That this House notes with concern issues emanating from the Launceston General Hospital over the past two months where the services of cardiology/angioplasty services come into question because of the non-renewal of a medical specialist's contract and calls on the minister to ensure that a more open, consultative policy is implemented between Tasmanian hospitals and the communities they serve in the future.

Mr President, this motion occurs from the perceived ordinary handling of Dr Forrest's contract by the chief executive officer and the clinical directors of the Launceston General Hospital. That is the perception held by members of the public. I also believe that the Government must shoulder some of that responsibility in that there has been little or no transparency demonstrated with the handling of this very important matter.

It is well known here that I attempted on several occasions to elicit from the Government answers to the questions that are being asked by the residents in the north of the State and across the north?west as well. Why isn't the contract being renewed? Has the Government inquired into the circumstances? However, those questions, when asked - and my understanding is that they were asked I think on two occasions because on one occasion some of the questions were not answered - were asked without any avail. There was no real comment made in relation to those questions other than to say that there was no answer to them and that they would not be answered by the Government.

That upset me, I must say, at the least. I have looked at this long and hard and I have attempted to find answers to explain the way in which the contract has been managed and the real reasons for the contract not being renewed. I certainly could not find the evidence that the service was no longer needed. In fact the people in the north know very well from the many experiences cited when Dr Forrest is said to have saved lives that the service with no downgrading is absolutely essential for that part of the State. It leads me to these questions: is Dr Forrest not carrying out his function as a cardiologist to a satisfactory standard? Or is he far exceeding the level of service expected? Or is he too contemporary for the Launceston General Hospital? Or involved in or is at the centre of personality clashes with the chief executive officer and/or clinical directors? Or is he involved in other practices that are not acceptable to or condoned by the administration of the Launceston General Hospital?

Mr President, some explanation is either required from the chief executive officer of the hospital and/or the Minister for the Department of Health and Human Services who, after all is said and done in a Westminster system as we have, is the responsible officer and answerable and accountable for the affairs of his portfolios. This is why I cannot understand why a number of my questions were not answered in the first instance. This has not occurred publicly and will not occur and therefore further debate and policy changes, in my opinion, are necessary to shed some light on this unfortunate occurrence and to ensure it never occurs again without a public explanation or some consultation.

Mr President, if policy changes are not undertaken nothing is learned from the experience and we continue to allow bureaucracies to run rampant and perhaps see competent and professional employees unfairly dealt with. We will certainly see the public left tormented, distressed and aggrieved. That very clearly is the current position as it exists in the north and the north-west of this State. The public are grieving. I think that had they been given some explanation that may not have occurred.

I do not accept that it is the intention of any contract, however negotiated, to see any person dealt with less than transparently and fairly. If this is not the situation then I would expect and assume that employees in the future will be reluctant to enter into any contracted position. I have been there and I speak on this subject with some experience. Of course, in this instance Dr Forrest is resisting the way in which this case for renewal has been handled and has taken his case to the Tasmanian Industrial Commission and now we know it was taken to arbitration on Thursday of last week because he is alleging lack of due process - and rightly so if the little evidence we do have is correct.

Mr President, I refer in this instance to the Examiner report on Wednesday 10 September 2003 at page three of that paper. If that report is accurate, and there is no reason to believe otherwise, are we now to suspect that Dr Forrest's demise is connected to his desire to increase the efficiency and productivity in the State's public health system and his desire to resolve grievances through consultation and discussion? Are we to believe that?

Dr Forrest, like us, has asked repeatedly for reasons why his contract will not be renewed. He has met the same brick wall - the same brick wall met by me and the same brick wall met by everybody else inquiring into this case. At least in my case I was given the reason of succession planning, if nothing else. Dr Forrest is not even afforded that lame explanation.

