Why more health practitioners will take their own lives from now onwards?
News have covered Dr Yen-Yung Yap. https://www.goldcoastbulletin.com.au/news/south-australia/dr-yenyung-yaps-widow-requests-safework-sa-investigate-ahpra-treatment-before-death/news-story/751cb0b70fd45beeeb345fc5c2b9f94b
A week before dying, Dr Yap left a text message to me.
“BEING <1% IS NO EXCUSE FOR THE REGULATORS TO IGNORE THIS SERIOUS HARM.”
That day he shared two letters by two health ministers, with me.
One health minister wrote: “AHPRA HAS UNDERTAKEN SIGNIFICANT WORKS. TO IMPROVE ITS NOTIFICATION PROCESSES, INCLUDING:
IMPROVING ITS UNDERSTANDING OF VEXATIOUS COMPLAINTS. THROUGH WORLD’S FIRST INDEPENDENT RESEARCH. INTO THE INCIDENCE AND HARMS OF VEXATIOUS NOTIFICATIONS.”
Yap used the word “Harm” lifting it from the minister’s letter “Harms.”
Another health minister wrote: “The Senate Community Affairs Reference Committee into medical complaints process in Australia indicated. That truly vexatious complaints are very rare. Underreporting of well founded concerns is likely a far greater problem.”
So, what is the connection then?
On the 22 November of 2016 the CEO of AHPRA Mr. Martin Fletcher appeared before the Senate inquiry to give evidence.
“Senator Rachel Siewert: It is also a contempt to give false or misleading evidence.
[…]
Welcome, Mr Fletcher, and thank you for coming today. Could I just confirm that you have been given information on parliamentary privilege and the protection of witnesses and evidence.
Mr Fletcher: Yes.”
“Mr Fletcher: What I am saying is that in all of the available data and research evidence that we have looked at there does not appear to be a big problem with vexatious complaints, and by ‘vexatious’ I mean a harmful intent on the part of the person making the complaint and no patient safety concern emerging when we look at the issue. If I can just give you an example—
Senator XENOPHON: When you say ‘not a big problem’, do use mean that in terms of numbers?
“Mr Fletcher: we have a research partnership with the University of Melbourne. https://www.mja.com.au/journal/2016/204/1/reporting-health-practitioners-their-treating-practitioner-under-australias. They looked at 850 mandatory notifications over a 12-month period. They found fewer than six that they believed potentially met the criteria for a vexatious notification. The point I am also making is that, even though the numbers are small, we recognise that the impact on the individuals involved can be significant.”
The research at least explains: “AHPRA receives notifications on a prescribed form.”
The complaining person has to disclose the AHPRA registration number in there. If he or she is not registered, and is a member of the general public, his or her concerns are called “complaints.”
“Senator XENOPHON: You said there were 850 mandatory notifications and six were found to—
Mr Fletcher: Under six. They said ‘under half a dozen’.
‘Senator XENOPHON: Under half a dozen were found to be vexatious! What was the process to establish whether it is vexatious or not? There are 850 cases.
Mr Fletcher: The process involved a review of some of the core documentation in relation to, for example, the correspondence that is sent to a practitioner about a notification that has been received. I can give you a couple of examples to give you just the flavour.
One, for example, related to a couple who were both medical practitioners, who had been married and who were divorcing. There was an issue about the future of the practice in the context of their divorce. Another one related to two health practitioners who were in a relationship with the same other health practitioner, and notifications were made in the context of that.
So it is typically those sorts of issues around questions of commerce, emotion and rivalry in what we would term harmful intent with no patient safety concerns emerging as a result of a notification.’
Is Mr Fletcher’s evidence false and misleading?
Well, the following year, the same research team published a report. AHPRA calls it “vexing not vexatious”. https://www.ahpra.gov.au/News/2018-04-16-vexatious-complaints-report.aspx
AHPRA: AHPRA commissioned the research from the School of Population and Global Health, University of Melbourne to find out the size of the problem of vexatious complaints and identify how they can be better prevented, identified and managed. AHPRA initiated the work in line with its commitment to the Senate Affairs Reference Committee inquiry into the medical complaints process in Australia.
