency (ie the escape clause increasingly used by Commonwealth agencies in relation to the Freedom of Information Act) or as a result of prolonged or sustained industrial action.