Ministerial Cover Up at LB Prison Hospital

“The Law and Justice Committee of the Legislative Council is inspecting the Long Bay prison and forensic hospitals this morning after an urgency debate on the effect of the early lockdown on mentally ill patients” said JA Coordinator Brett Collins.

“The government has been condemned by the entire Australian mental health profession for that cost-cutting decision, and it promised to move all forensic patients into hospital conditions by the end of last month. That has not been done” said JA Coordinator Michael Poynder.

“The Minister for Justice Hatzistergos rejected Committee members’ requests for the Nurses Association and Justice Action to join the Parliamentary inspection as expert advisers. This leaves the mental patients to speak for themselves with guards present, despite the immense experience offered by both independent organisations. This arrogant abuse of power isolating patients from community support could never be justified” said Mr Collins.

“One of the patients, an Iranian citizen, has been rushed by ambulance to the Prince of Wales Hospital. He has refused his heart medication until the lockdown ends. The Iranian Ambassador Mahmoud Movahhedi has written to the Premier and Prime Minister saying the ‘allegations have become a matter of concern for the Islamic Republic of Iran’ and asked them to investigate alleged violations of his civil, legal and human rights” said Mr Poynder.

For comments:

Brett Collins on 0438 705 003
Michael Poynder on 0401 371 077

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Slow release for mentally ill prisoners

This would occur over time and there would be no sudden mass release of prisoners: MHRT

As many as 2000 NSW prisoners will receive improved psychiatric care under a revision to forensic mental health legislation.

The changes will also secure the earlier release, under community treatment orders, of some people whose illness had previously made them unsuitable for parole.

Greg James, QC, president of the Mental Health Review Tribunal and architect of the reforms - already enacted and likely to go into effect from February - said the tribunal would supervise psychiatric treatment for prisoners and ensure it continued after their release. According to some estimates, nearly half of prisoners have some form of mental illness.

Court diversion programs are preventing about 1600 mentally-ill people a year from receiving a jail sentence, but the changes mean that for the first time psychiatric treatment for those who are jailed will be co-ordinated with treatment after release. Both will be under the tribunal's supervision, with individual treatment orders made by a panel comprised of a judge, a forensic psychiatrist and another mental health practitioner.

Mr James said about one-fifth of some 2000 forensic patients had been judged unfit to stand trial on account of their mental illness, while the remainder were serving their sentences. Of these people, about 1000 might otherwise be eligible for parole, but "the parole board does not regard them as capable of adjusting to community life," he said.

The new treatment regime would accelerate such people's parole, Mr James said, but this would occur over time and there would be no sudden mass release of prisoners. "The expertise is all in place" in community health services, he said. "I don't think you'll find community agencies will be stretched."

Philip Mitchell, the head of the school of psychiatry at the University of NSW and chairman of the NSW Mental Health Priority Taskforce, said the standard of mental health care in jails was improving. "It's not perfect but there's been a shift and very capable people are moving into forensic mental health," he said. Young doctors now competed for training places that had previously been impossible to fill.

Nevertheless, the legislative changes and a new forensic hospital to be opened at Long Bay but run by NSW Justice Health (a division of the NSW Department of Health) represented "a huge expansion" in psychiatric services, Professor Mitchell said. "The challenge for the system will be getting enough staff."

John Basson, the statewide clinical director of forensic mental health within NSW Justice Health, said many senior doctors had applied to work at the facility, but the agency was having difficulty attracting enough junior doctors. Mental health nurse recruitment was also problematic. "We're struggling like everyone else," he said.

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Rise in hospital attacks by mentally ill

THERE has been a 50 per cent increase in assaults at NSW hospitals in the 10 years to 2006, mostly upon staff, with a significant rise in attacks by mental health patients.

A report by the NSW Bureau of Crime Statistics and Research said that most assaults occurred between 3pm and 9pm, peaking on Sundays between 3pm and 6pm, and more often involved males.

A lack of mental health facilities was raised at the Garling public hospital inquiry recently and mental health staff at Nepean and Prince of Wales hospitals have publicly complained about psychiatric patients blocking emergency and a sharp increase in assaults on staff.

The Illawarra region has had a spate of resignations from its mental health ranks, including the director, Monica Taylor, who quit two weeks ago, and the chief psychiatrist, Irwin Pakula, who was fed up with the administration.

The bureau's report found that from 1996 to 2006, police-recorded incidents of assault at hospitals across the state have increased from 214 to 322.

In more than two-thirds of the assaults, the victim was a stranger and was most often either a hospital staff member or police officer.

The report said the cause of the increase in assaults was "unclear" although there was anecdotal evidence that hospitals, particularly emergency departments, had become increasingly strained over the past 10 years.

The introduction of a "zero tolerance towards violence" policy by NSW Health might have encouraged staff to report incidences.

When adjusted for population, most of the assaults occurred in the Hunter region, followed by Sydney metropolitan and the Illawarra.

The most notable trend over the period was a "dramatic" increase in assaults by mental health patients, which increased from 19.2 per cent of all assaults in 1996 to 31.7 per cent in 2006, representing a 65 per cent increase, the report said.