No employee deserves this level of surreptitiousness and secrecy when it impacts on their future and their families. If we sit back and allow this to happen without some changes of direction then we can only expect employment conditions for State Service government employees to deteriorate to unacceptably low levels. It would not survive in private enterprise without considerable disruption to the employer, I would say. Dr Forrest is the only interventional cardiologist in the north and on the north-west coast. He is said to be very professional. He is said to be a good surgeon and one who will put the life of a person foremost, before inconvenience and financial imposts. I believe the financial position is a concern for the hospital in this instance. Why would it not be when it is not your life or the life of a loved one? That is not to say that wasting finances is condoned and I certainly do not condone that under any circumstances.

As I said in a special interest speech in this Chamber on 3 September, Dr Roger Allan, who is the director of cardiac services in medicine at the University of New South Wales, identified Dr Forrest as a capable angioplaster providing a level of service equalled by few centres across Australia.

This report was dated 29 November 2002. But why or by whom it was called for, the public do not know. This too is shrouded in mystery. The public assumes, of course, that it was called for by the CEO of the Launceston General Hospital. That is their belief. If it was, then I would say that it was not the type of response wanted or expected.

The service provided by Quentin Forrest and particularly the same level of service is necessary in the north of this State. If that same level of service is not maintained it will result in avoidable morbidity and mortality, and it is very likely there, too.

The community has a real concern that cardiology services in the north of the State will be downgraded despite the assurances given by the Health minister, Mr Llewellyn. They still have grave concerns that the services will not remain at the same level, and/or better. Mr President, I provided an example on Wednesday 3 September supporting the need for this service; I provide a different example on this occasion which supports the need for a similar level of service being maintained, and also supports the need for this inquiry. There are many examples that have come to me in the past few weeks that I could have referred to. I will select this one.

I will refer to this patient as Peter only, as it is his request at this time; I also use the word 'victim' because that is what he also became in this case. During the week of 1 September, Peter was admitted to the Launceston General Hospital where he was attended to by Dr Forrest. He was diagnosed as having a chronic heart ailment, necessitating a triple bypass operation. While not categorised as critical - that is, in a life?death situation - he was told that it was extremely serious and that an operation should be performed without any unnecessary delay. Had Peter fitted into the first category of critical life?death situation, then Dr Forrest could have carried out an operation at the Launceston General Hospital.
An attempt was made to book Peter into the Royal Hobart Hospital for the procedure to take place; however, Hobart advised that there was a backlog of patients, a dearth of beds and that there would be a waiting time of five to six days and possibly longer. This is my understanding, this is the information provided to me. This man was a private patient, had private health cover, and I am advised by both Peter and his wife that both Launceston and the Royal Hobart Hospital were aware of this fact, and that is significant. This is a given, and I will refer to it again in a short time.

Dr Forrest had further discussions with Peter and his wife during which he advised them the situation was serious and the operation should be performed as soon as possible, and waiting should not be a consideration. Peter was booked into the Warringal Hospital in Victoria and was operated on two and a half days later. Mr President, Peter and his wife advised me, it was their advice to me, that the surgeon involved made it plain that he, Peter, was unlikely to have survived another four days for the operation. He is making a slow recovery at his place of residence in the north, and is full of praise and admiration for Dr Forrest for the diagnosis, the advice and the urgency for operation.

This example is not complete and has another part to it, as I previously alluded to. The hospitals at Launceston and Hobart - this is not Dr Forrest - are now telling Peter and his wife that, as a private patient, a bed was available in Hobart and the operation could have been done within a day or so and, more importantly, they, Peter and his wife, were told this. That is what Peter and his wife have told me is the situation, they were never ever told that, that is their strong belief and view. Peter and his wife are extremely annoyed at the suggestion - as they say, that conversation never occurred, and had it taken place they would have opted for Hobart, as they did not want to leave the State. The family are of the opinion that this is an attempt to cover any further bad publicity for the system, or as protection for an individual or individuals. They are adamant this conversation did not occur and are in a position to assist further with any inquiry should anybody wish to undertake that.

