Ms O’CONNOR – Thank you, Chair. Minister, I have a question regarding the handling of a medical officer as described in the Custodial Inspector’s Report. The report claims a medical officer was banned from entering the prison as a result of their decision that a patient who’d swallowed a razor blade should remain at the Royal for a few more days against the wishes of the TPS. I note that the director of prisons responded that this was in fact the result of a series of decisions made by this doctor.
Minister, through you, it is the case though, isn’t it, that the decision to ban entry was a direct response to this particular clinical decision or advice from the doctor that the inmate should spend more time in the Royal because they’d swallowed a razor blade. The timing of this ban makes it pretty clear that while your director of prisons might’ve said there’s a range of reasons they banned that medical officer from prison it was a response to her advice that this inmate should spend more time in the Royal. The doctor provided clinical advice. Minister, why did TPS management think they knew better?
Ms OGILVIE – That is a question that I would like to refer. I understand there was some response to the report that you have referenced, and the department did have a look at that. Thank you.
Mr WISE – Thank you, minister, through you. I think, Ms O’Connor, the depiction of the issue is probably not as balanced as I think the TPS would like to see. Indeed Ian Thomas, the director of prisons submitted a response in the Custodial Inspector’s Report. It wasn’t a ban in the first instance. The matter was dealt with fairly clumsily, I think everyone would concede. But the doctor as she was entering the prison was asked to not go to her normal place of duty but to go to a meeting where a number of issues were going to be discussed. That was handled poorly, I think.
Ms O’CONNOR – By prison management?
Mr WISE – Well the communication between prison management and the people at the gatehouse, I think was substandard and indeed it caused some consternation. That consternation I must say was sorted out fairly quickly with the doctor in question and there is a very very good working relationship with that doctor. Things were sorted out, discussed, settled and people have moved on. It certainly wasn’t the case that the Tasmanian Prison Service was questioning the clinical judgment of the doctor. There were a number of issues that were of concern to prison management at the time involving the safety of staff and others and those matters were addressed and addressed absolutely satisfactorily.
Ms O’CONNOR – Thank you. I’m a bit surprised to hear that there’s a view that the custodial inspector may have been wrong about the treatment of this medical officer on site. Can you explain to the committee, and through you, minister, how a decision for the patient to remain in the Royal Hobart Hospital for a few days for monitoring created a potential risk to the safety of staff, which we’ve just had referenced including the doctor herself, from prisoners?
Ms OGILVIE – I’m very happy to answer that.
Mr WISE – Through you, minister. That wasn’t the issue that was potentially going to create the issue around the safety of staff. The clinical issue though is a tricky one as many of these are. We do have inpatient facilities at Risdon prison complex for the observation of people who are ill. When we take people to the Royal Hobart Hospital we need staff on them, and if we’ve got two or three staff managing a person in a hospital doing a bedsit at the hospital that means that those staff can’t be deployed in the prison getting people out of cells for example. Or alternatively it means that another person who might benefit from being taken to the Royal is unable to be conveyed there.
There is always an interest from the TPSs perspective in trying to clear people from that hospital environment where they can be placed in a safe environment with nursing staff providing that supervision in the inpatients area, and to free up staff to do custodial jobs and get people out of cells and so on, or to take other people to the Royal. There is legitimately, I think, some dialogue between the TPS and medical staff about can this be safely done.
Ms O’CONNOR – I guess that goes to the next obvious question. When there is clinical advice being presented where does the balance lie between a doctor saying, ‘I believe this in the best interests of the patient’, and TPS imperatives around staff management? I would’ve thought clinical advice trumps management worries.
Ms OGILVIE – I can see you’re ready to answer that. I’m very happy for that and then perhaps I’ll make a comment on the way back through.
Mr WISE – Through you, minister. Indeed, that is the case, Ms O’Connor. The clinical judgment is the one that prevails. The TPS will ask whether the matter can be dealt with in another way but if the medical advice is, ‘this person needs to stay in hospital’, that person stays in hospital.