The Opposition health spokeswoman, Jillian Skinner, said frontline workers bore the brunt of the Government's failure to deliver adequate mental health services.

"Hard-working doctors and nursing staff should not have to accept assaults on hospital premises as part of their job description," Mrs Skinner said.

The Health Minister, John Della Bosca, said NSW Health had improved security in public hospitals with more closed-circuit televisions and duress alarms, safer entry and exit points, and better lighting and car park security. Mr Della Bosca said the Government also provided 450 new mental health beds between 2001 and last year.

He said the bureau found a 25per cent drop in assaults from 2005 to 2006. Most increases in assaults occurred between 1996 and 2001, with a significant drop between 2005 and 2006 from 6.2 hospital assaults per 100,000 people to 4.7 per 100,000.

But the data includes only assaults reported to police, just a fraction of the average eight a day across the health system. In 2006, alcohol caused 30.5 per cent of assaults; drugs, 17.1 per cent.

Professor Gordian Fulde, the director of emergency services at St Vincent's Public Hospital, said the jump in assaults was probably due to increased reporting and a huge increase in mental health patients over the past five years.

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The reports, obtained under Freedom of Information, reviewed medical errors at western Sydney hospitals and found most of the avoidable deaths were due to delays in responding to a rapidly deteriorating patient.

In three cases last year, surgical material or instruments were left inside patients.

The Opposition's health spokeswoman, Jillian Skinner, says the findings are disturbing.

"I know that people are dying in hospitals through avoidable causes because this has been partly reported," she said.

"But the extent of this is really shocking and I think Reba Meagher has got some answering to do today."

Professor Steven Boyages from the Sydney West Area Health Service says there are lessons that can be learned from the errors.

"How do we address the issue is the key lesson that we have to take away from these individual cases," he said.

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Ten dead at nursing home

THE deaths of 10 elderly people in three weeks at a Blue Mountains nursing home last month were not reported to police or the State Coroner's special investigations unit, NSW police said last night.

It was incumbent on any medical practitioner treating patients at a nursing home to report a death, police said, if there were any other deaths that might be related.

"We have checked with the crime manager for the Blue Mountains Command and he has checked their records for the past month and there are no reported deaths to police from any nursing home … at Springwood," a police spokesman said last night.

Police are expected to begin an investigation today into a report by the Health Department, which broke the news of 10 deaths at Endeavour Nursing Home, Springwood.

The department played down suggestions the deaths were caused by gastroenteritis but said it would investigate again.

In a statement the department said 83 residents of the home were struck down with diarrhoea and other painful symptoms late last month.

Food poisoning was investigated as a cause but the NSW Food Authority ruled that out after inspecting the home.

The acting deputy chief health officer for NSW Health, Jeremy McAnulty, said the results from tests on a number of ill residents had found Clostridium perfringens, a bacterium that can cause food poisoning.

"Infection with this germ is characterised by sudden onset of diarrhoea of brief duration, often with stomach cramps, 10 to 12 hours after ingestion of contaminated food," he said in a statement. "During the outbreak period 10 residents died from a variety of apparently unrelated conditions. Some of these had had mild diarrhoea."

Dr McAnulty said many of the death certificates gave the cause of death as pneumonia and other unrelated conditions. The risk of further infection was thought to be low. "However, all precautions are being taken, including an epidemiological investigation and reinspection of all food-handling procedures, to protect other residents."

Extra control measures during food preparation and handling would be implemented, he said.

The NSW Food Authority inspected the home and found no obvious breach of protocols, the statement said. NSW Health said a panel had been convened to help the investigation. The nursing home had appointed an officer to monitor staff and food handling.

The NSW Combined Pensioners and Superannuants Association last night called for an investigation by the State Coroner.

The association's policy co-ordinator, Paul Versteege, said NSW Health and the federal Minister for Ageing needed to explain how it could be presumed that the 10 deaths had nothing to do with bacterial infection after bacteria was detected in residents after two gastroenteritis outbreaks.

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Updated: Mon 14 10:24am (AEST)

Nursing home deaths: Old food blamed for outbreak

Health authorities believe a food-borne illness caused a gastroenteritis outbreak at a Blue Mountains nursing home, during which 10 elderly people died.

More than 80 people were struck down by gastroenteritis at the Endeavour Nursing Home in June.

New South Wales Health communicable diseases director Jeremy McAnulty says some of the 10 deaths during the period appear unrelated to the outbreak but it cannot be ruled out as a contributing factor.

"Certainly, some of those deaths seem unrelated in that they didn't have any diarrhoea at all," he said.

"Others were people who did have some diarrhoea that seemed to have gone away before they died of some other reason.

"But we can't rule out that some deaths in the frail people, on top of their underlying condition, having diarrhoea may have contributed to that, so we don't know that for sure."

Food Authority inspectors have given the nursing home the all clear and Dr McAnulty says there is no ongoing risk.

"We have found toxin that's commonly found in food-borne outbreaks that's called clostridium perfringens," he said.

"That's a toxin produced by bacteria that's found in food after it's been sitting around for a while, so that plus the nature of the outbreak - that sudden sharp increase and it going away - all adds up to a food-borne outbreak."