The public keep asking the questions. These came out at the public meetings that I have been to, they have come out from the many comments that have been made to me by members of the public. What is going on? What is happening? Why are we playing around with people's lives? We have a good surgeon, why can we not keep him? The evidence we have would suggest that there are underlying factors in this case that need further discussion and require an answer - factors that need to be brought out into the open as we are playing with the lives of many innocent people who should not suffer because of internal wrangling or, in their view, mismanagement, or personalities - and that does come out fairly strongly in this case - or whatever the underlying factors might be.

Mr President, one thing is clear in my opinion and that is that both the hospital and Government's handling of this case has left a lot to be desired. It has been ordinary, to say the least, in my view, and if we sit back now and do not push for some policy changes then we deserve to receive the wrath of the community, as we have done in this case. With a little openness and a preparedness to talk, I am convinced that many concerns of the public could have been allayed and perhaps this motion may never have eventuated. Of course there has now been discussion and a willingness to talk by the hospital and the Government - and I will refer to that aspect later. Surprise, surprise!

This is an extremely emotive matter for the public and particularly those people who are alive today and family of those people who have been the beneficiaries of the very professional expertise of Dr Quentin Forrest. There is a groundswell of support for the retention of his services and if that cannot occur the community wants an assurance that future similar cases will be dealt with transparently and in a consultative manner. That is what the public is asking for. A petition containing, as I understand it, about 8 600 signatures has been presented to the Government. I also understand that a number of those signatures were not valid and were deleted from that list, but nevertheless, 8 600 signatures appeared before the Government, I understand, in the first instance as part of that petition. I do not believe that the Government has an appreciation of the extent of the public concern regarding this matter. Surely the petition numbers will cause the Government to stand up and realise changes to policy are necessary. They have to take into account the groundswell of support there is in the north of this State in this instance.

Mr President, I call on all members to unite in this instance in support of government policy changes. If the CEO, the clinical directors and the Government have acted with fairness, honesty and in the best interests of the northern public, why have they not come out and delivered a carefully worded explanation for this debacle to the community? It is all we are asking for and it is all the public were asking for: a carefully worded statement, not breaching any contracts, but a carefully worded statement.

I previously made reference to the reluctance of the Launceston General Hospital and the Government to talk openly about this matter. Lips were sealed on every aspect of the hospital and so much so that correspondence to the hospital was ignored. Albeit an explanation has now been forthcoming on this failure, I remain with my belief that this also was handled poorly by the hospital. That reluctance to talk about this issue was abruptly and, I might say, expectedly broken on the day following the media statement concerning the public meeting at Devonport. This silence ended on 11 September. Of course we know that on 10 September the media reported that a motion came out of the public meeting the prior night calling for a Legislative Council select committee inquiry into the circumstances surrounding Dr Forrest's demise and the services provided by the Launceston General Hospital.

Mr Harriss - They were probably on the same wavelength at the same time, that's all.

Mr DEAN - Maybe. Perhaps that can be explained.

I had a conversation with a Launceston General Hospital board member and I might say many of my concerns were answered there and then. However, I should say that I continue to have some reservations concerning the process and the real reasons for not renewing the contract and the future services of the hospital with cardiology matters. But a lot of my questions were answered, and that is what I have said all through this case: had some answers been provided at the right time then this never would have reached this stage. At that meeting with me a willingness was demonstrated to also talk with the public committee that had been set up in the north of the State to pursue this case. This committee is made up of concerned residents and includes Mr Doug Stingle and Mr John Archer who are well-known identities in the north of this State and would be known, I would suggest, to a number of people here today.

Mr Stingle set up the meeting to take place at the hospital on 23 September because of an indication to me that the hospital would be prepared to talk with the public committee. A meeting was set up to take place on 23 September and in turn the committee kept the appointment. The public committee kept that appointment and they went to the hospital.

