Questions for every party

1.1

Do you accept that, since the initial improvements resulting from Targeting Zero, successive restructures and budget cuts have weakened Victoria’s capacity to detect, investigate and respond to patient harm, and are reintroducing the patient risks identified in the Targeting Zero report?

1.2 · Role of safety and quality teams in clinical care

Will you recognise that safety and quality, clinical governance, incident review and clinical analytics staff are part of clinical care teams, not “back office”, in savings targets, VPS review implementation and “live within budget” directions to boards?

1.3

Do you accept that further cuts to these functions risk repeating the failures found at Bacchus Marsh?

1.4

An independent review of the implementation and long-term outcomes of Targeting Zero, incorporating the VAGO findings and taking account of the current health and fiscal environment and the VPS and health system structure, may be of benefit in identifying the challenges and opportunities to improve safety and quality for the community through improved detection, investigation and response capability across the health system. Would you initiate and/or support the commissioning and unconditional release of such a review?

2.1

Which of the identified issues would you prioritise, and what will be in your first budget?

2.2 · Equal priority for safety

The national safety commission found departmental meetings “concerned themselves primarily with budget and activity data” (ACSQHC). Targeting Zero warned that a focus on financial targets can drive “critical understaffing and a neglect of safety and quality”, and told the department to “cease to aggregate quality and safety with the financial and access dimensions of performance” (Targeting Zero, p. 84). The Auditor-General found that the separate safety and quality performance framework Targeting Zero called for had not been enacted (VAGO). If health service boards’ statements of priorities and the Department of Health’s own actions do not prioritise safety and quality, health services are unlikely to do so either. How will you ensure safety and quality outcomes are given similar prioritisation to meeting financial and activity-based targets in the next term of government?

2.3

Will you exempt statewide and health service safety and quality functions from further savings targets and separation packages?

3.1 · Professional leadership

Will you return the Chief Medical, Nursing and Midwifery, Allied Health, Mental Health Nursing and Paramedic officers to Safer Care Victoria, reporting to its CEO with direct safety oversight roles, as Targeting Zero recommended?

3.2.1 · Data analytics

Will you restore resources for the Data Request Hub to service government agencies external to the Department of Health, health services and researchers?

3.2.2 · Data analytics

Will you review the requirements of existing DH eHealth, shared government IT support providers and consultancies, to meet health system safety and quality monitoring and analytical requirements?

3.2.3 · Data analytics

Will you review the impact of the restructure on VPS epidemiological and health data analytical expertise within the Department of Health and the safety and quality agencies, and where recommended, restore resources to support in-house epidemiological and analytical expertise within safety and quality agencies?

3.3 · Maternal morbidity surveillance

Will you fund linked, statewide surveillance of severe maternal morbidity, so that safety and quality teams and health services are resourced to learn from serious harm and improve care?

3.4 · Independence

Will you legislate Safer Care Victoria and the health information agency as statutory bodies independent of the department, with protected budgets and the power to publish?

3.5 · Support for health services

Will you ensure evidence-based funding for health service safety and quality teams, and reinstate public quality reporting, so that harm is found and acted on locally?