The Crime and Corruption Commission (CCC) has finished assessing a referral from the Queensland Audit Office (QAO) about the treatment and billing practices of 12 senior medical officers (SMOs) and has determined it will not launch an investigation.
The findings of the assessment are outlined in a CCC report released today: Conduct of Senior Medical Officers in treating and billing private patients in public hospitals .
In January 2014, the Queensland Audit Office (QAO) referred a copy of its report Right of private practice: Senior medical officer conduct to the former Crime and Misconduct Commission (CMC) to determine whether the information raised a suspicion of official misconduct and warranted an investigation.
The QAO report identified 12 SMOs who were allegedly inappropriately treating and billing private patients in Queensland public hospitals. In particular the QAO report alleged:
- That SMOs without right of private practice contracts were treating and billing their private patients in public hospitals, and were therefore being paid by the hospital and earning private sector income at the same time, effectively double dipping and potentially in breach of the Health Insurance Act.
- That SMOs with right of private practice contracts were treating their private patients in public hospitals in their own time and keeping the income earned, allegedly in breach of their contracts.
When the CMC/CCC receives a referral, it first assesses the matter to determine whether it is within jurisdiction, whether further investigation is warranted and, if so, what is the appropriate body to conduct that investigation.
Due to the large volume of material involved and the need for specialist legal advice, the CMC engaged retired Supreme Court Justice, the Hon. Stanley Jones AO QC, to independently review information provided by the QAO, assess the allegations and advise whether an investigation was warranted.
In relation to both sets of allegations, the Hon. S Jones concluded that while the material in some instances exposed conduct which justified the concerns raised by QAO, there was insufficient evidence of official misconduct to warrant investigation by the CCC, particularly given the absence of any other adverse conduct.
Regarding the SMOs without right of private practice contracts, the Hon. S Jones found that their practices were done with the knowledge and apparent agreement of hospital administrators. He found no evidence that their practices were dishonest or done so as to deliberately deceive hospital administrators.
Regarding SMOs with right of private practice contracts, the Hon. S Jones found that the issue of whether specialists were entitled to retain fees earned from treating private patients outside rostered Queensland Health time depended on the interpretation of their contracts, and that different hospitals had adopted different approaches.
Having been informed by the Hon. S Jones’s consideration of this matter, the CCC agreed with the assessment and has determined not to investigate the matter.
The CCC notes that the uncertainty around the SMOs’ contracts has been resolved, and that Queensland Health has accepted recommendations stemming from the QAO report.
The CCC did identify information about two SMOs which warranted further examination. The CCC determined that these matters could be most appropriately dealt with by the relevant Hospital and Health Service.
Further information about the assessment of this matter and the alleged conduct of SMOs is available from the CCC’s report available on the CCC’s website:
ENDS
