Do bureaucracies ever listen?

Do bureaucracies ever listen?

May 27, 2014

A very silly question, not even the right question,  of course they listen.  The problem is not that they don’t listen, the problem is that they don’t take any notice of what they hear.

For some years I have been a member of the Victorian AMA subcommittee that deals with workers compensation and transport accident matters. It has been the most frustrating experience. Dealing with the Victorian WorkCover authority and the Transport Accident Commission has been an exercise in futility. We have raised many issues and have had heard how important our input is, how important it is that we be consulted, what a vital cog in the system we are etc etc. The reality is that consultation takes place at the end of the process, to say it has occurred, our comments and warnings are disregarded and the bureaucracy does what it had always intended to do. Sometimes our involvement leads to perverse outcomes. We raised the issue of dangerousness regarding independent medical examiners. The Victorian WorkCover authority operates behind a fortress to protect themselves from angry injured workers. Similar problems have occurred with transport accident victims. We suggested that the authorities consider their responsibilities to  independent medical examiners ( IMEs) in terms of warning IMEs about possible dangerousness, providing a secure location for assessing some people and even providing security guards. Oddly, after some delay, the response we received was a lengthy document about our liability to provide a safe environment for claimants! The original issue we raised was ignored and has remained forgotten.

The most recent episodes of futility involve the Transport Accident Amendment Act 2013. I have already written about the consultation process and what a fiasco it was. One of my concerns was that the plaintiff lawyers would not be compensated for IME reports unless the claim was successful. However if the plaintiff lawyers agreed to a joint medical examination for both the plaintiff lawyer and the TAC, those costs would automatically be met. At the time I raised the issue that this effectively provided the TAC with a veto over who did the work. Those claims were pooh-poohed.

In early April this year I received a lengthy document stating that I must become a member of the TAC medical panel if I wanted to become a joint medical examiner (JME). This arrived on a Friday and had to be submitted the following Monday week giving me effectively five working days to complete the 40 page document including arranging for two referees. I was annoyed both by the absurdly short timeframe and by the fact that I did not want to become a member of the TAC medical panel. I am well known to the TAC and indeed have had frequent requests for supplementary reports from them. Why should I jump through all these hoops? I was further irritated because the document stated what I had to do but did not include any information about what the TAC would do such as provide a schedule of fees. It appeared I was providing them with a blank cheque.

I rang the TAC and spoke to a senior manager who made comments like “I understand your concerns”. I told her I did not care whether she understood my concerns I wanted her to do something about them. I said the timeframe was absurd, I was being asked to sign a blank cheque and why should I have to join the TAC medical panel with what seemed to me excessive demands to attend training sessions, peer review processes and so forth.

Subsequently I recalled that I was an accredited IME examiner with the Victorian WorkCover authority and contacted this person again who told me that accreditation had nothing to do with the TAC. I told her that the letterhead I had received was headed Victorian WorkCover authority and TAC and that most of the documentation provided to me was labelled Victorian WorkCover Authority! She said she would get back to me. I received a phone call the following day saying that if I signed a document and send it back that would be satisfactory. I was also told I would be informed about the fee structure at the end of the day.

I understand that 90 such applications were sent out of which 13 were returned!

In the meantime I heard nothing about fees. There was a meeting with a representative of our forensic psychiatry group in Victoria who spoke to several of us and as a result had compiled a lengthy document indicating the various costs involved in doing this work especially as a joint medical examiner with all the additional responsibilities involved. There were at least two meetings with representatives of the TAC. At the first meeting the TAC representatives stated they were prepared to pay 30% above the usual rate for these examinations and would not pay for any extra such as excessive reading, use of interpreters, complex claims and so forth. Our representative stated that this was inappropriate for a variety of reasons citing fee schedules in other states. The outcome? No change from 30% above the usual fee. In other words more consultation that was meaningless. Our representative feels quite disgusted and used by the whole process.

What a waste of time, we had numerous meetings and subsequent consultations about the Act itself. We pointed out the flaws in the Act. The response of the TAC when the Act was passed in its original form was to issue a series of policy advice papers telling us how the Act was to be interpreted. I had the naive idea that it was the role of the courts to interpret the Act and not the TAC. I envisage being an expert witness and stating that although the Act may say black, the TAC has told us to interpret this as meaning white. imagine the response of the judge. Similarly a great deal of time and effort was put into compiling a realistic fee schedule, bearing in mind the extra responsibilities the costs and the issues involved in dealing with complex claims and so forth. No notice was taken of this at all, another total waste of time.

I think that the only way to operate is by means of a type of guerrilla warfare. I will accept their fee schedule then demand extras for excessive reading, use of interpreters and so forth and see how I go. I will keep you informed.









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