The second party representing the hospital failed to show up and the committee was told that a breakdown in communication had occurred and the meeting could not take place. I mention this simply to demonstrate the further mismanagement that I believe has been synonymous with this case throughout. There was no reason for that to have occurred. The public committee could have been told prior to that meeting date and prior to their arrival at the hospital that the meeting would now not take place.

A further meeting took place on 24 September with senior hospital and government staff and those present on this occasion were the CEO, Ms Liz Stackhouse; Dr Peter Renshaw, Deputy CEO, Director of Clinical Services, Division of Medical Services and Clinical Support, Launceston General Hospital; Mr John Ramsay, Secretary, Department of Health and Human Services; Ms Anne Brand, Deputy Secretary and Director, Hospital and Ambulance Services Division; and Mr David Morris, Senior Private Secretary to the Minister for Health and Human Services.

Also at that meeting were members of this House: Mr President and honourable members Sue Smith, Norma Jamieson, Michael Aird and myself. The meeting was welcomed and I thank those people involved. It assisted in allaying further concerns and confirmed with me that cardiology/angioplasty services provided by the Launceston General Hospital will not decrease and in fact are most likely to improve.

That came out of that meeting. Wonderful news. We were assured that Dr Forrest will be replaced, and almost assured - I am not quite sure where I should go with that - that an additional cardiologist would be appointed in the near future. So Dr Quentin Forrest would be replaced and there would be an additional person. Unfortunately these meetings have been unnecessarily delayed and resulted only from the call for a select committee inquiry, in my opinion.

I doubt that the Government or hospital would deny this position, I doubt it very much. This has caused me undue worry and anxiety and was not necessary, in my view. That is not to mention the concerns and tribulations experienced by other northern and western members and the public. I appeal to the Government to ensure that a similar position does not arise again.

I want to refer to the select committee inquiry into the Health Act 1997. Mr President, to complete my position on this matter I need to refer in some detail to the abortion of the select committee inquiry application.

This is the application that I had been asked to put up by the public attending the public meeting. I understand that legal opinion has been sought from the Solicitor-General with regard to section 4 of the Health Act 1997. Section 4 and the subsections thereunder relate to quality assurance committees declared under the Health Act 1997 and their disclosures of information - evidence - to any court, tribunal, board, agency or person.

The section identifies that:

'a committee or member is not required to produce any documents or divulge any communications or any matter or thing within their notice or to which they have knowledge.'

A parliamentary select committee inquiry is a court, tribunal, board, agency or person within the meaning of that section, and I accept that position. The legal opinion received, I understand, identifies that on its face a select committee inquiry would be a waste of time and public money, having regards to the restrictions imposed by section 4 and in particular subsections (3) and (4) thereunder.

I just make this comment. The words 'not required' are interesting, in my opinion. My interpretation of those words is that the Launceston General Hospital committee board, made up of the five senior clinicians, could disclose all information in their possession should they desire to do so. I am told the committee did rely on the Health Act 1997, section 4, subsections (3) and (4), and they would not disclose any information. This worries me because if the Launceston General Hospital clinical directors committee - and that is what it is referred to, as I understand it - have acted transparently and fairly in their decision not to renew the contract of Quentin Forrest, what would they have to fear from such an inquiry? One could be cynical and say that they could be uncomfortable with the process as it evolved and that there is a realisation of unfavourable information coming to light if it were to proceed. I do not know the reason but this very clearly has been raised by a number of people in the north and we know of 8 000 plus because of the petitions and these people all harbour concerns for the process and the failure to renew the contract - and that was a part of that petition.

Mr President, I have great difficulty in accepting that the intention of this legislation is for the purpose of thwarting reasonable inquiry and a bringing into the open of practices or events that do not accord with due process or are a denial of natural justice. I was not here in 1997 when this legislation made its way through this Council and therefore had no say in its current form. It is unsatisfactory legislation in my view and needs revision and I would ask the Government to do exactly that. It is dangerous, in my opinion, and an unhealthy practice to allow any committee, whether it be public or otherwise, to run with immunity. There is a very common saying, 'Power corrupts, absolute power corrupts absolutely'. It has proven to be right in many instances. I am not saying that the clinical directors committee is anything other than competent, ethical and fair. However, I am saying that checks and balances are a necessary part of any committee, board or what have you.

