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
- 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
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.
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
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
and the relationship between the diagnosis and the elements of employment
that HealthQuest considers the employer cannot perform.
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.
appeal mechanisms when people are declared unfit for work.
- The practices
employed by MAP were not considered transparent or fair.
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
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.
Patient Support Office