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SISA General Meeting - Friday 17th April 2009

SISA General Meeting - Friday 17th April 2009






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    SISA General Meeting - Friday 17th April 2009 SISA General Meeting - Friday 17th April 2009 Presentation Transcript

    • Penny Markham, A/Registrar & Amanda Le Poidevin, Managing Solicitor Operation of Medical Panels SA 17 April 2009
    • Overview
      • Key Features of Medical Panels
      • Benefits
      • Operations
      • Selection of Doctors
      • Facility
      • How to refer to a medical
      • Convenor’s directions – consultation and concepts
      • Opinions and reasons
      • Contact us
    • Key Features
      • An independent body separate to WorkCover & WCT
      • An important part of the dispute resolution process
      • Medical experts making final and binding decisions on medical questions
      • Pool of medical practitioners appointed by the Governor in Council on the recommendation of the Minister
      • Doctors are experienced and from a range of specialty groups
      • From the pool medical panels will be convened to determine particular medical questions referred to it
      • Expected number of referrals annually = 1500
    • Why change?
      • Disputes arise from disagreement over medical information
      • No avenue for a definitive ruling on medical matters
      • Judges hear competing and often substantially different medical opinions
      • Decisions may not be entirely consistent with medical opinion
      • Medical practitioners often have an actual or perceived bias toward the party they represent
      • Disputes can become protracted and subject to significant delays
      • Significant scope for improving the efficiency of resolution of disputes relating to medical information
    • Benefits
      • Timely and accurate decisions on medical issues
      • Support a focus on return to work and a return to the community
      • Increase efficiency in resolution of disputes
      • Increase consistency of decision making
      • Remove the actual or perceived bias in decision making
      • Increase quality of decision making according to best practice and the current evidence base
    • Operations
      • Model based on Medical Panels Victoria
      • Convenor and Registrar oversee operations with supporting legal and administrative staff
      • Medical questions are referred from a number of sources (Corporation, SI’s, WCT, EML)
      • Up to five member multi-speciality medical panels will be constituted to hear a matter
      • Constitution of the panel will be tailored to the question and medical condition being considered
      • Other consultants may be co-opted as considered necessary by the panel in each case
    • Operations
      • Appoint presiding member
      • Consider all documentation referred and examine the injured worker
      • Enable the injured worker to tell them their story
      • Discuss the relevant information, results of the examination and each member’s perspective
      • The Presiding Member will also confer with legal staff as necessary
      • Issue a certificate of opinion and reasons for that opinion to the referrer and injured worker
      • A Medical Panel must form its opinion on a medical question within 60 days
      • The decisions of the medical panel are final and binding on all parties (judicial review available on grounds of procedural fairness/breach of natural justice)
    • Selection of doctors
      • MPSA Selection Committee formed by the Minister for
      • Industrial Relations
      • Prof. Paddy Phillips, Chief MO appointed as Chair of the
      • Selection Committee by the Minister
      • Stakeholder driven selection process comprising:
        • Medical Board of South Australia
        • Specialty Colleges
        • Australian Medical Association
        • Employer representative
        • Employee representative
    • Doctors Appointed by the Governor
      • 85 doctors from 21 specialties were nominated by the Committee to the Minister for Industrial Relations and were appointed by the Governor on 12 March 2009
      • Approximately 18 doctors from 13 other specialties and 14 health professionals from 8 health disciplines are also required
      • Recruitment is currently underway for the above
    • Medical Practitioners Nominated by Selection Committee
      • Cardiology (1)
      • Dermatology (3)
      • Endocrinology (1)
      • Gastroenterology (2)
      • General Medicine (1)
      • General Practice (21)
      • General Surgery (1)
      • Infectious Diseases (1)
      • Neurology (2)
      • Neurosurgery (3)
      • Obstetrics and Gynaecology (3)
      • Occupational Medicine (9)
      • Ophthalmology (1)
      • Orthopaedic Surgery (10)
      • ENT surgery (3)
      • Pain Medicine (2)
      • Psychiatry (11)
      • Rehabilitation Medicine (4)
      • Rheumatology (4)
      • Thoracic Medicine (1)
      • Urology (1)
      • Vascular Surgery (1)
    • Medical Practitioners Round 2
      • Doctors
      • Allergy
      • Cardiology
      • Endocrinology
      • Gastroenterology
      • General surgery
      • Infectious diseases
      • Oncology
      • Ophthalmology
      • Oro-maxillofacial surgery
      • Plastic & reconstructive surgery
      • Public health medicine
      • Respiratory medicine
      • Urology
      • Vascular surgery
      • Other health professionals
      • Chiropractic
      • Dentistry
      • Neuropsychology
      • Occupational therapy
      • Orthotist
      • Physiotherapy
      • Prosthodontist
      • Psychology
      • ~ closes 5 th June 2009 ~
    • Use of doctors in Medical Panels Victoria
    • Facility
      • Based at Level 1/ 44 Currie St
      • Specially designed
      • Now operational
    • Consultation processes
      • Completed consultation on MPSA referrals
      • process
      • Consulted on Convenor’s Directions with
      • stakeholders
      • Consulted with employee and injured worker
      • groups about frequently asked questions
      • s98G requires that MPSA be provided with a document specifying medical issues that have been agreed and those in dispute
      • Referral is accompanied by medical reports, notes, surveillance film, photographs of scars and so on
      • Working party has endorsed referral form – available on website
      How to refer
      • Procedures affecting the day to day management of the panels are contained in the Convenor’s Directions
      • The Minister may issue Ministerial Guidelines
      • Working party discussion
      • Final draft for Convenor and Minister endorsement
      Convenor’s Directions
    • Opinions and Reasons
      • The wording of each medical question is scrutinised to ensure
      • it fits within the parameters of the definitions of a “medical
      • question”
      • If any question is unclear or is not (even broadly) within the
      • definitions of a “medical question”, the Convenor may decide
      • not to put the question to the Panel.
      • The answer to any medical question contained in a Certificate
      • of Opinion and must be accepted as final and conclusive by
      • any body /person.
      • A Certificate of Opinion can only be clarified if it is considered
      • to be non-responsive by the referring person/body and the
      • Medical Panel agrees.
      • Detailed reasons for the opinion will be distributed to the
      • referrer and the worker
    • Contact us      
      • www.medicalpanels.sa.gov.au
      • Ph: 8204 1530
      • Fax: 8204 1550