Senior RAH physician Dr Megan Brooks calls out ‘enormous errors’ in SA Health’s finances

The senior physician who quit in a bombshell resignation letter has ripped into SA Health, claiming its executives are blowing millions of dollars.

A senior physician’s departing warning that SA Health is bleeding cash due to “delusional” accounting is being taken “seriously” by officials.

Dr Megan Brooks last month quit as medical lead for acute and urgent care at the Royal Adelaide Hospital in a bombshell resignation letter.

While part of the four-page letter focused on enormous pressures facing frontline staff, it was also scathing of the hospital’s economic management, with a warning the RAH “has no chance of financial solvency” unless administration improves its work.

Dr Megan Brooks lashed SA Health in a four-page resignation, which claims there are “enormous errors’ in their accounting. Picture: Mark Brake

Stressing she is an emergency physician, not an accountant, Dr Brooks said the mismatch between costs being recorded accurately against the clinical work meant the health system was losing federal funding.

“Enormous errors, that Finance themselves admit reflect their lack of consultation, go uncorrected year on year,” she wrote.

“The end result is SA falling behind other states in federal funding simply because SA Health is not accurately recording what services clinicians are providing.

“For years I have stated, on every possible occasion, that we are not recording our activity correctly.”

This means SA Health does not accurately calculate its National Efficient Price (NEP) – a measure that is used to apply for federal funding.

“When combined with Finance’s lack of alignment of cost with activity – it means we have no reliable measures of financial efficiency,” she wrote.

“This fundamentally means that South Australia has not been seeking an appropriate allocation of federal health spending for years.”

In 2018, consultants KordaMentha found the Central Adelaide Local Health Network, which runs the RAH, was blowing $105m every six months due to its costs for health services running at up to 29 per cent higher than the national benchmark.

“This puts a dollar figure on the money that is being spent on inefficiency,” the report stated.

Dr Brooks blasted SA Health for holding clinicians “accountable to a budgeting process using activity and costing methodologies … best described as delusional.”

“CALHN has no chance of financial solvency until such time as the Executive and Board compel the Finance and Service Planning leadership to do their jobs properly,” she warned.

“If the clinical teams conducted our work with the same flagrant disregard for basic governance processes and professionalism, we would be at risk of being barred from clinical practice.”

Dr Megan Brooks last month quit as medical lead for acute and urgent care at the Royal Adelaide Hospital in a bombshell resignation letter. Picture: NCA NewsWire/Brenton Edwards

Dr Brooks’ concerns date back a decade, to the previous Labor government and when now Premier Peter Malinauskas briefly was health minister.

CALHN released a statement saying: “We take the matters raised by Dr Brooks seriously, including the financial matters.

“We will continue to listen to and work with our workforce and patients to improve our health network and support our clinical staff to provide safe and effective care for patients.

“CALHN chief executive Professor Lesley Dwyer has met with Dr Brooks to speak about the issues raised and CALHN continues to work with our staff to improve demand management.

“Addressing these challenges is a whole of network responsibility that will remain a priority for CALHN this year.”

Dr Brooks gave six weeks’ notice when she resigned in mid-December and no replacement has yet been announced. Citing “overwhelming despair” at the situation, she wrote: “The ED clinicians are as horrified as I am by our daily inability to provide care to patients when they need it. It offends our very humanity, and flies in the face of all that we are trained to do.”