86 The Ombudsman Denies It Acted Corruptly (2): 7 November 2024
This is a copy of the email I
received today (Thursday 7 November 2024) at 10.41 am from “Alison, Assistant
Director, Industry Investigation/ Investigations Branch” at the Commonwealth
Ombudsman. The email attached a letter dated
5 November 2024 from Commonwealth Ombudsman Iain Anderson.
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RE: [External] FW:
HCF Misconduct in Relation to Lift Cancer Care Services Hankinredden Blogs
2024-803716 [SEC=OFFICIAL] Private Health
Insurance Ombudsman phi@ombudsman.gov.au To: John Hankin Dear Mr Hankin Please see attached
response from Iain Anderson, Ombudsman. Kind regards,
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The obsession of the Ombudsman
with the external trappings of politically correct behaviour is clear from the
amount of space taken up by acknowledging the local Aboriginal communities in the
email sign off. It is a pity the
Ombudsman obsesses so much about acknowledging local Aboriginal communities instead
of stopping health insurers from ignoring the law.
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This is a copy of the letter that was enclosed with the
email received today.
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COMMONWEALTH OMBUDSMAN 2024-803176 Hankin 5 November 2024 Mr Hankin via email: Dear Mr Hankin Thank you for your email of 10
October 2024. I am very sorry to hear of the
passing of your wife Margaret on 22 August 2023. I understand that you have published
details of your complaints with this Office on your website
www.hankinredden.au. In your blog you expressed your view that the Office
acted corruptly and incompetently in handling your case. I have previously acknowledged that the time
taken by my Office to investigate your case was not satisfactory, and I
apologised for this in my letter to you of 31 March 2023. You remain of the view that staff of
this Office acted corruptly. As you note in your email to me, we disagree on
this. As a result of the investigation of your
complaint against HCF and the Department of Health and Aged Care: ·
HCF confirmed it would pay Type C claims
received from Lift Cancer Care going forward ·
I advised Directors of Members Health Fund
Alliance insurers, including HCF, of their legal obligation to pay certified
claims going forward when I spoke at their annual conference on 7 February
2023 ·
I raised this issue with the CEO of the
Australian Private Hospitals Association on 24 February 2023, with the CEO of
Private Healthcare Australia on 1 March 2023, and with the Secretary of the
Department of Health and Aged Care on 20 March 2023 ·
I published a report “Can private health
insurers decide that a patient does not need treatment in hospital? - Paying
Type C claims: observations of the private health insurance industry” in
February 2024, providing guidance to private health insurers on best practice
when handling Type C claims and reminding them of their legal obligations ·
The Department of Health and Aged Care
confirmed it is working on amendments to the Health Insurance Act 1973 that
will encourage better certification processes for hospital admission by
medical practitioners and hospitals; and expand the authority and functions
of the Professional Services Review when certifying that Type C treatments or
procedures must take place in hospital. My Office has continued to monitor
complaints we received regarding Type C claims. Since your matter was closed,
the number of complaints about this issue declined rapidly and continues to
stay low, which suggests an ongoing improvement in how Type C claims are
being handled by the private health insurance industry. I recognise you do not agree with my
views. You have the right to express your disagreement, including by making
public statements on your blog and publishing correspondence to you from this
Office. You also have the right to refer your views to the National
Anti-Corruption Commission, if you wish to allege corrupt behaviour. However, I request that in your
comments on your blog, as well as if you publish correspondence from this
Office, you do not publish the unredacted full names and email addresses of
the junior complaint handling staff who dealt with your matter. Unfortunately, publishing the full
names and contact details of junior staff exposes them to a range of
behaviour on social media and elsewhere which in my view is not reasonable or
appropriate. I would be happy to discuss this with
you further, if that would assist your consideration of my request. Yours sincerely Iain Anderson Commonwealth Ombudsman Helping people, improving government 1300 362 072 ombudsman.gov.au GPO
Box 442, Canberra ACT 2601 |
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Iain Anderson lists a number of things which he says took
place “As a result of the investigation of your complaint against HCF and the
Department of Health and Aged Care”.
By the time Mr Anderson took up his appointment as
Ombudsman, I had already bludgeoned the health insurers into obeying the
law. Perhaps my letters to Mr Anderson
spurred Mr Anderson personally into action, but my complaints to the Ombudsman as a government agency resulted in
nothing except a refusal by the Ombudsman as an agency to do its job.
Mr Anderson lists four separate actions which he personally
took. If that has the effect of
encouraging obedience of the law by the health insurers, that is good – but I
doubt this will happen. Mr Anderson says
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· The Department of Health and Aged Care
confirmed it is working on amendments to the Health Insurance Act 1973 that
will encourage better certification processes for hospital admission by
medical practitioners and hospitals; and expand the authority and functions
of the Professional Services Review when certifying that Type C treatments or
procedures must take place in hospital. |
If the Health Department is working on amendments to the Health Insurance Act, I assume it is doing this solely to justify the conduct of the health insurers. The existing Type C certificate requirements have operated for some years and are very clear in what is needed. Despite this the Health Department – I believe at the behest of senior bureaucrat Penny Shakespeare – refused to do anything when the health insurers ignored the law.
I appreciate Iain Anderson trying to clean up the scandal
and protect the bureaucrats he supervises at the Ombudsman – but unless proper
criminal investigations take place and unless charges are laid, nothing will
ever change. If criminals get off scot free, they continue to commit their crimes.
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