The report found that the number of vexatious complaints dealt with in Australia and internationally is very small, less than one percent, but they have a big effect on everyone involved. The research also confirms that the risk of someone not reporting their concerns is greater than if the complaint turns out to be vexatious.
Clearly it is a research on complaints, and not the 850 mandatory notifications.
AHPRA: Commenting on the report’s release, AHPRA CEO Martin Fletcher:
‘The Senate committee quite rightly asked the question – is this a big problem in Australia?’
Did they really ask that?
“Mr Fletcher: What I am saying is that in all of the available data and research evidence that we have looked at there does not appear to be a big problem with vexatious complaints, and by ‘vexatious’ I mean a harmful intent on the part of the person making the complaint and no patient safety concern emerging when we look at the issue. If I can just give you an example—
Senator XENOPHON: When you say ‘not a big problem’, do use mean that in terms of numbers?”
Shows. Who asked and said what?
Martin Fletcher: ‘We commissioned this research to find out: is there a potential for misuse of our complaints processes for health practitioners? Are vexatious complaints against health practitioners a big problem in Australia?’
What did Fletcher specify in the Senate hearing? Complaints, or mandatory notifications?
“Mr Fletcher: we have a research partnership with the University of Melbourne. https://www.mja.com.au/journal/2016/204/1/reporting-health-practitioners-their-treating-practitioner-under-australias. They looked at 850 mandatory notifications over a 12-month period. They found fewer than six that they believed potentially met the criteria for a vexatious notification.”
Shows, Nothing left to tell.
AHPRA: “While vexatious reports are frequently talked about, Assoc Prof Bismark maintains there is very little hard evidence about how often they occur. The best available evidence suggests that truly vexatious complaints are very rare, and that under-reporting of well-founded concerns is likely a far greater problem.”
AHPRA: “The report found that the number of vexatious complaints dealt with in Australia and internationally is very small, less than one percent, but they have a big effect on everyone involved. The research also confirms that the risk of someone not reporting their concerns is greater than if the complaint turns out to be vexatious.”
Writes a health minister to Dr Yap: “The Senate Community Affairs Reference Committee into medical complaints process in Australia indicated. That truly vexatious complaints are very rare. Underreporting of well founded concerns is likely a far greater problem.”
But, Prof Bismark is not the The Senate Community Affairs Reference Committee.
So texts Dr Yap: “BEING <1% IS NO EXCUSE FOR THE REGULATORS TO IGNORE THE SIGNIFICANT HARM.”
Dr. Yap refused to classify whether <1% is “complaint” or “notification” only as a symbol of expression, a symbol of protest. Then he takes his own life blaming AHPRA in a suicide note within a week of such a text.
Research reports: “There is a paucity of robust research about the actual incidence or impact of vexatious complaints in the health sector, but the best available estimates suggest no more than 1% of complaints are vexatious. The limited literature on vexatious complaints focuses almost exclusively on complaints made by members of the public who display obsessive and unreasonable complaining behaviour. There is essentially no empirical evidence on the incidence of professionals lodging vexatious complaints about each other for personal or professional gain, or as a bullying tactic.
What factors may contribute to vexatious complaints?
Evidence supports the idea that lay complainants who become vexatious may be driven by needs the complaints system has not addressed or cannot address, or psychopathology. Their behaviour is more likely to take on an obsessive and ‘out-of-control’ quality, and thus is often relatively easily identified as it intensifies.
By contrast, some people believe that professional complainants who become vexatious are more often driven by personal conflict with a fellow practitioner and/or a desire for personal or professional gain. It is suggested that their behaviour is more likely to be targeted and calculated, and thus more subtle and difficult to detect. However, we could not find evidence to support or refute these claims, due to the lack of evidence regarding the behaviour of professional complainants.
So who is this “By contrast, some people?” Marie Bismark’s research is pointing to?
