The report found patients had been harmed by "unsafe" and inefficient radiology medical imaging services at Hawke's Bay Hospital. Photo: 123RF
A damning health services report Te Whatu Ora kept hidden for months using whistleblowing laws has finally been released to RNZ.
The whistleblower, senior radiologist Dr Bryan Wolf, says he told the agency numerous times he consented to the open disclosure of his identity and of the report to RNZ.
Nonetheless, Te Whatu Ora says it got legal advice it had to protect his identity, but that now he has gone to the media it can release the report.
Wolf, in letters to the Ombudsman last month, said the lack of transparency amounted to a crime.
The report, completed in April, found patients had been harmed by "unsafe" and inefficient radiology medical imaging services at Hawke's Bay Hospital, which had been that way for years.
"Known harm has been identified and documented," it said.
It agreed with several written reports Wolf had submitted since late last year to health leaders - as well as sending written warnings to the health minister, ombudsman and various health watchdogs - that themselves were triggered by RNZ's reporting of radiology problems across the entire Central region.
"Inadequate responses have left staff feeling demoralised, burnt out and helpless," the newly released report by external investigators said. "Workarounds have been created which led to increased workloads for staff."
The agency said it had completed or was implementing most of the 18 recommendations.
Health Minister Ayesha Verrall said on Monday she had been assured "the immediate safety concerns have been resolved".
But at the same time, communications between doctors this week, sighted by RNZ, talked about the system still playing up all the time and having to find workarounds that would inevitably fail.
RNZ requested the report in May and was refused in June under the Protected Disclosures Act. The act forbids releasing Official Information Act (OIA) information if it might identify a whistleblower. Another section says a whistleblower can consent to be identified, or the information can be released "to prevent a serious risk to public health, public safety".
The Office of the Ombudsman refused to confirm whether he had been asked to investigate the alarms raised about the safety risks.
In a 10 July letter to the Ombudsman, Wolf wrote: "I have identified serious systemic cultural issues within Te Whatu Ora leadership chains that attempt to obscure the downstream consequences of administrative negligence from the public. To that end, I have submitted comprehensive reports to your office informing of significant standards, rights, ethics and legal violations within Te Whatu Ora."
He wrote that the review he had triggered must be fully disclosed, at which time doctors would stand with the agency and "ask for the public's forgiveness".
"Within my written reports, letters and attachments, the phrase 'open disclosure' appears 41 times, 'transparency'/'transparent' appear 67 times and 'accountability'/'accountable' appear 105 times," he wrote on 10 July.
"Beyond any reasonable doubt, the Te Whatu Ora board and executive leadership team were exhaustively and intimately informed of my consent to open disclosure and my desire for institutional transparency. Pertinently, the Office of the Auditor-General recently sought my consent for possibly revealing my identity during potential investigations; I gave consent without hesitation."
But Dr Richard Sullivan, interim chief clinical officer for Te Whatu Ora, told RNZ on Monday night it did not break any OIA rules in keeping the report from the public till now.
"I don't believe we broke the rules, no," he said.
The report itself only named Wolf once, among a list of people interviewed, and his name could have been blanked out; such redactions are hugely common in OIA responses.
But Sullivan said "it was really important that we upheld that, particularly in the context of reporting the identity of the whistleblower at the time".
"Obviously, that situation has changed, with Bryan having gone through media and indeed, we've talked to him and he's supported the disclosure."
Asked if the agency checked with Wolf to ask if he consented to disclosure in June, at the time it was considering RNZ's OIA request, Sullivan said: "Myself personally, I don't have - don't want it to sound like an excuse - I haven't seen any documentation in June around correspondence with Dr Wolf.
"He gave permission for the report to be released on Thursday... last week."
The agency took the matter very seriously "and that's why we acted so quickly when the concerns were raised".
The review began in December. Three months before that, an internal report warned Te Whatu Ora about frequent failings in radiology reporting systems across the Central region that were endangering patients' lives. Sullivan told RNZ last night he was not aware of that report.
Asked if Wolf was disciplined for raising the alarm, Sullivan said no. Wolf, though, said he was removed from a key committee.
Sullivan said he thanked Wolf and apologised to him last week.
"I've had a long conversation with Dr Wolf... both thanking him for really bringing this to our attention and equally, wanting to recognise that it's an incredibly difficult place for a colleague to be in, that they feel they need to go through this pathway to both disclose concern over a process and systems that are not meeting the quality of care that we would we would expect, and as I say, that has unfortunately been in the system for some time, and that we've addressed and have stabilised.
"I wouldn't say we have the system we would like to use moving forward, [but] we have a stable, safe system.
"I certainly apologise to Dr Wolf for having to go, you know, having to be part of that process, but also thank him for that as well."
- RNZ will report more on the findings of the newly released report later on Tuesday or Wednesday.