Ms O’CONNOR – So what happened in that instance in terms of making sure that we’re not having these issues again and has there been any engagement with the director of prisons, for example, just to reinforce that when clinical advice is provided it really has to take priority in terms of decision-making?
Mr WISE – Through you, minister. That dialogue was not required with the director of prisons. The director of prisons fully understood that that was the case and continues to be.
Ms O’CONNOR – Through you, minister, it was the gatehouse staff, was it? Is that where the problem laid?
Mr WISE – No. They were separate issues. Through you, minister. They were separate issues. There were a number of issues. The clinical judgment in relation to that one prisoner was just one of them.
Ms O’CONNOR – I just want to get to the bottom of what is an apparent contradiction between what’s in the custodial inspector’s report about this medical officer being effectively banned from the site and what I’m hearing here at the table today. What exactly happened with this medical officer who was providing this clinical advice in relation to this inmate? If it wasn’t a ban or a prevention from this doctor entering the site, what was it? How could the custodial inspector get this wrong, apparently?
Mr WISE – That’s a very very good question.
Ms O’CONNOR – So, you think they got it wrong?
Mr WISE – I think they got it wrong. There were a number of issues that the TPS management wanted to discuss with this particular doctor. She wasn’t banned from entering the position. The intention was to get her into a meeting where some of these issues could be discussed. The custodial inspector’s team was entering the gatehouse at exactly the same time as –
Ms O’CONNOR – Serendipity.
Mr WISE – Serendipity maybe, and so witnessed something and I think got the wrong end of the stick and –
Ms O’CONNOR – But that wasn’t clarified between the department and the custodial inspector?
Mr WISE – I can assure you that there were many discussions with the custodial inspector about his team’s interpretation of what happened and what the TPS believed was the case.
CHAIR – Thank you.
Ms O’CONNOR – So just to be really clear, just one more. Sorry, Chair. The custodial inspector describes it as a ban that relates to a clinical decision that was made by the doctor in relation to an inmate. On those two grounds I am hearing that the prison service thinks the custodial inspector got it wrong.
Mr WISE – Through you, minister, I think that the commentary in the custodial inspector’s report is absolutely contested.
Ms O’CONNOR – Thank you.
CHAIR – Thank you.
Ms OGILVIE – Sorry, and just to add a couple of comments – and thank you very much, both, for what I think was a helpful dialogue, but I do want to also note for the record that the report itself does note that the good working relationship exists between the correctional primary health service and also the prison service. Whilst maintaining that the actions were necessary, TPS has conceded – and I think you said this originally – that the matter was handled or managed ‘clumsily’ and they have apologised. I just thought it was worth making sure that we wrap that up at the tail end.
CHAIR – Thank you, minister.
Ms O’CONNOR – Thank you, Madam Chair. Minister, I want to take you back to the custodial inspector’s report: Adult Healthcare Inspection Report 2023, to page 200 and 201. We have just been told at the table that what the custodial inspector reports about a ban on a medical officer who was a member of the corrections primary health service was not a ban. On page 201 it says that, and now we know the inspection team was there at the time that this medical officer was, according to this report, told by a junior correctional officer that they were ‘banned from entering the premises’ with no explanation given. But the report states that the decision to ban this medical professional had been made by the Director of Prisons the day before.
We have been told at this table that this medical officer was not banned. It is stated here in black and white by the custodial inspector that the Director of Prisons did make that decision the day before, obviously had not conveyed it to the medical officer. I mean, I am baffled here, that we are being told black is not black. The question is, did the Director of Prisons, the day before this incident, make a decision not to allow this medical professional to enter Risdon Prison?
Ms OGILVIE – Thank you for the question. It goes to those operational matters, so with the approval of the Chair I would ask to refer that for further detail if you have it.