‘Mr Fletcher: One, for example, related to a couple who were both medical practitioners, who had been married and who were divorcing. There was an issue about the future of the practice in the context of their divorce. Another one related to two health practitioners who were in a relationship with the same other health practitioner, and notifications were made in the context of that.
So it is typically those sorts of issues around questions of commerce, emotion and rivalry in what we would term harmful intent with no patient safety concerns emerging as a result of a notification.’
Shows, nothing left to tell.
“Mr Fletcher: we have a research partnership with the University of Melbourne. https://www.mja.com.au/journal/2016/204/1/reporting-health-practitioners-their-treating-practitioner-under-australias. They looked at 850 mandatory notifications over a 12-month period. They found fewer than six that they believed potentially met the criteria for a vexatious notification.”
“Senator Siewert to Mr Fletcher: Senator Rachel Siewert: It is also a contempt to give false or misleading evidence.
[…]
Welcome, Mr Fletcher, and thank you for coming today. Could I just confirm that you have been given information on parliamentary privilege and the protection of witnesses and evidence.
Mr Fletcher: Yes.”
Shows. How contempt to give false or misleading evidence looks like. Nothing left to tell.
~~~~
Ombudsman told the Committee 12/182 or 6.5% health practioners raised allegations of vexatious complaints/notifications.
“NHPOPC estimates that twelve complaints have been received from health practitioners during this period where the health practitioner has raised an allegation of vexatiousness in relation to a notification. This represents 6.5 per cent of the 182 complaints received during this period.”
A great idea occurred to the Committee to misrepresent “from health practitioners, where the health practitioner has raised an allegation of vexatiousness in relation to a notification” with simply “vexatious notification:”
“2.28 NHPOPC’s submission to the committee also indicates vexatious notifications for the 2016–17 year were trending higher than in the previous two years, with an estimated twelve complaints received at the time of submission, or 6.5 per cent of the total notifications received during the period.”
Then they formed a recommendation based on the great idea.
Recommendation 3
5.28 The committee recommends that the COAG Health Council consider whether recourse and compensation processes should be made available to health practitioners subjected to vexatious claims.
There is no such 6.5% health practioners subjected to vexatious claims. It is a senatorial myth.
It is also the only recommendation rejected by the realistic government.
Then the Government responds to the recommendation, but after one year three months, once AHPRA has published research report:
“AHPRA has commissioned research to better understand the extent of vexatious complaints. AHPRA will use the research to improve its processes and inform best practice for reducing, identifying, and managing vexatious complaints.’
The currently available evidence suggests that the incidence of vexatious notifications is very low, and that greater risk is posed to the public from people not reporting their concerns. [Compare with: AHPRA: “The best available evidence suggests that truly vexatious complaints are very rare, and that under-reporting of well-founded concerns is likely a far greater problem.”]
It is acknowledged however that vexatious notifications can have a significant impact on practitioners. [Compare with Mr Fletcher’s evidence: They looked at 850 mandatory notifications over a 12-month period. They found fewer than six that they believed potentially met the criteria for a vexatious notification. The point I am also making is that, even though the numbers are small, we recognise that the impact on the individuals involved can be significant.”]
If Federal Government and endorses Martin Fletcher’s evidence about Marie Bismark, which Marie Bismark herself rejects, then health practioners subjected to vexatious claims will naturally commit suicide blaming AHPRA in notes.
If Senate Committee misrepresents Ombudsman to design myth, as a basis of a trash worthy recommendation, obviously health practioner like Yap would commit suicide protesting such design.
If the CEO is such a flaunting liar in the public, how different could be his investigators from him?
How can such a team work with honesty?
I recommend AHPRA be dissolved.
I recommend health practioner subjected to vexatious claims be found. Recourse and compensation be granted.
Or else the Senate inquiry into AHPRA by the particular Committee right before national elections would look like a election stunt, a mere outward show, or a performance, with no intention whatsoever to solve the issues. The witnesses will be sacrificed to AHPRA at the altar of national elections. The Senate inquiry into AHPRA by Senate Committee was launched before 2016 national elections. It still is before 2021/2022 national elections.