The public have been very active in this case, Mr President, as you would be aware, and have formed a committee to work through this case and as a conduit to government and Parliament for the people. I cannot speak highly enough of this committee and a community that has fought hard and long in this case. There have been two public meetings called in support of an upgrading of services at the Launceston General Hospital and in support of Dr Forrest holding his position as an interventional cardiologist. These people will not give up and will remain formed and active until such time that improved services are in place, in line with the statements of the minister, for interventional cardiology services in Launceston. They will continue to fight for Quentin Forrest and a restoration of his position into the foreseeable future, until they can see that there is no possible chance for them in any way whatsoever. They have made it strong and clear that they will not give up. This is such an important issue for them that they are not prepared to sit down. People are to be congratulated for hanging in there, in my view, and for the professional way in which they have been or are handling this matter. They are deserving of kudos and, in my opinion, have been largely responsible for ensuring that cardiology services in the north will not be downgraded and in fact will be upgraded. That is what we are told. I take my hat off to these members of the community; we need those types of people in a community.

Whilst I have been involved in this matter there have been a number of twists and turns. I am really not quite sure at times where I have been or what has been going on. There was another one late last week, I understand, and I will refer to that now. It confirms with me that things have not gone the way they should have done in this case.

Since putting this brief together, which was not long ago, another interesting turn of events has surfaced. I have really had difficulty in keeping up with the twists and turns, as I have said, in the case, and this information is just another part of what I believe highlights inadequacies of the processes in place to openly and fairly deal with high-level employees in our public hospital system. It has now come to my attention that on Wednesday night last at 6 p.m. - and this date is significant in that it is the evening prior to the commencement of the arbitration hearing for Quentin Forrest; this is the night before - a document was faxed to Dr Quentin Forrest advising him that the clinical staff credentialling and appointments committee, at its meeting on 24 September 2003, the day prior to the arbitration hearing, recommended a review of his, Quentin Forrest's, clinical privileges. It contained other detail. This is the meeting a day before arbitration.

That fax, I understand, purports to have been sent by the CEO of the Launceston General Hospital, Ms Liz Stackhouse. I am told and I understand the fax is dated 12 August 2003; it refers to a meeting that occurred on 24 September - mental telepathy, I suppose, I am not quite sure, but I suspect it was a typographical error if that in fact is right. The letter is signed off 'Yours sincerely, Liz Stackhouse'. Accepting that the document is an authentic document - and there is no reason for me to believe otherwise - what is going on? What is happening? The day before arbitration and Quentin Forrest has been told, at this stage he has been told categorically his contract will not be renewed, and he also only has, at this stage, a few days to serve. I would like confirmation and an explanation of the facts, but I doubt that I will ever get that. Perhaps the Leader could inquire into the circumstances. If it is authentic, then maybe a logical explanation is available.

In conclusion, Mr President, I am more than satisfied that the handling of this case leaves a lot to be desired. I am satisfied that the lack of communication, consultation and transparency led to this case creating enormous unrest and hurt in the north and north?west of this State. I am satisfied that changes must occur to ensure that it is not likely to occur again. I call on the minister to put into place a policy or amendments to any existing policies that ensure transparency and adequacy of explanation for the public, and I refer to our public hospital system in this regard. I further call on the minister to put into place whatever guidelines are necessary within DHHS to cause improved communication channels within the hospital system.

Mr President, I make no apology for time taken in this case, as it is critical, requiring immediate attention to ensure that patients requiring interventional cardiology services in the north of the State are provided similar services to those in the south of this State. We are talking about life and death and nothing less.

I urge all members to support this motion.