Mr WISE – Yes. Through you, minister, as I have previously said, the issue was not one of a ban. There was an instruction given by the Director of Prisons that, when the doctor attended, that she was to be taken to another part of the prison, not her normal workplace, to have a discussion with the General Manager of the prison, and so the decision was made. I dispute that it was a ban. It was ‘do not allow the doctor to go to her normal workplace, but instead let’s have a meeting with her’. That is where I indicated everyone concedes it was handled really clumsily, but it wasn’t a ban, and – notwithstanding the custodial inspector who has indicated in his report.
Ms O’CONNOR – I will point to what an email from the Director of Prisons to the Correctional Primary Health Service in his own words said to management, and this is on p200. ‘If a professional from another agency cannot work constructively with us, I see little value in them having access, and indeed such behaviour causes greater risk of unrest for us all’. That is pretty clear, don’t you think, that the Director of Prisons had told this medical officer’s management that this person – that there was little value in them having access?
Mr WISE – Through you, minister, the meeting that was arranged was actually inside the prison. It can hardly be said that the doctor was banned from entering the prison. The arranged meeting was inside the prison. It was accessed through the normal workplace, and it was hoped that the matters would be resolved.
Ms O’CONNOR – Actually, I will need to correct you there, with respect. They were prevented from entering her normal workplace at the prison and diverted to a meeting room, as a result of a directive of the Director of Prisons.
Mr WISE – Through you, minister, that was the intention: to have that meeting and resolve the issues.
Ms O’CONNOR – Okay. So –
CHAIR – Final question on this, because we need to move on.
Ms O’CONNOR – Okay, Madam Chair. It is really important that we get some clarity here.
CHAIR – It is important, but we also need to move on.
Ms O’CONNOR – Yes. What the custodial inspector says is that this event illustrates a number of issues about the pervasive culture at the prison. It also references a senior member of staff who was there at the time, minister, who said they were disgusted by what had happened and were ashamed to be wearing their uniform today. They said they were not surprised as ‘they do this sort of thing’. And presumably – actually clearly, ‘they’ in this instance is prison management. What is your response to that observation about the culture at the prison, both from the custodial inspector and a senior staff member?
Ms OGILVIE – Are you happy to?
Mr WISE – Through you, minister –
CHAIR – I think the question was to the minister, though. Your response, minister, not to the –
Ms OGILVIE – Well, let’s would you like a response from both of us? I am happy for both of us to respond.
CHAIR – Was that correct, honourable member?
Ms O’CONNOR – Well, there is a shared responsibility for culture which has come in for some damning criticism in this custodial inspector’s report. I am happy for the minister to make some observations about what she is doing to deal with this culture where apparently sort of arbitrary decisions are made, but also to refer it to –
Ms OGILVIE – I think both, an answer from both is helpful. Because I agree with you: there is shared responsibility. It is my expectation and desire and I’m putting personal energy into ensuring that our TPS service is respected, the people who work for the service are valued. I do that personally and I love to come and meet the people who are new recruits. I go to the graduations. The effort that we make with the people piece really matters, and I know that the senior management of the prison also feels that.
Ms O’CONNOR – Have you read this report, minister?
Ms OGILVIE – Yes, I have –
Ms O’CONNOR – The adult healthcare inspection report.
Ms OGILVIE – Also just to complete my sentence. I have read the report. The issue that you’re discussing, and I also agree it is important and it is a serious question, but I do feel that the statement that the services made that the situation was managed clumsily is an accurate one and I know an apology has been made –
Ms O’CONNOR – Disrespectfully to that medical officer too, I would suggest.
Ms OGILVIE – Yes, and I think an apology has been made. I think that’s the appropriate step to take. It’s very unfortunate that it happened, and I think, then I perhaps would ask you to speak a little bit more to the cultural piece which I know you’re working on and take very seriously.
Mr WISE – Thank you, minister. Through you. I don’t accept that there is a cultural issue in relation to this. But by the same token, I do accept that there were learnings for senior management out of the way that this matter was handled, and I think that the senior management team has taken all of those learnings on board.
Ms O’CONNOR – It won’t happen again?
Mr WISE – It shouldn’t ever happen again.
